I just received my bone marrow biopsy results as of yesterday and my myeloma specialist said that I had 15% to 20% myeloma cells. I do not have an M-spike but rather very high free lambda light chains. Since 2012 I have been in the MGUS category until yesterday. He has re-classified me as smoldering. I have already had infusion of Zometa for my osteoporosis in September.
My question: Does "smoldering multiple myeloma" mean you have cancer? Sorry if it is a dumb question but just seems to been in a gray area. Thank you!
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Re: Is smoldering multiple myeloma cancer?
Restlessrebel,
This is a common question and it was the very first question I asked my hematologist when I was being diagnosed. Unlike MGUS, smoldering multiple myeloma is technically a diagnosis of cancer.
This is a common question and it was the very first question I asked my hematologist when I was being diagnosed. Unlike MGUS, smoldering multiple myeloma is technically a diagnosis of cancer.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Is smoldering multiple myeloma cancer?
Thank you Multibilly for your response. Of all the questions I asked my oncologist, this was the one I forgot. Take care of yourself.
Re: Is smoldering multiple myeloma cancer?
Do you mind showing the results of your bone biopsy? I have been in the MGUS stage for five years.I had a fat pad done two days ago to rule out amyloidosis. I am just trying to learn a little.
My bone marrow biopsy that I had two years ago showed D138 scattered plasma cells present. It showed small lymphocytes present composed of T-cells positive for CD3. My doctor said it was negative.Then she called and said she had sent these results to Mayo Clinic for their diagnosis. I just don't understand why to wait two years for a second opinion. I hope you the best in your future life and will be praying for you.
Thanks
My bone marrow biopsy that I had two years ago showed D138 scattered plasma cells present. It showed small lymphocytes present composed of T-cells positive for CD3. My doctor said it was negative.Then she called and said she had sent these results to Mayo Clinic for their diagnosis. I just don't understand why to wait two years for a second opinion. I hope you the best in your future life and will be praying for you.
Thanks
Re: Is smoldering multiple myeloma cancer?
Hmmm .... I thought the answer to this question wasn't so clear. Typically, "cancer" is reserved for the description of neoplasms that are malignant, meaning that they will grow uncontrollably unless checked in some way. And I thought that it's an open question whether or not smoldering multiple myeloma can be considered a malignant condition, as explained by Dr. Hoffman in the thread
"Smoldering myeloma - is it a malignant condition?" (started Nov 30, 2014)
If the criterion for something being considered "cancer" is simply whether or not it is a neoplasm, then you could make a good argument for many (all?) cases of MGUS being classified as cancer. Yet I think there would be pushback from many doctors on such a classification.
Or am I missing something?
"Smoldering myeloma - is it a malignant condition?" (started Nov 30, 2014)
If the criterion for something being considered "cancer" is simply whether or not it is a neoplasm, then you could make a good argument for many (all?) cases of MGUS being classified as cancer. Yet I think there would be pushback from many doctors on such a classification.
Or am I missing something?
Re: Is smoldering multiple myeloma cancer?
Hi Cheryl,
I now recall the post from Dr. Hoffman and I should not have been so definitive in my reply to Restlessrebel. A couple of my docs had said that smoldering multiple myeloma is indeed a cancer. But as with so many things related to the spectrum of plasma cell disorders, there often seems to be a lack of consensus in the medical community. So, I bet if I were to go to a couple more clinics that I might find that those docs would say that my smoldering multiple myeloma was technically not cancer. So, thanks for pointing that out.
Restlessrebel: For what it's worth, I've become comfortable with the "C" word over the past three years and don't really think much at all about the designation "cancer" any more.
I now recall the post from Dr. Hoffman and I should not have been so definitive in my reply to Restlessrebel. A couple of my docs had said that smoldering multiple myeloma is indeed a cancer. But as with so many things related to the spectrum of plasma cell disorders, there often seems to be a lack of consensus in the medical community. So, I bet if I were to go to a couple more clinics that I might find that those docs would say that my smoldering multiple myeloma was technically not cancer. So, thanks for pointing that out.
Restlessrebel: For what it's worth, I've become comfortable with the "C" word over the past three years and don't really think much at all about the designation "cancer" any more.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Is smoldering multiple myeloma cancer?
Hi Ellajane, I will get a copy of my bone marrow biopsy report so I can answer your questions.
Cheryl and Multibilly – Thank you for your insights! What I had read was smoldering myeloma has all the clinical criteria for active myeloma, minus any of the CRAB criteria. That is where I got confused.
Hang in there everybody!
Cheryl and Multibilly – Thank you for your insights! What I had read was smoldering myeloma has all the clinical criteria for active myeloma, minus any of the CRAB criteria. That is where I got confused.
Hang in there everybody!
Re: Is smoldering multiple myeloma cancer?
Restlessrebel,
Not to complicate the discussion too much, but the IMWG recently changed the definition of multiple myeloma to include three additional "myeloma defining events" (MDEs) beyond the classic CRABi criteria. Together, all these new criteria are known as SLiM CRABi. See this article:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
Note the closing statement in the article, as not all multiple myeloma specialists (including mine) would automatically begin treatment based on a smoldering patient developing an MDE.
Not to complicate the discussion too much, but the IMWG recently changed the definition of multiple myeloma to include three additional "myeloma defining events" (MDEs) beyond the classic CRABi criteria. Together, all these new criteria are known as SLiM CRABi. See this article:
SV Rajkumar, "New Criteria For The Diagnosis Of Multiple Myeloma And Related Disorders," The Myeloma Beacon, Oct 26, 2014
Note the closing statement in the article, as not all multiple myeloma specialists (including mine) would automatically begin treatment based on a smoldering patient developing an MDE.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Is smoldering multiple myeloma cancer?
Dr. Hoffman stated:
Confusing categories? I don't see why there is a difficulty in answering the question from doctors. Either you have cancer or you don't. Whether or not you are being treated or not, malignant or pre-malignant shouldn't matter.
I know that doctors can't tell you if and when it will go active, how long you have to live, etc. But it appears to me that one sure absolute would be cancer or not cancer.
Here's another question, can we get life insurance? How do we answer the question "do you now or have you ever had cancer?"
A little bit of cancer can go a long way.
It is best in my opinion is to understand what SMM is and not too try to hard to place it in confusing categories. If desired, you could refer to it as malignant, or, if desired, it can be called pre-malignant.
Confusing categories? I don't see why there is a difficulty in answering the question from doctors. Either you have cancer or you don't. Whether or not you are being treated or not, malignant or pre-malignant shouldn't matter.
I know that doctors can't tell you if and when it will go active, how long you have to live, etc. But it appears to me that one sure absolute would be cancer or not cancer.
Here's another question, can we get life insurance? How do we answer the question "do you now or have you ever had cancer?"
A little bit of cancer can go a long way.
Re: Is smoldering multiple myeloma cancer?
I am with you. This limbo diagnosis is irritating. I live my life in 3 months increments awaiting the other shoe to drop. The life insurance questions is a "whole nother show".
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