YOUR HEALTH

DEAR DR. DONOHUE: My husband is 64 and has just learned that he has multiple myeloma. No treatment has been discussed as yet. We wonder what that might entail and would appreciate anything you can tell us to help us understand this illness. He complained of back pain for many months. Could the back pain have been a sign of myeloma? -J.T.

ANSWER: The "myel" in multiple myeloma indicates trouble in the bone marrow, the place where all blood cells are made. The "multiple" suggests that there are many marrow sites involved with this trouble, but that is not always true. Sometimes it is a single marrow site.

One blood cell suddenly begins producing astonishing numbers of selfreplications. It's like a copy machine that has gone wild. In the section

of bone where the marrow is acting up, bone loss occurs, and that can be quite painful. Your husband's back pain could have been an indication of multiple myeloma.

Myeloma accounts for about 1 percent of all cancers. It most often appears in a person's late 60s. It is twice as common in blacks as whites, and that's something that has never been explained. Nor has its cause.

Patients complain of bone pain. They also complain of enervating weariness. Myeloma cells are the kind of cells that, when normal, produce antibodies, the body's protective ammunition. Once these cells have become myeloma cells, they make abnormal antibodies, ones that are not protective. Infections, therefore, are common in myeloma patients.

Treatment of myeloma is age-dependent in some respects. For people younger than 70, large doses of chemotherapy are given to wipe out the marrow and all myeloma cells. Then, after an interval, the patients are given adult stem cells to reconstitute their marrow. This treatment is not the treatment for all myeloma patients. Conventional chemotherapy is the usual treatment.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475.