Newly Diagnosed with Smoldering Multiple Myeloma: Watch & wait

Posted by lfevold @lfevold, Oct 22, 2020

Interested in connecting with others with the same diagnosis. Looking into dietary changes that could help.
I will introduce myself to the group. This will be long so sorry in advanced.

I was a Lab Tech for 15 years so of course we ran test samples on ourselves in training. I have always had an elevated ESR - I put that down to allergies. Jump ahead to 2013 I started to have GI issues plus a couple of cycles of Diverticulitis. Local doc ran a panel for Celiacs but the was negative but the IgA was 1533 mg/dl, no follow-up even though I asked. GI symptoms went away. 2019 started having issues with GI again plus a slightly decreased Hgb not bad but put me through colonoscopy and upper GI - nothing remarkable. Blood work the IgA was now 1960 mg/do. Total Iron was slightly decreased so just put me on over the counter Iron supplements. Fast forward to June 2020, gi issues (diarrhea for 6 weeks) - local doc ignored it. At that point I requested a referral to Mayo Clinic/Rochester. Through all of the testing for GI issues which nothing found remarkable, I asked about the IgA which they ran again, came back 2350 mg/dl. Also C Reactive Protein was elevated. They referred me to a Rheumatologist who ran all of the RA type testing but included the MGUS screening. I have an M Spike of 1.6 mg/dl. Low Lambda Light Chain but Kappa was right on the top end so the Kappa/Lambda Ragio is a little over 5.0. Also re ran the Immunology levels IgG low at 326, IgM low at 10 and IgA still at 2350. So the RA doc referred me to Hematology. They ordered Iron studies which are normal now, CT Skeletal no lesions seen, and Bone Marrow Biopsy - came back as Plasma Cell Myeloma with approx 20% plasma cells. Slightly hupocellular. Plasma Cell morphology abnormal large cells with large nucleoli and binucleation. Plasma Cells express: monotypic kappa light chains, CD38 & CD138. They do not express CD18 or CD45.

Final DX after meeting with specialist.
Smoldering Multiple Myeloma Subtype IgA Kappa Light Chain with an average risk of progression. 20% Plasma Cells, 1.6 M-Spike, 5 Kappa/Lambda ratio. On FISH I do have the 1q gain marker. At this point I am at a Watch & Wait with blood & physical exam every 3 months.

Interested in more discussions like this? Go to the Blood Cancers & Disorders Support Group.

cathy56 | @cathy56 | Dec 12, 2023

Heard back from oncology but they saw I have C40.22 and refer me to Ortho/Onc, one of specialist reviewed my records and told her to refer me to Hem/Onc?? for MGUS work up!
I am totally confused and this delay is not good !

barbdk | @barbdk | Dec 13, 2023

I haven’t read thru this whole thread, but in case it hasn’t been mentioned, there is an online support group for you, called Smolder Bolder. The co-leaders are Jessie Daw, a patient in South Dakota, and Teresa Miceli, a Mayo myeloma nurse who is also on the IMF Nurse Leadership Board. You can see their webpage at https://www.myeloma.org/smm.
I just returned from the American Society of Hematology annual meeting where there were quite a few sessions on MUGUS. I encourage you to check out our blogs from the meeting https://ash2023blogs.myeloma.org/.

cathy56 | @cathy56 | Dec 14, 2023

In reply to @barbdk "I haven’t read thru this whole thread, but in case it hasn’t been mentioned, there is..." + (show)

I feel this is medical gaslighting as I waited 2 days no call so I called oncologist and the person stated the oncologist told her “ she does not have cancer” then she said “ we are only seeing new patients and you have been here before” I was flabbergasted as the doctor obviously did not read thru the 43 pages my Radiation oncologist sent them all imaging , bone and marrow biopsies and reports that diagnosed C40.22 cancer Mets l lower limb and the incomplete bone biopsy 2020 that did not do flow cytometry to confirm what the findings: Atypical Lymphoid infiltrate suspicious B cell Non Hodgkin Lymphoma but suggest fresh biopsy w cytometry to confirm! Never called me,
I think the oncologist looked at the PET CT scan I had done 2 months ago which should of never been sent but it is a concern that he would not have looked thru every paper and ortho/onc should have dealt w this fibula !
I filed a complaint with patient experience but I feel that will not do me any good and after this insult to my character I do not care to see that hem/onc and ? If I can trust anyone at Mayo and like I stated I have always been nice friendly and open with these doctors but I can’t say that in how so many have judged me, even sent to shrink to rule out hypochondria!! And the shrink stated “ you are not a hypochondriac but you have a lot of medical stuff going on and the doctors are not listening to you !
Well I wonder why as my signs symptoms have been dismissed for years, bone scans misinterpreted as normal then changed to metastatic disease and I was happy to hear the truth behind those bone scans results as Dr Anderson told me “ they are often misread! “ it is no wonder cancer patients get diagnosed when they are metastatic and no treatment available!
Sick of this whole mess