New research shows that excess weight increases the risk that a benign blood disorder will progress into multiple myeloma, a cancer of the blood.
The study, by a team at Washington University School of Medicine in St. Louis, is published Nov. 18 in the Journal of the National Cancer Institute.
Being overweight or obese has been known to increase the risk of multiple myeloma, a cancer of the plasma cells in the blood and bone marrow that develops more often after age 60.
Multiple myeloma is preceded by a blood disorder called monoclonal gammopathy of undetermined significance (MGUS) in which abnormal plasma cells produce many copies of an antibody protein. This precancerous condition does not cause symptoms and often goes undiagnosed.
“But our findings show that obesity can now be defined as a risk factor for developing multiple myeloma through this condition,” said the study’s first author, Su-Hsin Chang, PhD, an assistant professor of surgery in the Division of Public Health Sciences at Washington University.
“For patients diagnosed with MGUS, maintaining a healthy weight may be a way to prevent the progression to multiple myeloma, if further confirmed by clinical trials.”
The researchers analyzed data from a U.S. Department of Veterans Affairs database, identifying 7,878 patients, predominately men, diagnosed with MGUS from October 1999 through December 2009.
Among these patients, 39.8 percent were overweight and 33.8 percent were obese. The researchers then tracked whether the patients developed multiple myeloma. They found that 4.6 percent of overweight patients (followed for a median of 5.75 years) and 4.3 percent of obese patients (followed for a median of 5.9 years) developed multiple myeloma, compared with 3.5 percent of people at normal weight (followed for a median of 5.2 years) – a difference that is statistically significant.
Overweight and obese MGUS patients had a 55 percent and 98 percent higher risk of progression to multiple myeloma, respectively, than normal-weight MGUS patients.
African-American men also were more likely than their Caucasian counterparts to experience a progression from MGUS to multiple myeloma.
MGUS is caused by elevated levels of an antibody protein, known as M protein, that is found in 3 percent of people over age 50. By itself, MGUS is difficult to diagnose and often does not warrant treatment.
“The diagnosis is usually by accident, often driven by tests performed for the diagnosis or management of other conditions,” Chang said. “Although our study does not directly suggest screening for MGUS, regular check-ups can help physicians monitor whether MGUS is progressing to other disorders, including multiple myeloma.”
Multiple myeloma is the third most common type of blood cancer. An estimated 30,330 new cases of the cancer will be diagnosed in 2016, and 12,650 deaths will be attributed to the disease, according to the American Cancer Society.
“Based on our finding that being overweight or obese is a risk factor for multiple myeloma in MGUS patients, and since extra weight is a modifiable risk factor, we hope that our results will encourage intervention strategies to prevent the progression of this condition to multiple myeloma as soon as MGUS is diagnosed,” Chang said.
“Also, for black people diagnosed with MGUS, close monitoring of the disease progression, in addition to maintaining a healthy weight, should be prioritized.”
Future studies are planned by Chang and other School of Medicine researchers – including senior author Kenneth R. Carson, MD, PhD, an assistant professor of oncology, and Graham Colditz, MD, DrPH, a cancer expert who also is associate director of prevention and control at Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital.
“In the future, we will look at whether healthy weight loss is inversely associated with the progression of multiple myeloma in MGUS patients or how weight change plays a role in the progression of MGUS to multiple myeloma,” Chang said.
Back pain occurring along with abnormal lab results, weight loss or fatigue should alert clinicians to the possibility of multiple myeloma, according to research published in the Journal of the American Board of Family Medicine.
“Presenting symptoms of [multiple myeloma] are vague and nonspecific. Early detection poses a diagnostic challenge in primary care,” Neta Goldschmidt, MD, of the department of hematology, Hadassah-Hebrew University Medical Center in Jerusalem, Israel, and colleagues wrote. “We sought to identify ‘red flags’ that should alarm physicians that [multiple myeloma] is the cause of the symptoms and signs.”
Researchers wrote that although back pain is the second most common reason patients consult their primary care physician, fewer than 1% of these cases are related to malignancy, and the average primary care physician may see fewer than 10 cases of multiple myeloma in their professional career.
Goldschmidt and colleagues conducted a retrospective population-based study of 110 patients with multiple myeloma between 2002 and 2011, and matched cancer-free controls with low back pain. Laboratory and clinical data were extracted from medical records for the 2-year period prior to diagnosis of multiple myeloma, or of back pain in the controls. During that time window, 37 patients with multiple myeloma experienced weight loss or fatigue and 64 experienced back pain. There was no significant difference in pain complaints among the case-controls.
In a multivariate analysis, fatigue, weight loss, anemia, elevated erythrocyte sedimentation rate and creatinine were more frequent in patients with multiple myeloma compared with controls (P < 0.001 for all). “Given the changing clinical course of [multiple myeloma], recommendations for early treatment of smoldering myeloma, and calls for screening using free light chain levels, it is important to repeat this study in larger populations and in other clinical settings to determine whether there is justification for a policy recommending early detection of [multiple myeloma],” Goldschmidt and colleagues wrote. – by Janel Miller
A new study has found a close relationship between Agent Orange exposure during the Vietnam War and high blood pressure, a conclusion that could lead the Department of Veterans Affairs to dramatically expand the number of veterans eligible for compensation.
The study, published last week by VA researchers in the Journal of Occupational and Environmental Medicine, found a higher rate of hypertension among members of the Army Chemical Corps who handled Agent Orange during the war compared to those who didn’t. Corps members who served in Vietnam but did not spray the chemicals also had a higher rate of hypertension than their peers who served outside Vietnam.
Both results were statistically significant and add to a body of evidence linking Agent Orange exposure and hypertension.
The findings come 41 years after the close of the Vietnam War and decades since the last supplies of Agent Orange were incinerated. Since then, veterans have become increasingly distrustful of the VA. They maintain that their exposure to Agent Orange, which contained the toxic chemical dioxin, has harmed their health and has been passed on to their children.
A VA working group has been studying the latest scientific literature since March to determine whether any illnesses should be added to the agency’s list of diseases for which vets are automatically entitled to compensation if they served in Vietnam. Specifically, the group has been looking at new evidence linking bladder cancer, underactive thyroid, Parkinson’s-like symptoms and hypertension to Agent Orange exposure.
The VA had been expected to announce its decision this year, but officials now say that will be left to the administration of President-elect Donald Trump.
“For this administration, the deadline for proposing new rules for potential new presumptions [of service connection to herbicide] has passed, and this will become work for the new administration to take to completion,” VA officials said in a written statement first reported last week in Stars and Stripes.
Hypertension is the most common ailment among veterans seeking health care at the VA. It is one of the most common ailments among older adults generally.
The study released last week found the prevalence of hypertension among members of the Army Chemical Corps to be higher than among other aging veterans. Although most of the Agent Orange used in Vietnam was sprayed from Air Force planes, the Army Chemical Corps also sprayed the herbicide from hand sprayers and helicopters.
This is a great time of year to visit Panama City Beach. The weather is still warm, the water is clear (but COLD), the tourists are gone and the kids are back in school. (And the pesky beach service guys are off of the beach).
Most of the restaurants are open and there's rarely a wait for a table.
Celebrating 29 years of marriage in December '17. After over 7 years of remission, Dom's Multiple Myeloma (Cancer of the blood plasma cells- attributed to Agent Orange Exposure while Dom served in Vietnam) has returned. Much of this blog concentrates on our adventure leading up to a Stem Cell Transplant, his remission, and our new adventure.