A month ago, Pat Williams had never heard of multiple myeloma.
Now he's intimately familiar with the blood disease.
Diagnosed with the disease after a physical in January, the 70-year-old Orlando Magic executive is undergoing chemotherapy twice a week in hopes of sending the disease into remission.
There is no cure for multiple myeloma, but Williams' physician, Dr. Robert Reynolds, has told him that he has a 70 to 75 percent chance of remission.
Although some people call multiple myeloma a "cancer of the bone marrow," it's technically a cancer of the plasma cells, which primarily are found in the bone marrow.
White blood cells are present in many tissues in the body, but they are primarily found in the bone marrow. Plasma cells are part of the body's immune system.
According to the Leukemia & Lymphoma Society, about 20,180 Americans will be diagnosed with myeloma this year. It is estimated that approximately 69,598 people in the United States are living with or are in remission from myeloma.
Those affected by the disease may show no signs of it, but specialists say there are some symptoms to be aware of. The most common symptom is fatigue, said Dr. David Molthrop, an oncologist at Florida Hospital Cancer Institute. In addition, patients often lose weight and may experience repeated infections, such as sinus infections, bladder or kidney infections. Other symptoms include nausea, increased constipation, or weakness or numbness in the legs.
As the disease progresses, patients may experience bone pain in the back, pelvis, ribs and skull. A blood test also may show a high level of calcium in the blood, which occurs when calcium from the affected bones dissolves into the blood.
The disease is often discovered during a routine physical, Molthrop said. A patient's blood work, known as a complete metabolic profile, may show signs of anemia or impaired kidney function, in addition to calcium in the blood and high protein levels. If that's the case, a family doctor would then recommend that the patient see a hematologist, or blood specialist.
Before being diagnosed, Williams ran the Disney marathon in early January and several days later experienced "crushing, crunching back pain."
"I woke up with my back just on fire," Williams said. "It just exploded with pain — the worst back pain I've ever had in my life, seemingly out of nowhere."
X-rays and an MRI showed nothing, but after the diagnosis, Reynolds agreed that it was an indicator of the disease. "Whatever was going on made its grand announcement with a back pain that was just crushing," the doctor said.
In late January, during an annual physical, doctors discovered Williams' blood work was abnormal and the Magic physician, Dr. Vince Wilson, recommended he see Reynolds, a Florida Hospital oncologist.
The disease, though it is not widespread, is becoming more common — and is one of the most common blood malignancies, Molthrop said. In part, that's because the nation's population is aging and baby boomers have moved into the age range where myeloma strikes. However, the disease is often discovered early now because many people have standard blood tests performed annually.
Most people with myeloma are older than 50. Americans of African descent are diagnosed with myeloma about twice as often as Americans of European descent. People of Asian and Hispanic descent have lower rates of myeloma than other groups.
Most myeloma patients have the disease in several places in the body, which is why it is called multiple myeloma.
Patients with the disease are often treated with chemotherapy medicines, as Williams is.
But in the past several years, doctors have used chemotherapy in combination with a series of newer drugs, including angiogenesis inhibitors, which inhibit the growth of new blood vessels. Doctors believe that these newer drugs — and combination of drugs — may result in many patients experiencing complete remission, in which all the signs and symptoms of the disease disappear.
"In the past — in the '80s and '90s, and even in the early 2000s — when people had this disease diagnosed, they were looking at a very short life expectancy," Reynolds said in a press conference Wednesday. "Nowadays, people live commonly for many years with something like this."
To administer the chemo medications, doctors have implanted a port in Williams' chest. And though Reynolds couldn't say how long Williams would continue to undergo chemotherapy, Molthrop noted that many patients go through about six months of chemotherapy, if they're responding well to the treatments.
If the disease goes into remission, patients are checked regularly to monitor the disease, with regular blood tests, bone marrow tests and x-rays.
"Complete remission is not the same as a cure, which means it never comes back," Molthrop said. "But we've seen a higher likelihood of complete remission than we have seen in the past. Whether that's going to translate into better statistics in the future, we don't know yet. But it looks very, very promising."
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