Experts say multiple myeloma has many different levels and manifestations, even without symptoms, making it difficult to diagnose and prone to complications.
Multiple myeloma is a malignant blood disease, common in people over 65 years old. The disease is caused by malignant accumulation of plasma cells in the bone marrow and some organs. This creates many foci of bone loss, leading to pathological fractures and dysfunction of some organs such as kidney failure, anemia, and immunodeficiency.
Currently, the Central Institute of Hematology and Blood Transfusion treats nearly 1,000 cases. 150 new cases of multiple myeloma are discovered each year, 700-800 people are followed on an outpatient basis.
Dr. Vu Duc Binh – Deputy Director of the Central Institute of Hematology and Blood Transfusion – said that many people do not know about this disease, leading to difficulty in diagnosis. Symptoms of the disease are quite diverse, common symptoms are bone pain, anemia, kidney failure, fatigue, and recurring infections.
He pointed out that in some cases there are no symptoms until accidentally discovering soft tissue tumors, broken bones or treating other diseases. Some people treat kidney failure, bone pain, and joint pain that won’t go away. They go to the hospital for a check-up and find out they have multiple myeloma. Even in many cases, this disease was discovered after surgery to treat bones and tumors.
“Multiple myeloma has many different levels and manifestations, so it is difficult to diagnose,” according to Dr. Vu Duc Binh. About 10% of cases are mild and require examination by a hematologist. The institute invests in new technical equipment that can diagnose.
Dr. Vu Duc Binh (right) talks about the reasons why multiple myeloma is difficult to diagnose. Photo: NVCC
Dr. Do Huyen Nga – Head of Hematology Department, K Hospital – cited world statistics: the disease is common in people over 60 years old, rarely seen in people under 30. “However, in Vietnam, we We still accept cases under 30 years old. Therefore, it is necessary to detect and treat them early to help them maintain stable health and prolong their lifespan and quality of life,” she said.
There is currently no complete cure for multiple myeloma. Therefore, patients have to “fight for a long time”, maybe for the rest of their lives, according to Dr. Hoang Thi Thuy Ha – Deputy Department of Hematology at Cho Ray Hospital.
In the initial stage of maintenance treatment, patients must go to the hospital for injections twice a week. Currently, many multiple myeloma patients in Cho Ray, Ho Chi Minh City, have to rent accommodation near the hospital for convenient treatment.
Many people have difficulty with travel expenses, relatives’ care, transportation, especially paying for maintenance medications. Currently, there is one type of medication that is covered 100% by insurance, another 50%.
“The lowest level for maintenance treatment is 4-5 million VND per month. Oral medication somewhat improves the condition. Patients can receive outpatient treatment, get medication monthly and have regular check-ups to reduce the financial burden,” said Dr. Thuy Ha.
Simulation of plasma cells in bone marrow (purple) causing many diseases, including multiple myeloma. Photo: CDC
Dr. Do Huyen Nga also said that the treatment of multiple myeloma in Vietnam is more convenient than in some Southeast Asian countries because insurance covers some drugs. However, with the current treatment regimen based on injection schedule, we need to find ways to extend the time patients have to go to the hospital.
“In fact, in the first year of intensive treatment, about 15-20% of cases drop out midway because they cannot go to the hospital for scheduled injections. This situation causes the treatment effectiveness to decrease, progress more severely, and require treatment. start over when they return to the hospital,” said Dr. Huyen Nga.
Experts point out that for chronic diseases, global researchers are always looking for new approaches: oral, intravenous or subcutaneous. Each method has its own advantages and disadvantages, and medical staff will create a suitable regimen for each condition.
Oral medications have many advantages and can be treated on an outpatient basis, but are not for stomach and reflux diseases (must be administered via injection). “With oral medication, patients will comply with the regimen better, reducing the rate of dropping out of treatment midway. However, the limitation is that the medication is not currently covered by insurance, so it is difficult for patients to access it,” Dr. Huyen Nga said.
Meanwhile, Dr. Thuy Ha said that after the prolonged Covid-19 outbreak, it is very difficult for people to go to the hospital. In fact, some cases have stopped treatment during Covid-19 and are now returning, unintentionally putting a burden on the health system. Therefore, taking maintenance medication at home will be more convenient.
Doctors also agree that oral multiple myeloma drugs should be included in the “Health Insurance Coverage” list, helping patients access them easily, reducing the rate of treatment abandonment and saving costs.