Multiple Myeloma Surgery

Cancer » Multiple Myeloma Cancer » Surgery

Multiple myeloma surgery unlike other cancers is not just focused on removing tumors. It also works to partially or completely replace the building blocks of the body known as stem cells.

Multiple myeloma depletes healthy blood cells replacing them with damaged plasma cells born out of the bone marrow. Multiple myeloma slowly destroys the skeletal structure resulting in bone structural deformities and bone lesions. Excess calcium is released in the bloodstream which damages vital organs like the liver, the kidneys and the stomach. This is where surgery can work to restore the organ damage.

Surgery for multiple myeloma is targeted at the following areas:

  • Restore bone marrow function
  • Help in reducing bone damage
  • Assist in reducing organ damage or replacing organs completely
  • Introducing stem cells back into the system

Stem Cell Transplant: Stem cells are simply cells which give rise to other types of blood cells such as white cells, plasma cells and red blood cells. As the number of healthy blood cells in myeloma patients decrease it becomes necessary to reintroduce healthy cells back into the body. This can be achieved by transplanting healthy cells from the patient's own body or a donor's body to the patient. Before undergoing such treatment, patients are given chemotherapy and radiation therapy treatments. These treatments work to reduce the number of cancerous cells. Also tumors, if any, reduce in size. Chemotherapy destroys a significant amount of healthy cells too. This is why healthy stem cells are extracted before the treatment, so that they can be grown and reintroduced back into the system.

Harvesting: Minimally invasive surgery is used for harvesting of bone marrow cells. Here the patient or the donor is given a general anesthesia. A specialized needle is inserted to the source such as the hip bones and the bone marrow is extracted. The donor may have to undergo a few days of hospitalization to help his body recover the bone marrow depletion.

Reintroducing the stem cells: The patients who is about to receive the healthy stem cells must first be treated by chemo or radiation therapy. This helps destroy his original damaged bone marrow cells. Once he is clear, the harvested stem cells are reintroduced back into the bone marrow using similar injecting technique. It may be done a few more times to generate significant amounts of bone marrow tissue and new healthy cells.

Based on the way the stem cell transplant is done, it can be autologous (healthy stem cells from patients own body are harvested for reintroduction later), syngeneic (where the patients twin donates his healthy stem cells for the patient) and allogeneic (where a donor who can be a maximum match for tissue and human leukocyte antigen (HLA) to the patient provides the healthy stem cells)

Features of stem cell transplant are:

  • Requires a significant amount of time for recovery
  • Harvested stem cells are frozen for later use
  • Involves risk of lowering immunity and contraction of other diseases
  • Requires special growth factor promoting agents that aid cell division into red, white and plasma cells
  • There is a huge risk of rejection of new stem cells and requires special medication to avoid the graft rejection.
  • Some side effects of the treatment are injury to mucosal lining such as those present in the mouth or throat, probability of inflammation due to graft versus host disease (GVHD) and probability of giving rise to liver damage and mouth ulcers or mouth cancer

Other surgeries for multiple myeloma:

Multiple myeloma as stated earlier damages multiple organs. Surgeries may be needed from time to time to prevent or repair such organ damage. For example liver and kidney surgery

Liver surgery: In extreme cases, if liver of the patient is damaged a liver transplant is carried out. This involves grafting a portion or the complete liver from a donor to the patient

Kidney surgery: Kidney damage is common in multiple myeloma patients due to excess of calcium and lower immunity. As with the liver transplants, kidney transplants may be carried out to replace the damaged kidneys. However, such operations are rare.

Surgeries for bone damage: Bone fractures, bone deformities can be corrected once a patient undergoes stem cell transplant using bone surgeries. Bone grafting and other bone surgeries are used commonly to correct such damage

Thus multiple myeloma surgery is useful to recover organ damage and help the proliferation of healthy blood cells. Surgery for multiple myeloma is carried out after careful evaluation of the patient's age, overall health and his prognosis for the cancer.

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