Multiple myeloma (MM) is a type of blood cancer that primarily affects older adults, with the risk increasing significantly with age. 35% of MM patients are diagnosed at age 75 or older, including 10% who are 85 or older. The average age for this disease is 70, highlighting the importance of understanding and addressing MM in the elderly population.

Advancements in medical care have revolutionized the treatment landscape for older adults with MM. The introduction of newer drugs and treatment approaches has significantly improved survival rates. A recent study focusing on 3,449 MM patients revealed promising results, particularly for older individuals. Among those aged 65-75, the odds of survival increased by 27%, while individuals aged 75 or older saw a remarkable 32% increase in survival rates.

Moreover, supportive care measures, including physical therapy, massage, and nutrition, have undergone enhancements, further improving survival rates and enhancing the overall quality of life for elderly MM patients. This blog explores the treatment strategies and advancements contributing to better outcomes for older adults battling multiple myeloma.

What Causes Multiple Myeloma in Older Adults?

Multiple myeloma (MM) in older adults is often linked to aging, a primary risk factor. Other factors include:

• Gender: Men are more prone to MM than women
• Race: Black individuals have a higher risk compared to other races
• Family history: Having a close relative with MM increases the risk
• History of MGUS: This condition, featuring an abnormal protein in the blood, is more common in older men. While MGUS has low M protein levels, it can progress to multiple myeloma.

What Are the Symptoms of Multiple Myeloma in Older Adults?

When 65 or older, signs and symptoms of myeloma can show up in many ways, including:

• Unexplained anemia (low red blood cell count)
• Fatigue
• Bone pain
• Fractures
• Spinal cord compression
• Too much calcium in your blood (hypercalcemia)
• Kidney problems
• Repeated infections
• Thickening of blood (hyperviscosity)

Many of these symptoms, such as hypercalcemia and kidney problems, might overlap with other age-related illnesses, such as:

• Diabetes
• Chronic kidney disease
• Parathyroid hormone issues
• Osteoporosis
• Bone cancer

Also, anemia affects around 10% to as many as 44% of older adults. It’s often linked to a lack of iron in your blood, a long-term disease, or insufficient vitamin B12 or folate.

What are the Treatment Options for Multiple Myeloma in Older Adults?

Dr. Sumant explained that the treatment options for multiple myeloma in older adults include various therapies designed to manage the disease and enhance quality of life.

The treatments often involve a combination of approaches tailored to each individual’s situation.

• Chemotherapy: A cornerstone of multiple myeloma treatment, chemotherapy uses drugs to target and kill cancer cells, including fast-growing myeloma cells. High-dose chemotherapy may be used before a stem cell transplant to reduce the number of cancer cells in the body.
• Corticosteroids (Steroids): Corticosteroids, such as dexamethasone, are commonly used with other treatments to help control inflammation and combat myeloma cells.
• Immunotherapy: Immunotherapy drugs boost the body’s immune system by helping recognize and attack cancer cells. These therapies can be particularly beneficial for older adults, as they can be less harsh on the body than traditional chemotherapy.
• Radiation Therapy: This treatment uses high-energy beams, such as X-rays, to target and kill cancer cells. Radiation therapy is often used to reduce pain from bone lesions or to shrink tumors in specific areas.
• Stem Cell Transplant (Bone Marrow Transplant): In an autologous stem cell transplant, a patient’s stem cells are collected and reintroduced into the body after high-dose chemotherapy. This procedure aims to restore healthy bone marrow function.
• Targeted Therapy: Targeted therapy drugs precisely target and attack cancer cells while causing less harm to normal cells. These drugs can effectively treat multiple myeloma and may be used in combination with other therapies.”In cases where stem cell transplant is not an option due to age or other health concerns, a combination of immunomodulatory drugs (such as bortezomib, daratumumab, and lenalidomide) along with corticosteroids may be used as maintenance therapy to manage the disease and prevent it from progressing” suggests Dr. Sumant.

Rajesh Sharma, age 68: “I was diagnosed with multiple myeloma last year, and I was worried about the treatment options available at my age. Thanks to Dr. Sumant and his team, I received personalized care and a combination of therapies that have significantly improved my quality of life.”

Sunita Kapoor, age 72: “Dealing with multiple myeloma was challenging, but the support and treatment I received from Dr. Sumant and the healthcare team were exceptional. The combination of immunomodulatory drugs and supportive care has helped me manage the disease and enjoy life to the fullest.”

What is the Cost of Multiple Myeloma Treatment in India?

Below is an estimated cost of multiple myeloma treatment in India:

Treatment	Cost (INR)	Cost (USD)
Chemotherapy	2,00,000 – 5,00,000	2,700 – 6,800
Corticosteroids	10,000 – 20,000	135 – 270
Immunotherapy	3,00,000 – 6,00,000	4,100 – 8,100
Radiation Therapy	1,00,000 – 3,00,000	1,400 – 4,100
Stem Cell Transplant	10,00,000 – 20,00,000	13,500 – 27,000
Targeted Therapy	2,00,000 – 5,00,000	2,700 – 6,800

Please note that these are approximate costs and can vary based on the hospital, location, and specific treatment plan. It is essential to consult with a healthcare provider for accurate cost estimates.

Conclusion

The treatment of multiple myeloma in older people has evolved significantly, focusing on personalized approaches considering the individual’s age, overall health, and specific needs. Advancements in medical care, including newer drugs and supportive therapies, have led to improved survival rates and enhanced quality of life for older adults with MM. Continuing research and innovation will be crucial in further improving outcomes and ensuring that elderly patients receive the best possible care for this complex disease.

FAQs

Q: Can multiple myeloma be prevented?

A: There is no known way to prevent multiple myeloma, but maintaining a healthy lifestyle may help reduce the risk.

Q: What is the role of genetic factors in multiple myeloma?

A: While genetic factors can contribute to the risk of multiple myeloma, most cases occur sporadically without a family history.

Q: Are there alternative treatments for multiple myeloma?

A: Some patients may explore alternative therapies, but discussing these options with a healthcare provider is essential to ensure their safety and effectiveness.

Q: What is the prognosis for older adults with multiple myeloma?

A: Prognosis varies depending on factors such as age, overall health, and response to treatment, but advancements in treatment have improved survival rates for older adults with multiple myeloma.

Explore more blogs: How Are Monoclonal Antibodies Used For Multiple Myeloma?