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Importance of Myeloma Staging?
What is the importance of myeloma staging? When you are told you have a blood cancer called multiple myeloma, what is the importance of figuring out what stage you are or how advanced your MM is? Should you care?
When newly diagnosed MM patients ask their oncologists about their stage at diagnosis, they are told that staging doesn’t matter or that the oncologist doesn’t stage MM because myeloma treatment is all the same.
My reply to those two answers is that conventional oncologists and even MM specialists are smart, well-educated people. Conventional oncology has advanced MM diagnostic testing and treatment over the past several decades.
But conventional oncology is biased. Board-certified medicine strictly follows the Food and Drug Administration here in the United States. That’s fine…as far as it goes. MM is a relatively rare cancer and, as such, receives relatively little research compared to the more common cancers such as breast, prostate, or colorectal cancers.
In practical terms, this means that there is one FDA-approved standard-of-care therapy plan for all standard-risk newly diagnosed MM patients. Whether you are 50, 70, stage 1, stage 3, etc. you are usually prescribed the same therapy plan.
Of the many videos that talk about MM staging, I posted the one below because it is more wide-ranging in its discussion.
Let’s Talk about Diagnosis and Staging Multiple Myeloma
I am a MM survivor and MM cancer coach. The bottom line is regarding the importance of myeloma staging is one of patient choice, in my opinion. The MM patient must decide how much they want to know about their MM, and how much they want to know about possible therapy plans.
Scroll down the page and post a question or a comment if you are wondering about your MM stage. I will reply to you ASAP.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Staging is important in myeloma because it helps doctors choose the best treatment plan, predict the patient’s prognosis, and allows for consistent analysis in clinical trials. Unlike staging for solid tumors, which focuses on tumor size and spread, myeloma staging uses factors like bone damage, blood test results (e.g., beta-2 microglobulin, albumin), and genetic changes to determine disease risk.
Why staging is important
- Informs treatment decisions: Staging helps determine if the disease is standard-risk or high-risk, which is crucial for guiding treatment choices.
- Predicts prognosis: The stage is used to provide an outlook for the patient, though it’s more complex in myeloma and evolving with newer systems that are better at predicting survival.
- Standardizes clinical trials: Staging provides a consistent framework for classifying patients in clinical trials, allowing researchers to accurately assess the effectiveness of new drugs and treatment combinations.
How myeloma staging is different
- Systemic disease: Myeloma is a blood cancer that originates in the bone marrow and is systemic, meaning it affects the entire body. This is different from solid tumors like breast cancer, where staging focuses on the size and spread of a localized tumor.
- Key factors: Staging systems for myeloma consider factors such as:
- Bone damage: Evidence of lesions, fractures, or weakening in bones.
- Blood markers: Levels of calcium and creatinine, and the presence of anemia.
- Genetic markers: Specific chromosome changes in cancer cells, like deletion 17p or translocations t(4;14) and t(14;20).
- Imaging results: Modern imaging techniques like PET scans and MRIs provide detailed anatomic and functional information.
Evolution of staging
- Durie-Salmon system: The original system was based on tumor burden and clinical signs.
- Revised International Staging System (R-ISST): A revision that incorporated blood markers to better predict survival.
- Second Revised International Staging System (R2-ISS): A newer, more refined system that includes genetic factors to further improve risk stratification.
The role of staging in multiple myeloma
Abstract
Introduction: The importance of cancer staging is determined by how accurately it can predict prognosis, and how useful it is for treatment decisions. Compared to other malignancies, multiple myeloma (MM) staging proved more challenging because of unreliable prognostic factors and wide-ranging life expectancy. As traditional MM staging continues to evolve, it requires reassessment of its prognostic and predictive value.
Areas covered: The studies that included prognostic and predictive value of MM stages from 1975 through 2023 were selected for this review using PubMed, MEDLINE platforms. The history and evolution of MM staging are revisited, including its role in predicting survival, treatment planning and potential practical implications for the future. The role of MM staging for oncological practice and patient counseling is discussed.
Expert opinion: The utility of the traditional MM staging remains unsatisfactory because it lacks a strong connection with the disease biology, prognosis or treatment planning. Additionally, it demonstrates a modest value for patient counseling because individual prognosis is subject to under- or overestimation, and the median survival or survival rates are difficult concepts to grasp. Although the role of MM stages may change in the future, the current research upholds the notion that MM staging benefits more medical research and clinical trials than oncological practice.
importance of myeloma staging