Stage 2 Multiple Myeloma

What is stage 2 Multiple Myeloma?

Stage 2 multiple myeloma is characterized by the presence of a high amount of cancer in the body. All cases of multiple myeloma that don’t fall within stage 1 and stage 3 are considered to be stage 2. Patients with stage 2 multiple myeloma have severe bone complications because of their disease and may require treatment for their symptoms.

The gradual buildup of myeloma cells can cause fewer blood cells in the bone marrow and damaged bones, along with severe pain and an increased chance of infection.

There is no cure for stage 2 multiple myeloma, but it is possible to prolong survival by several years using a combination of immunotherapy, stem cell transplantation, and immunotherapy. The only potential cure for multiple myeloma is high-dose therapy followed by stem cell transplantation with donor cells. This treatment has severe side effects and is only used as a last resort in patients who have failed to respond to other treatments [¹].

What are the subtypes of stage 2 Multiple Myeloma?

There are several subtypes of multiple myeloma classified by the type of heavy chains, such as lpG lambda, lgA lambda, lgG kappa, and lgA kappa [²]. The Durie-Salmon staging characterizes stage 2 multiple myeloma by the following factors:

The number of myeloma throughout the body
The damage done to the bone by the myeloma cells
Amount of M-protein in the urine or blood
Blood calcium levels
Hemoglobin and albumin levels

Stage 2 Multiple Myeloma staging and diagnosis

Multiple Myeloma staging

The Durie-Salmon Staging system classifies myeloma in stage 1, stage 2, and stage 3. Myeloma may be further classified into Group A or B depending on the type of damage done to the kidneys. Group A multiple myeloma has not affected the kidneys, while Group B has disrupted kidney function, requiring further treatment.

The international staging system (ISS) is characterized by multiple myeloma based on the albumin level (greater or lesser than 3.5 mg/dL) and B2-microglobulin level. The data for these staging systems comes from over 10,000 cancer outcomes.

How common is stage 2 Multiple Myeloma?

According to the American Cancer Society’s Cancer Statistics Center, stage 2 multiple myeloma is relatively uncommon in the United States. About 35,730 new cases will be diagnosed in 2023, with 12,590 deaths. The prevalence of multiple myeloma is 1 in 132 (0.75%), which is highly uncommon [³].

It is worth noting that stage 2 multiple myeloma is not common in younger individuals. The incidence of the disease increases sharply with increasing age. Multiple myeloma is more common in men over the age of 60. However, most cases of the condition are diagnosed at around 70.

How is stage 2 Multiple Myeloma diagnosed?

It is difficult to diagnose stage 2 multiple myeloma. In general, patients at this stage of multiple myeloma will experience symptoms such as loss of appetite, fatigue, and bone pain, all of which require treatment. Patients will be likely to have MRI scans and CT scans of their arms, skull, spine, and pelvis to look at any signs of damage.

A more comprehensive diagnosis of stage 2 multiple myeloma will require a bone marrow biopsy. This is done by taking a small sample of bone marrow with the help of a needle. Doctors may also remove a small sample of bone by administering local anesthesia.

In addition, several tests may be used to confirm the diagnosis, including:

Blood tests to measure the number of red and white blood cells in the blood.
Urine protein electrophoresis to check the number of abnormal proteins produced by myeloma cells
Bone marrow biopsy, as discussed earlier
Imaging tests, including X Rays, CT scans, MRI, and PET scans to detect bone damage and other abnormalities

Stage 2 Multiple Myeloma symptoms

Stage 2 multiple myeloma can cause a wide range of symptoms to indicate disease progression, including:

Fatigue and shortness of breath due to anemia
A persistent bone pain in the back, hips, and ribs
Hypercalcemia (high calcium levels in the blood) can cause extreme stomach pain and thirst
Blurry vision
Weight loss
Exposure to infections
Fragile bones that are prone to fracturing
Problems in the kidney
Easily getting bruised and prone to bleeding, including frequent bleed, heavy periods, and bleeding gums

Stage 2 Multiple Myeloma treatment

Treatment for stage 2 multiple myeloma is tailored to the individual patient’s symptoms, risk of myeloma recurrence, and whether they are eligible for stem cell transplant. At stage II, patients will receive treatment with a number of approved medications in an attempt to induce the disappearance of myeloma cells.

The selection of medication depends on the patient’s risk, age, and overall medical condition. Patients in good health are exposed to more aggressive treatment for complete remission, while older patients may receive less aggressive therapy. Preferred drugs include Velcade, Dexamethasone, and Revlimid.

Corticosteroids are used to kill myeloma cells and are taken by mouth after eating food. Relapses can be treated if myeloma ever returns. Treatment for relapses is very similar to initial treatment, although non-intensive treatment is often preferred.

Stage 2 Multiple Myeloma primary/first-line treatment

First-line treatment for stage 2 multiple myeloma involves the use of various drug combinations such as bortezomib, thalidomide, dexamethasone, and daratumumab. After the maximum response to induction therapy, the patient may be prescribed an autologous stem cell transplant (ASCT) after maintenance therapy.

Targeted therapy also focuses on specific weaknesses found in myeloma cancer cells. Blocking these abnormalities causes cancer cells to die. Some patients continue taking these drugs to keep the myeloma in control.

Note that the research for stage 2 multiple myeloma is ongoing, with clinical trials comparing new treatments with existing ones to see if the new treatment is more effective.

Other types of treatment for stage 2 Multiple Myeloma

Besides the first-line treatments for stage 2 multiple myeloma, patients may also need treatment to help relieve the symptoms of the condition, such as:

Using painkillers to reduce pain
Radiotherapy relieves bone pain and helps heal after a bone is surgically repaired
Bisphosphonate medicine, administered by injection or as oral tablets, to prevent bone damage
Bone transfusions to increase red blood cell count
Surgery to strengthen the damaged bones
Dialysis in case of kidney failure
Plasma exchange to replace the liquid that makes up plasma

Secondary treatment for stage 2 multiple myeloma depends on a number of factors, including the patient's age, health, and lifestyle factors. All treatments can cause severe side effects and complications.

Can stage 2 Multiple Myeloma be cured?

There is no cure for stage 2 multiple, and treatment is aimed at minimizing the symptoms while improving the patient's quality of life. Current therapies, including chemotherapy, proteasome inhibitors, and other medications, are aimed at prolonging the patient's life while minimizing the side effects of medications.

It is important for patients to regularly follow up with their healthcare team and provide them with blood tests, bone density tests, urine tests, and various imaging studies to monitor disease progression and symptoms of stage 2 multiple myeloma.

Prognosis: Stage 2 Multiple Myeloma survival rate

Despite the fact that there is no cure for stage 2 multiple myeloma, the disease has a high survival rate, provided that it is caught and treated early. Patients under the age of 50 have a relative survival rate of 76.8%, while those in the age range of 50 to 62 have a survival rate of 67.5%. Meanwhile, the survival rate plummets sharply to 49.6 in patients older than 65.

Localized myeloma has a higher survival rate of 78.5%. In all cases, additional treatment will be required to prevent a recurrence.

Stage 2 Multiple Myeloma survival rate

Research indicates that the 5-year survival rate for people with multiple myeloma in the US is about 55%. Early diagnosis of the disease is important and is attributed to a higher life span. However, the survival rate is only about 54% once cancer has spread to distant parts of the body.

Stage 2 Multiple Myeloma recurrence rate

Stage 2 multiple myeloma relapse is very common, according to the International Myeloma Foundation (IMF) [⁴]. One study found that 16% of patients with multiple myeloma experienced early relapse within a 12-month period. 884% of patients had a relapse after one year or no lapse at the time of the follow-up [⁵].

Stage 2 Multiple Myeloma growth rate

Stage 2 multiple myeloma has a slow growth rate. Researchers found that there is a 73% chance of disease progression in stage 2 multiple myeloma over a 15-year period [⁶].

Lifestyle changes for preventing and managing Multiple Myeloma

Although there is no known cure for multiple myeloma, it is important for patients to take care of their health after diagnosis. This includes making regular appointments with the healthcare team and making treatment decisions based on their recommendations.

Here are a few steps that can be taken to prevent and manage the symptoms of stage 2 multiple myeloma.

Being active: People with stage 2 multiple myeloma can manage their pain and fatigue levels by being active. Staying active also improves their self-esteem and overall quality of life. However, it may be difficult to stay active due to bone pain. Consider seeing a physical therapist to help you find activities that suit your needs.
Eat a balanced diet: Although researchers have been unable to identify a definitive diet plan for patients with multiple myeloma, the goal is to eat from healthy food groups. A healthy balanced diet is crucial for aiding recovery and making treatments more effective.
Avoid smoking: Smoking can worsen the side effects of therapy for multiple myeloma compared to individuals who do not smoke. Smoking also raises the chances of getting other chronic conditions, which can make the experience worse. Consider looking for nicotine replacement solutions if you’re finding the prospect of quitting difficult.
Avoid alcohol: Alcohol can prevent treatment and will interfere with your medications. For many people with stage 2 multiple myeloma, alcohol consumption can be detrimental to their treatment. Alcohol disrupts the balance of bacteria in the digestive tract, which can severely lower their immune response. As a result, the body is prone to getting more infections [⁷].
Improve your quality of sleep: Stage 2 multiple myeloma patients experience high levels of stress due to their treatment. Although getting sleep may not make the symptoms better, it will go a long way in reducing fatigue. Try to create a consistent sleep schedule and ensure that the bedroom is kept dark and at a comfortable temperature to induce a deeper sleep. This also improves the immune system and stress levels of the body.
Find Emotional Support: It is essential for patients to take care of their emotional well-being. This means participating in support groups and discussion forums to connect with others who can empathize with their situation. Support groups may take place in person or online.

Conclusion

Takeaway

Stage 2 multiple myeloma is an intermediate stage of cancer that can cause symptoms requiring treatment. Patients diagnosed with this condition should stay on top of their health by closely coordinating with their healthcare team and improving their lifestyle factors. Although there is no cure for multiple myeloma, early treatment and diagnosis can ensure the best possible outcome for patients.