"I Went to the Hospital for Back Pain, Only to Find Out It Was Blood Cancer?"... The SOS Signal from the Bones [Health Talk]

[Financial News]  If unexplained bone pain, anemia, and kidney problems occur together, older adults should be evaluated for multiple myeloma, a blood cancer that primarily affects the elderly. Multiple myeloma is a blood cancer that often causes bone pain and is not infrequently diagnosed after patients visit a hospital for back pain or an unexplained fracture. Along with leukemia and malignant lymphoma, it is considered one of the three major blood cancers. However, because its symptoms vary widely, it is often mistaken for ordinary aging and discovered only at a late stage.
Multiple myeloma is a blood cancer that develops when plasma cells, a type of white blood cell found in the bone marrow, differentiate and multiply abnormally. Plasma cells normally produce antibodies and play a role in immune function. When they increase abnormally, however, they interfere with the production of normal blood cells and damage various organs, including the bones and kidneys.
According to data released this year by the Ministry of Health and Welfare (MOHW) and the National Cancer Registry, South Korea recorded 2,010 new cases of multiple myeloma in 2023. By age group, people in their 60s accounted for the largest share at 32.2%, followed by those in their 70s at 31.8% and those aged 80 or older at 18.1%. People aged 60 and over account for more than 80% of all cases, making multiple myeloma a blood cancer that primarily affects older adults. The average age at diagnosis is around 70. However, there is no need to give up treatment because of age.
Advances in treatment have also significantly improved survival rates. The same statistics showed that the five-year relative survival rate for multiple myeloma was 50.8% from 2019 to 2023. That was more than double the 23.7% recorded in the early 1990s.
Seong Hwajeong, a professor of hematology and oncology at Korea University Ansan Hospital, said, "Multiple myeloma is often detected late, but survival rates have improved significantly with the recent active development of new treatments. Anyone with symptoms that raise suspicion should not hesitate to consult a specialist."

The main symptoms of multiple myeloma are summarized by the term 'CRAB.' It is formed from the initial letters of hypercalcemia, renal insufficiency, anemia, and bone lesions.
The most common symptom is bone pain. It may begin as pain in the back or ribs and can lead to fractures even after a minor impact. Extreme fatigue and shortness of breath caused by anemia may also occur. Kidney dysfunction can cause proteinuria, while excessive secretion of abnormal antibody proteins can make the blood more viscous. Reduced immune function also makes patients more susceptible to infections.
The problem is that these symptoms are easily confused with ordinary aging or other diseases. In many cases, the condition is discovered incidentally during tests for anemia, kidney function, or protein levels.
Professor Seong said, "Multiple myeloma often causes a combination of bone pain, anemia, and kidney problems, but many patients mistake these symptoms for ordinary aging and are diagnosed only after the disease has progressed. If unexplained back pain, fatigue, or kidney problems persist, it is important to have a blood test."
Diagnosis involves blood and urine tests, imaging tests such as X-rays, CT scans, MRI, and PET-CT, and a bone marrow biopsy. A bone marrow biopsy is essential for diagnosis. It plays a key role in determining the treatment approach and risk level by assessing the proportion of plasma cells and the presence of genetic abnormalities.
M-protein, or monoclonal protein, detected in the blood and urine is also an important indicator. M-protein levels are used not only for diagnosis but also to assess treatment response and prognosis. Under the International Staging System (ISS), the disease is divided into stages 1 through 3. The treatment approach is determined according to the stage and risk level.

Multiple myeloma remains difficult to cure. However, as a wider range of treatments has become available to manage repeated relapses, it is increasingly regarded as a disease compatible with long-term survival.
Treatment generally proceeds in three stages. The first is targeted therapy and immunochemotherapy aimed at reducing M-protein levels as much as possible. The second is autologous hematopoietic stem cell transplantation, in which the patient's own stem cells are transplanted after high-dose chemotherapy to restore bone marrow function. It is mainly used for suitable patients under the age of 70. The third is maintenance therapy to prevent relapse, which involves taking medication over the long term.
In addition to autologous transplantation, allogeneic transplantation using hematopoietic stem cells from another person is also available. Although allogeneic transplantation may offer treatment benefits, it carries greater risks for the patient and is considered cautiously when no other treatment options remain.
Professor Seong emphasized, "Multiple myeloma is a disease that frequently relapses, but each relapse can be addressed with new treatments. It is important to approach the disease as one that requires long-term management rather than a cure. Because patients can control their symptoms through treatment, maintain their quality of life, and live for a long time, receiving active treatment after diagnosis is especially important."


[email protected] Jung Myung-jin, medical reporter Reporter