The Critical Role of Primary Care Physicians in Identifying Hematologic Malignancies
At Moffitt Cancer Center, our Multiple Myeloma Program is dedicated to addressing the full spectrum of plasma cell disorders, including multiple myeloma, monoclonal gammopathy of undetermined significance (MGUS) and primary systemic amyloidosis. Unlike some solid tumor cancers, hematologic malignancies lack standard screening procedures. This places a pivotal responsibility on primary care physicians (PCPs) to recognize initial signs and symptoms and refer patients to specialists promptly.
Rachid Baz, MD, Myeloma Section Head of the Department of Malignant Hematology at Moffitt Cancer Center, explains multiple myeloma and key signs and symptoms to watch for:
Multiple myeloma is a rare type of cancer that affects plasma cells, a type of immune cell found in bone marrow that makes antibodies to help the body fight infections. For those with the disease, malignant plasma cells accumulate in the bone marrow and crowd out healthy blood cells. Instead of producing helpful antibodies, the cancer cells produce abnormal proteins that can cause complications in addition to the cancer cells.
The Prevalence of MGUS
MGUS is particularly noteworthy, found in approximately 5% of patients over the age of 40. This common diagnosis underscores the need for vigilance among PCPs. As the primary point of contact for many cancer patients, PCPs play a crucial role in identifying potential indicators of blood cancers and initiating timely referrals.
Signs and Symptoms
To aid PCPs in this critical task, here are some key signs and symptoms to consider:
- Anemia: While often benign and multifactorial, anemia can be a presenting sign of hematologic malignancies, especially when nutritional causes are ruled out.
- Abnormal Bloodwork: Elevated total protein may indicate the presence of a monoclonal protein, suggesting a plasma cell disorder. Other signs of multiple myeloma include renal dysfunction, proteinuria, and hypercalcemia.
- Fatigue: Cancer-related fatigue (CRF), characterized by overwhelming exhaustion, trouble concentrating, and persistent weakness, could be indicative of underlying blood cancers.
- Cardiac Symptoms: Shortness of breath, edema, and unexplained heart failure can be signs of primary systemic amyloidosis.
- Abnormal Bruising: Unexplained bruising or bleeding, coupled with low platelet counts, may suggest the presence of cancer cells disrupting the bloodstream's normal functions.
Advanced Treatments at Moffitt
At Moffitt, we offer advanced treatments including bone marrow transplants and chimeric antigen receptor T cell (CAR T) therapy. Our transplant practice is the largest in the Southeast US, and we are among the largest volume centers for CAR T therapy, delivering outcomes that surpass expected survival rates.
The Importance of Collaboration
Collaboration between PCPs and specialists is paramount to ensure timely interventions for cancer patients. Your proactive response to concerning blood test results and symptoms can significantly improve patients' prospects in their fight against cancer. By working together, we can enhance early detection and treatment of hematologic malignancies, ultimately improving outcomes and survival rates for our patients.
If you’d like to refer a patient to Moffitt, complete our online form or contact a physician liaison for assistance. As part of our efforts to shorten referral times as much as possible, online referrals are normally responded to within 24 - 48 hours.