Date of Award
Spring 2022
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Lisa Murphy
Abstract
Multiple myeloma (MM) is a hematological malignancy arising from differentiated B-lymphocyte white blood cells called plasma cells. Hematological malignancies are the fourth most diagnosed cancers, composing approximately 9% of all cancer diagnoses. Specifically, multiple myeloma attributes to approximately 2% of cancer diagnoses in the United States2. MM incidence has increased significantly over the past years, increasing 40% in the United States and 126% globally from 1990-2016 2. Affecting 7.0 out of every 100,000 people2, multiple myeloma is considered a rare form of blood cancer. Many strides have been made in the treatment of multiple myeloma patients. The five-year survival rate for multiple myeloma in 1998 was a grim 34.6%3. In 2016, the 5-year survival rate was estimated at 53.9% 3 due to the innovation of new pharmacotherapies including immunomodulatory agents and proteasome inhibitors. Despite these large advances, multiple myeloma remains difficult to diagnose in its early stages. The classical signs and symptoms of multiple myeloma do not reveal themselves until end organ damage processes have commenced. Symptoms of multiple myeloma can be ambiguous and easily attributed to other comorbidities. In this article, the ambiguous presentation and diagnosis of MM will be reviewed with focus to encourage providers to retain a clinical index of suspicion. Additionally, methods to investigate high risk patients in a primary care setting will also be investigated.
Recommended Citation
Schweidler, Anna, "Detecting Multiple Myeloma in the Primary Care Setting" (2022). Capstone Showcase. 82.
https://scholarworks.arcadia.edu/showcase/2022/pa/82
Detecting Multiple Myeloma in the Primary Care Setting
Multiple myeloma (MM) is a hematological malignancy arising from differentiated B-lymphocyte white blood cells called plasma cells. Hematological malignancies are the fourth most diagnosed cancers, composing approximately 9% of all cancer diagnoses. Specifically, multiple myeloma attributes to approximately 2% of cancer diagnoses in the United States2. MM incidence has increased significantly over the past years, increasing 40% in the United States and 126% globally from 1990-2016 2. Affecting 7.0 out of every 100,000 people2, multiple myeloma is considered a rare form of blood cancer. Many strides have been made in the treatment of multiple myeloma patients. The five-year survival rate for multiple myeloma in 1998 was a grim 34.6%3. In 2016, the 5-year survival rate was estimated at 53.9% 3 due to the innovation of new pharmacotherapies including immunomodulatory agents and proteasome inhibitors. Despite these large advances, multiple myeloma remains difficult to diagnose in its early stages. The classical signs and symptoms of multiple myeloma do not reveal themselves until end organ damage processes have commenced. Symptoms of multiple myeloma can be ambiguous and easily attributed to other comorbidities. In this article, the ambiguous presentation and diagnosis of MM will be reviewed with focus to encourage providers to retain a clinical index of suspicion. Additionally, methods to investigate high risk patients in a primary care setting will also be investigated.