Risk factors are certain exposures, behaviors and inherited traits that can increase the likelihood of cancer development, but do not directly cause cancer. An individual who has no risk factors can still develop cancer; likewise, an individual who has several risk factors may never develop cancer.
Scientists are still working to gain a better understanding of multiple myeloma, a relatively uncommon type of blood cancer that develops in the infection-fighting white plasma cells in the bone marrow. However, the precise causes of the malignancy remain unknown. By learning about multiple myeloma risk factors and discussing any usual changes in your health with your doctor, you will be more likely to catch the malignancy in its early stages, when more treatment options are generally available.
What are the risk factors for multiple myeloma?
Researchers have linked several risk factors to multiple myeloma, including:
- A family history of blood cancer. A close relative, such as a parent, sibling or child, was diagnosed with multiple myeloma or another blood cancer, such as leukemia or lymphoma.
- Immune system impairment. Viruses that damage the body’s immune system, such as human T-lymphotropic virus (HTLV) and human immunodeficiency virus (HIV), are sometimes associated with multiple myeloma.
- Exposure to radiation and specific chemicals. Prior radiation exposure and contact with certain insecticides, herbicides, petroleum products, heavy metals, plastics and asbestos can increase the likelihood of developing multiple myeloma.
- Exposure to certain occupational hazards. The incidence of multiple myeloma is higher than average among people in certain occupations, including agricultural and farm workers, cosmetologists, petroleum workers and employees in the leather industry.
- Advanced age. In most multiple myeloma cases, the patient is 65 or older at the time of diagnosis.
Who is most at risk for multiple myeloma?
Most people who develop multiple myeloma had an early warning sign known as a precursor condition, which is a certain early-stage blood condition that may progress into cancer. The known precursor conditions for multiple myeloma include:
- Early myelodysplastic syndrome (MDS). The bone marrow does not produce enough healthy blood cells.
- Monoclonal gammopathy of undetermined significance (MGUS). Abnormal plasma cells in the bone marrow produce monoclonal proteins, which may be detected in a routine blood or urine test.
- Smoldering multiple myeloma. Abnormal plasma cells in the bone marrow produce monoclonal proteins or free light chains, which are smaller units of the immunoglobulin produced by healthy plasma cells.
- Smoldering Waldenström’s macroglobulinemia. Abnormal lymphocytes and plasma cells in the bone marrow secrete monoclonal immunoglobulin M (IgM) proteins.
Most people who have a precursor condition for multiple myeloma do not experience any symptoms. Additionally, because there are currently no screening tests available that have proven to be reliable enough for regular use in the general population, most precursor conditions are detected through routine blood work or a urinalysis performed for an unrelated reason.
A racial disparity
Multiple myeloma affects people of all races. However, as compared to their white American counterparts, African Americans are twice as likely to develop multiple myeloma and also have an earlier average age at diagnosis (by 5 to 10 years). In fact, multiple myeloma is the leading hematologic malignancy in African Americans.
Currently an active area of research, the reason for the racial disparity is not yet fully understood. The racial difference in incidence cannot be explained by tobacco use, alcohol use, obesity or socioeconomic status. However, scientists believe certain genetic defects that can increase the likelihood of multiple myeloma development may occur more frequently in the African American population. For example, African Americans are more likely to have immunoglobulin heavy chain gene translocations in chromosome 14, which are believed to cause multiple myeloma.
Other possible reasons for the racial disparity include a general lack of awareness about multiple myeloma risk factors and barriers to healthcare access and clinical trials in African American communities. With that said, recent studies show similar outcomes among all multiple myeloma patients who receive timely and appropriate treatment, regardless of their race. These results suggest that the racial disparity can be overcome and underscores the importance of learning about multiple myeloma risk factors.
Multiple myeloma treatment at Moffitt Cancer Center
If you believe you may have a heightened risk of developing multiple myeloma, it is important for you to speak with a physician, especially if you are experiencing symptoms such as unrelenting back pain, overwhelming fatigue, frequent urination or constipation. You can receive outstanding and individualized care at Moffitt Cancer Center.
Our Malignant Hematology Program is dedicated to the prevention, diagnosis and treatment of all forms of hematologic cancer, including multiple myeloma. The experienced physicians on our multispecialty team are available to provide advice and guidance to those who may be at risk, share prevention strategies and educate patients about symptoms. For those who are diagnosed with multiple myeloma, Moffitt offers some of the most advanced treatment options available, including a robust portfolio of clinical trials, all in a single, convenient location.
If you would like to discuss your multiple myeloma risk profile with a specialist at Moffitt Cancer Center, you can request an appointment by calling 1-888-663-3488 or completing a new patient registration form online. As Florida’s top cancer hospital, Moffitt is changing the model, and we provide every new patient with rapid access to a cancer expert as soon as possible. A referral is not required.
Multiple Myeloma Awareness and African American Disparities - NCI
Multiple Myeloma Stages & Prognosis
Multiple Myeloma in African Americans - themmrf.org
Myeloma Different for African Americans | The IMF
How Multiple Myeloma Affects the Black Community