Key Takeaways
- Multiple myeloma is a rare cancer of plasma cells. Black people face a much higher risk of multiple myeloma compared to white people, with genetics and social factors like healthcare access, income, education, and exposure to environmental toxins contributing to these outcomes.
- Black people are almost twice as likely to die from multiple myeloma. Misdiagnosis, delayed treatment, limited access to advanced therapies, and underrepresentation in clinical trials are major healthcare barriers that worsen their outcomes.
- Improving outcomes for Black people with multiple myeloma requires recognizing symptoms early, ensuring equal diagnosis and treatment access, and increasing participation in clinical trials to develop more equitable and effective interventions.
Multiple myeloma is a rare type of cancer that affects plasma cells. Plasma cells are a specific type of white blood cells that are formed in bone marrow.
In multiple myeloma, cancerous plasma cells produce an antibody called monoclonal immunoglobulin (or monoclonal protein). This antibody can damage cells of the bones, blood, and other organs, leading to serious health complications.
Although multiple myeloma is rare, in the United States, Black people are much more likely to develop the condition than white people, according to the
In fact, in 2016 alone, the number of new cases of multiple myeloma in Black Americans was more than double the number of new cases in white Americans.
Below, we’ll explore what the research says about the racial imbalance of multiple myeloma, including how we can help improve the diagnosis and treatment of multiple myeloma for Black Americans.
Multiple myeloma disproportionally affects Black people more than any other racial or ethnic group, according to statistics from the
Below, you’ll find a comparison of the number of new cases (per 100,000 people) of multiple myeloma among various racial and ethnic groups in pooled data from 2018 to 2022:
| Race and ethnicity | Males (per 100,000) | Females (per 100,000) |
|---|---|---|
| white | 8.2 | 5.1 |
| Black | 17.2 | 13.2 |
| Asian/Pacific Islander | 5.0 | 3.4 |
| American Indian/Alaska Native | 8.5 | 5.9 |
| Hispanic | 8.1 | 5.9 |
But why does this condition affect Black people more than other groups?
Researchers in a 2020 meta-analysis review investigated the role of genetic differences in the risk of multiple myeloma. They found that certain genetic components may play a large role in myeloma risk.
According to researchers, there are certain high risk gene variants that may place people of African descent at a higher risk of developing multiple myeloma.
For example, researchers found that people in the highest genetic risk category (the top 10%) had an 80% increased risk of developing multiple myeloma than those in lower genetic risk categories.
In a
According to study researchers, people with more African ancestry who had multiple myeloma were more likely to have those specific genetic abnormalities than those with the lowest African ancestry.
Genetics only plays one part in the development of cancers like multiple myeloma. Other
Many of these factors — which disproportionately affect Black people and other marginalized groups in the United States — can potentially have an effect on the development of cancers like multiple myeloma.
According to
A
Misdiagnoses and late diagnoses
Misdiagnoses and late diagnoses for conditions like multiple myeloma are more common in populations that lack access to proper medical treatment, according to the
Not receiving an early diagnosis — or even a diagnosis at all — can lead to late-stage diagnoses that are much harder to treat effectively.
Barriers to accessing healthcare
Many people in the United States face barriers to accessing healthcare services, which can lead to fewer opportunities for prevention, diagnosis, and treatment.
Some of these
- lack of income or proper transportation
- inadequate health education
- no health insurance
- little or no paid medical leave from work
Lack of access to novel treatments
When people with multiple myeloma don’t have access to the most effective treatment options, it can significantly lower their chances of remission.
Researchers in one
Underrepresentation in clinical trials
According to medical literature, while Black people encompass 14% of the U.S. population, they only represent a small percentage of clinical trial participants, and sometimes as low as 4.5% of participants in multiple myeloma trials.
A lack of representation in these trials can negatively affect the treatment outcomes of Black people with multiple myeloma.
The standard of care affects your outcome
Research suggests that providing equal access to treatment can not only equalize multiple myeloma survival rates between Black and white people but also improve survival rates for Black people to a significant degree.
In a
When equal treatment was provided to both groups, younger Black people (below age 65) had equal or higher survival rates than any of their white counterparts.
According to the
People who do have symptoms may notice:
- bone pain, often in the back, hips, or skull
- weakness in the bones, sometimes resulting in fractures
- low red blood cell count, which can cause anemia
- low white blood cell count, which can cause increased infections
- low blood platelets, which can cause problems with blood clotting
- high blood calcium levels and hypercalcemia symptoms
- severe pain in the back from pressure on the spinal cord
- numbness and muscle weakness, especially in the legs
- pins and needles in the fingers, toes, or extremities
- confusion, dizziness, or stroke-like symptoms, from thick blood
- symptoms of kidney damage, like weakness, itching, or swollen legs
Recognizing symptoms and receiving treatment early is important
Because many of the symptoms of multiple myeloma can also be associated with other conditions, getting a diagnosis can be difficult. However, just like any other type of cancer, early diagnosis and treatment are important.
A stem cell transplant is the standard treatment, as it gives people the best chance of controlling the cancer for the longest time.
And researchers in a 2021 review suggest that early diagnosis and treatment of multiple myeloma — especially the precancerous smoldering type — are essential for both preventing myeloma and improving remission rates.
If you think you may have symptoms, ask a doctor for the following diagnostic tests
If you’re concerned you may have symptoms of multiple myeloma, ask a doctor or other healthcare professional for a closer look with
- Labs: Blood tests, such as the serum protein electrophoresis (SPEP) test, can check for antibodies that are commonly associated with multiple myeloma. Standard blood tests, such as a complete blood count (CBC), can also be used to check for changes in your blood, bones, and other organs that multiple myeloma can cause.
- Imaging: CT scans, MRIs, and X-rays can all detect changes in your bones that might be the result of multiple myeloma. Imaging tests also help doctors identify any changes to your organs that can happen because of multiple myeloma.
- Biopsy: Biopsies play a major role in diagnosing multiple myeloma, especially a bone marrow biopsy. By taking a bone marrow sample, a doctor can check for myeloma cells. They can also analyze those cells to help determine your outlook if cancer is present.
Multiple myeloma resources
Whether you’ve already received a diagnosis of multiple myeloma or are looking for resources for a loved one with the condition, here are some resources to get you started:
- The Leukemia & Lymphoma Society’s Clinical Trial Support Center can help you find multiple myeloma clinical trials.
- The Multiple Myeloma Research Foundation has a support group finder to help you find support groups in your area.
- The American Cancer Society has a
resource finder that helps you find treatment-related resources in your area. - The International Myeloma Foundation has a full page of online resources for finding financial, legal, and other types of support.
Consider participating in clinical trials
If you’ve received a multiple myeloma diagnosis and are interested in exploring your treatment options, consider participating in clinical trials.
More Black representation in clinical trials that explore genetic components or new treatments can help improve the early diagnosis and treatment of multiple myeloma for Black Americans.
According to the American Cancer Society, preventing multiple myeloma can be difficult because most of the risk comes from things that are hard to avoid or change, like genetics. But interventions like genetic screening can help you better understand your individual risk.
There are no screening tests for multiple myeloma, but routine visits with a primary care doctor may detect early signs before the disease causes symptoms.
If you or your doctor suspect that you have multiple myeloma, blood work and imaging are the next steps toward diagnosis.
Most cases of multiple myeloma are treated with surgery, chemotherapy, radiation, or a combination of these approaches.
In some cases, depending on your overall health status, your doctor might recommend a stem cell transplant. This may help you stay in remission from multiple myeloma for longer.