Understanding Smoldering Myeloma
While you may not be familiar with SMM or Smoldering Multiple Myeloma, it's a condition that affects a significant number of people, with an estimated 1 in 100,000 individuals being affected. It's particularly prevalent in those over 60 years of age.
As the name suggests, SMM is a disorder that progresses slowly, altering specific blood proteins and plasma cells within the bone’s marrow. It's important to note that SMM is a precancerous condition, an early form of multiple myeloma that has not yet become cancerous. While scientists know that abnormal plasma cells and proteins indicate SMM, they aren't yet sure what converts these once-normal cells into abnormal ones. Two potential links to SMM may be genetic mutations and obesity.
The National Cancer Institute explains that SMM is slow to grow and is caused by abnormal plasma cells creating too much protein, which then builds up in the blood. As the word smoldering suggests, SMM moves slowly; think of it as a smoldering fire that barely burns but may flare with the right conditions. Once active, smoldering multiple myeloma becomes cancerous myeloma. Again, the progression of the disease is different for everyone in terms of becoming active, if ever.
It's important to remember that SMM is not cancer. While many with SMM will develop the rare blood cancer MM (multiple myeloma), not all will. Furthermore, it often takes years for MM to develop, providing ample time for intervention.
What are the Signs and Symptoms of Smoldering Multiple Myeloma?
Regrettably, SMM often remains silent, not manifesting any symptoms. Therefore, once diagnosed, it's crucial to maintain regular monitoring to track the disease's progression carefully. This proactive approach can provide reassurance and a sense of control. The diagnosis of SMM may unexpectedly emerge from a routine blood test. The Cleveland Clinic explains how a simple blood test can unveil the presence of SMM:
Blood tests will show evidence that the abnormal plasma cells are producing abnormal immune proteins (M proteins), and if a bone marrow biopsy is performed, healthcare providers would expect to see these abnormal plasma cells in the marrow.
Like many other illnesses, SMM is challenging in that it is asymptomatic. While there may not be any symptoms, plasma cell infiltration into the bone marrow occurs. As the Cleveland Clinic states, it “doesn’t cause any noticeable symptoms.” However, several diagnostic tests can be performed.
How is SMM Diagnosed?
Regrettably, there is currently no definitive test to predict the development of multiple myeloma in individuals with smoldering myeloma. However, ongoing research into genetic changes may provide valuable insights into potential risk factors, offering hope for more accurate predictions in the future.
Your healthcare providers have several tests at their disposal that will allow them to confirm the presence of SMM. While routine tests will show the presence of abnormal protein within the blood that may confirm SMM, other tests include further blood tests and more, such as:
- CBC or complete blood count, which will measure how many blood cells and platelets are produced by the bone marrow.
- Measurement of creatine levels, which will show how well the kidneys are working, and a measurement of calcium levels to determine if the bones are breaking down.
- Measurement of the amount of immune proteins within the blood and in urine.
What are the Options for Treatments?
The National Institute of Health stated in 2019 that:
Because there are no approved treatments for smoldering myeloma, doctors have long adopted a “watch and wait” approach, closely monitoring individuals for evidence of progression to active (symptomatic) multiple myeloma, such as damage to certain organs.
The NIH goes on to suggest that the drug lenalidomide may delay the progression of smoldering myeloma; this drug is currently being used to treat multiple myeloma. However, the most common care plan for SMM is to simply observe, with regular monitoring of, the levels of protein and plasma cells within the bone marrow. In addition, there is not yet any way to prevent the development of smoldering multiple myeloma.
As with all serious diseases and disorders, self-care is a critical tool in living the best life possible, and adopting healthy habits is straightforward and simple! By taking control of your diet, avoiding harmful habits, and managing stress, you can maximize your health and well-being.
Eat as healthy a diet as possible, rich in fruits, vegetables, legumes, lean meats, and whole grains. Avoid smoking and alcohol; these have no place in a well-lived life. Managing your stress with a great night's sleep, regular exercise, and meditation will maximize your health. Whenever possible, try to prevent needless infections; talk to your healthcare team about immunizations and other ways to protect yourself from common diseases.