Multiple Myeloma

This post is dedicated to my dad, Peter Wilkins who is still fighting his battle and another amazing dad and man, Kevin Oppriecht who lost his battle with Multiple Myeloma. You’re gone but not forgotten Kevin. I think of you each time I have to write in chalk 🙂 

Today is a very important (for lack of a better adjective) day for me and my family. My dad is being admitted into the hospital for his 2nd stem cell transplant related to his cancer, Multiple Myeloma(MM).

This is a little change of pace for me for a post, but I wanted to share this personal story.

My dad was diagnosed with MM about 6 years ago. Essentially he found out by being in the car, dropping something on the floor, reaching over across to the passenger seat floor and breaking  5-ish ribs. He went to the doctor because that’s  definitely not normal and after various tests and what have you, he was diagnosed. It was really scary for me and for him and for everyone involved. I’d never heard of it before and it’s so scary to have your parent be sick. After some attempts to maintain the disease it was determined that he needed to have a stem cell transplant. He has his first one about 5 years ago and has been in remission since. He is on various maintenance drugs and has regular appointments with his oncologist and doctor team. Last year it was identified that his blood count levels were increasing. Basically this meant that if they passed a certain threshold he would no longer be “in” remission and something would need to be done. His numbers did pass the threshold and it was determined a change in his maintenance drugs was not enough to keep the cancer at bay and he would need a 2nd stem cell transplant. That’s where we are today.

I wanted to share this part of my life with you. So here is some background on MM and stem cell transplants.

So first, what is MM?

This is a little technical but I feel this is important. Multiple Myeloma is a cancer formed by malignant(bad) plasma cells. Plasma cells are found in the bone marrow and are a very important part of our immune system.

The immune system is made up of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are the main cell type of the immune system. The major types of lymphocytes are T cells and B cells.

When B cells respond to an infection, they mature and change into plasma cells. Plasma cells make the antibodies that help the body attack and kill germs. Lymphocytes are in many areas of the body, such as lymph nodes, the bone marrow, the intestines, and the bloodstream. Plasma cells, however, are mainly found in the bone marrow. Bone marrow is the soft tissue inside some hollow bones. In addition to plasma cells, normal bone marrow has cells that make different normal blood cells.

When plasma cells become cancerous and grow out of control, they can produce a tumor called a plasmacytoma. These tumors generally develop in a bone, but they are also sometimes (rarely) found in other tissues. If someone has only a single plasma cell tumor, the disease is called isolated plasmacytoma. If someone has more than one  of these plasmacytoma, they have multiple myeloma.

Multiple myeloma is characterized by several features, including:

• Low blood counts- MM can cause an overgrowth of bad plasma cells that can push and crowd normal blood cells out leading to low blood counts. This usually leads to anemia and causes people to become weak and fatigued very easily. MM can also cause levels of platelets in blood to become low which can lead to increased bleeding, easy bruising and infections/wounds that won’t heal.
• Bone & Calcium Problems- MM also hinders growth and function of the cells that keep your bones healthy and strong. Bones are constantly being regenerated and maintained by the body to keep them strong. There are two main cells that do this, osteoclasts which break down the old bone and osteoblasts which build new ones. Through some medical mumbo gumbo MM tells osteoclasts to break down bones faster and osteoblasts can’t keep up, thus your bones become brittle, weak, and break very easily. (*This was why my dad’s ribs broke so easily in the car).
• Infections- cancerous plasma cells do not produce antibodies that normal plasma cells do. Antibodies are what fight off infections in our body and therefore when someone has MM, they are way way way more susceptible to infections and illness.
• Kidney Issues- Cancerous plasma cells create something (don’t fully understand) that can really harm the kidneys and lead to damage or failure.

Those are the main ones although there are more, they’re just a little more science-y and in-depth and I want you to keep reading!  🙂

So why does someone get MM? No one really knows. Bad luck of the draw? Genetics? Science has only come as far as to determine that specifics genes that may be linked to a higher probability of MM…soooo basically nothing.

How can you treat MM? You never really “treat” it but there are ways to manage your cancer and eliminate it to a point where you can live symptom free. These range from drugs, radiation, chemotherapy, to the most extreme- stem cell transplant.

What is a stem cell transplant? 

A stem cell transplant (sometimes called a bone marrow transplant) is a procedure in which diseased bone marrow is replaced by highly specialized stem cells that develop into healthy bone marrow.

There are two main types of stem cell transplants: autologous, in which the patient receives his or her own stem cells, and allogeneic, in which stem cells are donated by another person. I’ll mainly focus on the AUTO type as that is what my dad has undergone.

Stem cell transplant is a procedure that is most often recommended as a treatment option for people with leukemia, multiple myeloma, and some types of lymphoma.During a stem cell transplant diseased bone marrow is destroyed with chemotherapy and/or radiation therapy and then replaced with highly specialized stem cells that hopefully develop into healthy bone marrow.

A patient undergoing an AUTO stem cell transplant receives his or her own stem cells. During the AUTO transplant process, the patient’s stem cells are collected and then stored in a special freezer that can preserve them for a long time. When ready, the patient is treated with powerful doses of chemotherapy and/or radiation therapy, and then after that the frozen stem cells are thawed and infused into the patient’s vein. The healthy stem cells remain in the bloodstream until they find their way to the marrow where they grow and multiply, beginning the healing process.

The stem cell process includes

• Stem Cell collection– collection bone marrow usually from either hip or spine. OUCH! It hurts like hell.
• Transplant treatment– this really like the prep for the actual transplant. Consists of HIGH doses of chemo and or radiation to essentially kill of all the bad cells, which in turn also kill the healthy ones too. Very important to remain clean and very cautious of germs.
• Stem Cell infusion– Surprisingly very fast process. Not more than an hour or two. They just put your own healthy stem cells back into you 🙂
• Recovery– This is really just taking good care of yourself and managing your symptoms. You have virtually no immune system at this point so you have to be very cautious. You also are dealing with all the side effects of your treatments (think Chemo symptoms like nausea, dry mouth, bone soreness, muscle soreness, pain, oh and probably any other bad thing you can think of too) it seriously sucks.

How do you know if it “worked”?

“Success” means different things to different people. Two common milestones for patients, their families, and doctors to measure success are:

• Recovery of blood counts to safe levels. The true measure of recovery is the return of blood counts to normal levels through the multiplying of healthy stem cells.
• Cure of the disease. The intent of stem cell transplantation is to cure the disease. For some types of cancer(multiple myeloma included), a cure is not possible but prolonged remission (time spent without any signs of cancer) is the best result. For some other cancers of the marrow a permanent cure is possible.

So there you have it! All you ever wanted to know about MM. My dad went into the hospital at about 8 this morning and is getting his chemo as we speak most likely. It’s a little scary for all of us (him probably the most) because you are only allowed a certain number of transplants in your life, and he has already had one.  It also breaks my heart I do not live close enough to my dad to check in on him throughout this process, though it may be good as that’s one less germ cesspool he has to come into contact with 🙂

So, needless to say, we are all hoping he takes to the transplant as well as last time. If any one in the world could do it and succeed, it’s my dad. He has had and has THE.MOST. outstanding attitude towards this all from the very beginning. Which I swear is the reason he has done so well with his treatment and management of the cancer.

As my dad would say, this cancers “ass is grass” and he won’t let it kick him around or control his life. My dad has taught me so many wonderful things in my life and one of the most important to me has been watching him throughout this process. Life hands you some crappy things sometimes to no fault of your own and you just have to make the best of it. No whining, no wallowing, just live life.

Thanks for so many great lessons dad. I hope you are feeling relatively ok today. Don’t worry about your hair falling out- you are adorable either way 🙂 Here is one of my favorite pictures of us, not too long after your 1st transplant. Look at the curly hair!

Thanks for taking time out of your day to learn a little bit more about me 🙂 and please send good energy and healing thoughts to my dad.

xoxo

*A lot of this language pertaining to the explanation and symptoms come from  AmericanCancerSociety.org as well as cancer.net

*This information is for educational purposes only and shouldn’t be construed or used as medical advice.