Here is another disease that disproportionately affects African Americans. Mother Gilkey, Annie Works, and Augusta Gooch are just three in our community lost to Multiple Myeloma, the second most prevalent blood cancer after non-Hodgkin’s lymphoma. It represents approximately 1% of all cancers in White U.S. residents and 2% of cancers in Black residents. Among African Americans, myeloma is one of the leading causes of cancer death.
Myeloma typically occurs in bone marrow. The disease affects plasma cells, cells that produce immunogobulins (antibodies) that help fight infection and disease. In multiple myeloma, normal plasma cells transform into malignant myeloma cells and produce large quantities of an abnormal immunoglobulin called monoclonal (M) protein.
The malignant cells crowd out and inhibit the production of normal blood cells and antibodies in the bone marrow. In addition, groups of myeloma cells cause other cells in the bone marrow to remove the solid part of the bone and cause soft spots in the bone. These soft spots, also called osteolytic lesions, and other signs of bone loss are common with myeloma, although they do not occur in all cases.
The average age at diagnosis is 69 years for men and 71 years for women, and only 4% of cases are diagnosed in individuals under the age of 45, however recent statistics indicate both increasing incidence and earlier age of onset.
To date, no cause for myeloma has been identified. However, the search for a cause has suggested possible associations between myeloma and a decline in the immune system, genetic factors, certain occupations, certain viruses, exposure to certain chemicals including Agent Orange, and exposure to radiation.
Age is the most significant risk factor for multiple myeloma, with 96% of cases diagnosed in people over the age of 45, and more than 60% occuring in people over the age of 65. Because the peak age for multiple myeloma is among the elderly it is thought that susceptibility may increase with the aging process and the consequent reduction in immunity to the evolving cancer, or that myeloma may result from a lifelong accumulation of toxins in the body.
The higher incidence of myeloma in African Americans and the much less frequent occurrence in Asians suggest genetic factors.