Neither Rick Letterman nor Jeff Main had symptoms when routine bloodwork revealed they had multiple myeloma, a rare blood cancer. Diagnosed less than four months apart, the co-workers supported each other through treatment while becoming advocates for regular medical checkups.<\/p>\n
Letterman was feeling good before a routine physical in 2021. His diagnosis of the blood cancer that forms in the bone marrow sent him reeling.<\/p>\n
\u201cI wasn\u2019t having any symptoms. It was a shock,\u201d said Letterman, 62, of Moon. \u201cThe doctors were saying it was kind of rare, and when you hear cancer, it hits you.\u201d<\/p>\n
Multiple myeloma begins in plasma cells. Healthy cells make antibodies to fight off infections, but multiple myeloma cells multiply out of control. They produce proteins that impact the body with frequent infections, severe fatigue and neurological conditions such as tingling or pain in arms and legs.<\/p>\n
The disease is uncommon but highly treatable. It accounts for nearly 2% of all new cancer cases in the U.S. (roughly 36,000 people diagnosed), according to the American Cancer Society<\/a>.<\/p>\n In the U.S., the average lifetime risk of getting multiple myeloma is less than 1%, or about 1 in 108 for men and 1 in 133 for women.<\/p>\n During the initial months after Letterman\u2019s diagnosis, he leaned on Main, his friend and supervisor. The pair have worked together for 19 years at Main\u2019s Pittsburgh-based tech management firm, Questeq.<\/p>\n \u201cHe debriefed me through the whole process,\u201d said Main, 57, of Robinson.<\/p>\n Less than four months later, the men were blindsided when Main was diagnosed with the same illness.<\/p>\n \u201cI was driving when I got the call,\u201d Main said. \u201cI almost wrecked my truck. It was surreal. The first thing I did was call Rick and tell him, \u2018I think I\u2019m in the club with you.\u2019\u201d<\/p>\n According to the International Myeloma Foundation<\/a>, men are diagnosed 1\u00bd times more often than women. The disease hits Black people twice as often as other racial groups.<\/p>\n Most diagnoses happen in people 65 and older. Fewer than 1% of cases are in people younger than 35.<\/p>\n Main credits routine medical exams for catching cancer in the early stages.<\/p>\n \u201cI\u2019ve been getting a gamut of tests for years,\u201d he said. \u201cThe fact that my protein moved 1 point wasn\u2019t significant at all, but it caught my doctor\u2019s attention because it was a change.\u201d<\/p>\n Dr. Santhosh Sadashiv, an Allegheny Health Network oncologist and hematologist, said there is no identifiable cause for multiple myeloma. Researchers have suggested exposure to chemicals such as pesticides and Agent Orange, but theories have not been concretely proven.<\/p>\n \u201cThere are a few familial conditions that could make you high risk for developing myeloma, but the cause really remains elusive,\u201d Sadashiv said.<\/p>\n While some patients may be asymptomatic when diagnosed, most have bone pain or fractures, recurrent infections or worsening fatigue.<\/p>\n Physicians have grouped the most common clinical signs into an acronym, CRAB:<\/p>\n \u2022 Calcium elevation: Bone damage can release excess calcium into the bloodstream and can make people thirsty, nauseous or confused, and spur muscle or bone aches.<\/p>\n \u2022 Renal insufficiency: Excess abnormal proteins produced by the myeloma cancer cells can thwart a kidney\u2019s ability to filter blood. It can lead to renal failure, leg swelling, reduced urination and fatigue.<\/p>\n \u2022 Anemia: Abnormal plasma cells prevent healthy marrow cells from functioning and can cause anemia. This can cause symptoms such as weakness, fatigue, shortness of breath and dizziness.<\/p>\n \u2022 Bone disease: Myeloma can damage the bone and lead to pain, along with fractures from minor traumas.<\/p>\n \u201cPrevention is challenging since there\u2019s no identifiable cause, but if there\u2019s a strong family history, it\u2019s worth bringing it up with your physician,\u201d Sadashiv said.<\/p>\n He recommended people follow a healthy lifestyle of diet and exercise to \u201cpotentially prevent disease and also improve tolerance to treatment should one be diagnosed.\u201d<\/p>\n A national research project is underway to help identify precursor conditions and to try and prevent them from developing into cancer, Sadashiv said. The PROMISE Study<\/a> screens healthy people who could be at high risk for multiple myeloma with the goal of making it a preventable cancer.<\/p>\n The free study is available to eligible people online at enroll.promisestudy.org<\/a>.<\/p>\n Health experts also are looking to artificial intelligence as a tool to help determine which patients are most likely to benefit from specific therapies.<\/p>\n