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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 46936
Experience:  Board Certified Oncologist
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My gran was diagnosed with multiple myeloma last Christmas

Customer Question

Hi my gran was diagnosed with multiple myeloma last Christmas and would like to no what this means plasma cell myeloma and her g/l was 18 and evidence of immunoparesis with heavy bone marrow infiltrates with bone marrow treelike showing 70/80% beta microglobolin 2.4 albumin 43 and LDH normal Tp53 deletion and ISS 1 RISS 2 MRC risk group favourable if it's really bad news I would rather not know thank you I really want it to be early on
Submitted: 1 year ago.
Category: Oncology
Expert:  Dr. David replied 1 year ago.

This is Dr. David

I am sorry for your grandparent who was found to have multiple myeloma

multiple myeloma is a cancer if the plasma cells which come from the bone marrow

these cells make immunoglobulins which are protein parts which make up antibodies for the body's immune system.

it sounds like you are reading from a bone marrow biopsy report.

assessment of patients with multiple myeloma take into account several factors including the results of bone marrow biopsy, the results of skeletal survey and xrays of bones to see if the cancer has spread to bones, blood plasma electrophoresis testing to check protein levels in the blood and to check how high the M protein spike may be (the higher the spike, the more plasma cells are making this myeloma protein) and overall performance status of the patient and kidney function

patients who have multiple myeloma can live for years and years with treatments to suppress their myeloma

if the cancer has spread to the bones, 1-2 weeks of radiation therapy to those areas often can help kill the plasma cell cancer there and help decrease pain.

you should go with your grand parent to the doctor's appointment to support them and to learn about the testing results from the doctor and ask about the other tests I mentioned.

let me know if you have questions.

Customer: replied 1 year ago.
She has a few signs on her bones but there is no signs of the disease in the kindys or anything and she was told her last time at the hosptal she only has one lot of cancer cells what does that mean I'm hoping she will live another 20 years or more it's not a death sentence is it ? I don't think she had anything in her urine just something in her blood was a bit high
Customer: replied 1 year ago.
from what I said early in my first question what sort of stage is it at can you tell by the first question
Expert:  Dr. David replied 1 year ago.

I'm not sure what you mean by "one lot of cancer cells"

diagnosis of multiple myeloma is not a death sentence.

it can be treated.

is she starting to get treatment for her MM?

no, we can't tell the stage of her MM from the biopsy report from her bone marrow

we need more information including the results of her skeletal survey.

multiple myeloma cancer isn't staged in the same way as other cancers.

we assess the level of the cancer by looking at the M protein levels in the blood on protein electrophoresis

and if the bone lesions are progressing or not on xray scans.

let me know if you have other questions.

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Dr. David and 2 other Oncology Specialists are ready to help you
Customer: replied 1 year ago.
What does ISS 1 RISS 2 MRC risk group favourable mean
Expert:  Dr. David replied 1 year ago.

Revised ISS (R-ISS) is the revised international staging symptom for multiple myeloma.

Stage I includes ISS stage I (serum  2 - microglobulin level  3.5 mg/L and serum albumin level  3.5 g/dL), no high-risk CA [del(17p) and/or t(4;14) and/or t(14;16)], and normal LDH level (less than the upper limit of normal range)

R-ISS III includes ISS stage III (serum  2 -microglobulin level  5.5 mg/L) and high-risk CA or high LDH level;

and R-ISS II includes all the other possible combinations

MRC is Medical Research Counsel.

Customer: replied 1 year ago.
Her beta microglobolin was 2.4 albumin 4.3 and LDH normal and she's now on treatment so is that good
Expert:  Dr. David replied 1 year ago.

R-ISS is the Revised International Staging System (R-ISS) for multiple myeloma that incorporates the original staging system with chromosomal abnormalities (CA)
R-ISS stage I is serum beta2-microglobulin level < 3.5 mg/L and serum albumin level of 3.5 g/dL or greater, no high-risk CA [del(17p) and/or t(4;14) and/or t(14;16)], and normal LDH level (less than the upper limit of normal range)

R-ISS III: includes ISS stage III (serum beta2-microglobulin level > 5.5 mg/L) and high-risk CA or high LDH level

R-ISS II: includes all other possible combinations.

it sounds like her R-ISS stage is I but it says 2.

Customer: replied 1 year ago.
why would it stage 2 is that bad
Expert:  Dr. David replied 1 year ago.

no, that is not bad.

her multiple myeloma can still be treated and controlled for years and years.

Customer: replied 1 year ago.
Oh good I thought it was like terminal or to far gone that it would continue to go to a different stage but her treatment is going well wen she stop her treatment and if there signs of it starting agen it won't jump to a different stage will it ?
Expert:  Dr. David replied 1 year ago.

again, multiple myeloma can be treated and controlled for years, but it is not curable without a bone marrow transplantation

myeloma can progress and spread and become resistant to treatment after a period of time.

for every patient, this period of time can be different.

Customer: replied 1 year ago.
What does MRC risk favourable mean does it mean she's going to die earlier
Expert:  Dr. David replied 1 year ago.

no. favorable risk means her multiple myeloma should be controlled with treatment for a longer period of time.

Customer: replied 1 year ago.
Oh that's good so that could mean she could live another 20 years or so hopefully
Expert:  Dr. David replied 1 year ago.

how old is your grand parent?

Customer: replied 1 year ago.
71 I am hoping she will reach her late 80s or what I would love the most if she lasted till her 90s
Customer: replied 1 year ago.
Apart from her myeloma she's fit and healthy walks a lot with the dog and very active
Expert:  Dr. David replied 1 year ago.

I see.

it can be difficult to impossible to try to accurately predict how long she will live for

even her own doctors will not be willing to do that

because no way can play god that way