HJNO Sep/Oct 2025

44 SEP / OCT 2025 I  HEALTHCARE JOURNAL OF NEW ORLEANS ONCOLOGY DIAL GUE COLUMN ONCOLOGY IT IS NOT UNCOMMON for patients I see in my clinics to tell me something similar to the above quotation. Multiple myeloma is far less common and well-known in com- parison to cancers of the breast, prostate, colon, and lung. Despite prominent people like Tom Brokaw, Colin Powell, and Steve Scalise being diagnosed with multiple my- eloma and being very public with their di- agnoses and journeys, there remains a gen- eral lack of awareness of the disease and the measures people can take to decrease their chances of developing it. Multiple myeloma is a cancer of the bone marrow. In particular, it is a cancer of plas- ma cells, which are immune cells responsi- ble for producing antibodies to fight infec- tion. When a patient develops symptomatic multiple myeloma, they can develop one, some, or all of the set of signs and symp- toms that we refer to as CRAB: C = Calcium elevated R = Renal/kidney dysfunction A = Anemia B = Bone disease/destructive bone lesions “I had never even heard of this disease before I got diagnosed!” Many of the symptoms of CRAB are non- specific, meaning patients can just feel gen- erally unwell. The most common symptom is bone pain, particularly in the back, ribs, pelvis, or extremities. About 70% of all my- eloma patients will experience bone pain at diagnosis. This pain can sometimes be differentiated from typical muscle or ar- thritis pain in that it is severe and does not improve with time and conservative treat- ments. We know that all symptomatic multiple myeloma arises from precursor states called monoclonal gammopathy of un- known (or undetermined) significance (MGUS) or smoldering multiple myeloma. These conditions generally start from years to decades before a patient develops symp- tomatic disease. While multiple myeloma accounts for less than 2% of all new cancer diagnoses in the United States, it is the second most common form of blood/bone marrow cancer after lymphoma. In 2024 in the U.S., there were 35,000 new cases diagnosed and approximately 180,000 patients living with the disease. The number of patients living with the disease has risen rapidly with improvements in treatment and dura- tion of survival. The average age of diagno- sis is approximately 70 years, although the diagnosis is often made in patients in their 50s and 60s. Quite relevant to us here in Louisiana is that we have one of the top 10 state in- cidences and top 10 poorest outcomes for this disease. Part of the reason for the in- creased incidence in Louisiana is related to known risk factors for developing multiple myeloma, including older age, Black race (twice as likely to develop the disease than their white counterparts), obesity, pesti- cide exposure, smoking, and having a first- degree family member with multiple my- eloma. Several factors contribute to poor outcomes in Louisiana, primarily related to access to care and socioeconomic factors, rather than disease biology. While there are no established screening guidelines or recommendations, there are BRINGING AWARENESS TO MULTIPLE MYELOMA