HOME > Doctor’s Health Advice > Multiple myeloma 1

  • Doctor’s Health Advice
  • Yuzo Endo, M.D., Ph.D.
  • Masahito Hitosugi, M.D., Ph.D.
  • John E. Lewis, Ph.D.

Doctor’s Health Advice

Doctor’s Health Advice

Pathologist’s advice on how to combat cancer


Multiple myeloma 1

The main objective of my essay series was to explain how adult cancer as lifestyle-related diseases develops, and to suggest strategies for its prevention, diagnosis and treatment. I have already covered each topic, and was intended to end this series. However, quickly responding to requests from users of this website, I would like here to talk about multiple myeloma as the first of my additional essays.

Blood cancer-leukemia

This blood cancer is in short a cancer of a special kind of blood cell group, namely plasma cell. This disease doesn’t belong to lifestyle-related diseases, unlike other cancers I have covered in the previous essays. It belongs to almost the same category as leukemia, blood cancer of individual blood cell itself. In this type of cancer, cancer cells proliferate in the bone marrow just the same as leukemia. However, malignant cells of multiple myeloma in almost cases grow in forming multiple foci in the bone marrow without drifting in the peripheral blood, like usual leukemia. This cancer cell proliferates in any area of the marrow, creates tumor, and destroys bone tissue, which is detected by X-ray examination of the bone as “punched-out lesion”.

The name of this disease expresses its characteristics. “Multiple” means “innumerable scattered foci”, and “myeloma” means “a destructive tumor focus in the marrow”. Another characteristic of this disease is producing the special protein called M-protein, namely monoclonal immunoglobulin. It increases in the blood and can be detected by immunoelectrophoresis and used as the tumor marker of this disease in diagnosis and efficacy of treatment by anti-cancer drugs.

Blood cells

Before explaining this disease, I would like to give a brief description on relationship between peripheral blood and bone marrow (hematopoiesis).

So-called natural healing power is maintained by blood cells produced in the marrow. If those cells grow in the marrow and drifting everywhere in the body throughout blood as well as lymph circulation, it means that the body is under the healthy conditions. Each blood cell drifts individually in the blood and only white blood cells could move out through the peripheral capillary wall into the extravascular tissue, and function independently. And then lymphocytes are evacuated into the lymph circulation, which is then pouring into the venous blood. Those cells are categorized to the only unicellular group in the body and can move throughout the body as an organized surveillance patrol.

Functions of heart pumping enable blood to circulate throughout the body in less than one minute. This is an amazing speed, and blood circulation is an excellent system with minimal friction factor. Blood cells as well as plasma are conveyed in the vessels throughout our body, and play their own role. Among those cells, erythrocytes are drifting and conveying oxygen in terms of oxygenated hemoglobin as well as CO2.

On the other hand, leukocytes are composed of three kinds of granulocytes and lymphocytes as well as monocytes. They are playing various roles. Leukocytes in general can go out and back to blood capillary.

Immune cells

Immune cells can go out of the blood vessels in the lymph apparatus, such as lymph follicles, tonsils and Peyer’s patches and perform various functions, and they are gathered to lymph vessels. Two main lymph vessels are finally gathered to the cervical veins of both sides and come back to blood, and then recirculate throughout the body.

Like this, blood cell can uniquely move as a unicellular. This unicellular system is regarded as primitive cell system, evolutionally speaking.

On the contrary, other cell types in the body are destined to be attached. They are connected with each other and fixed, then functioning while helping each other.

Hematopoietic cells for natural healing power

Bone marrow which plays the central roll to maintain natural healing power is protected in the center of the bone, because it is irreplaceable for human life. Blood cells are produced in the bone marrow of the whole body in young people. As we get older, production of blood cells in the bones of legs and arms is ceased, and it becomes limited only at the trunk of the body. It gives an impression that human beings are designed to survive only with trunk of the body, the most important part of the body, even after losing arms or legs. This is a real aging process.

Most hematopoietic cells are produced every moment and die one after another, that is reform phenomenon. They are always in need of daily nutrition supply. Phospholipid at the cell membrane and various kinds of proteins at cytoplasm, and DNA-related substances at the cell nucleus must be continuously supplied from the food stuffs. You can imagine quite easily how important it is what you eat every day. If one has nutritionally- poor diets, it would be reflected in the conditions of the blood afterward. Contents of blood cells, proteins in blood plasma and fats change to reflect it, which influences natural healing power. Cell turnover occurs so speedily and new cells must proliferate one after another quickly. DNA replication is required for cell growth, which means copy is always produced. During DNA replication, cells are almost undefended, and easily influenced by radiation or anticancer-drugs. Therefore, those treatments severely damage natural healing power.

Pluripotent stem cells in the bone marrow

Blood cells of various functions are protecting our bodies, and those cells are surprisingly originated from only one kind of stem cell. This stem cell has the possibility not only to proliferate until huge number of cells, but also to develop from immature stage to the mature stage of the cells in terms of various differentiation stages, such as most of them changing into erythrocytes, and some others to leukocytes or to the cells producing platelets, respectively. In usual blood, 70% of leukocytes consists of neutrophiles. Neutrophile leukocytes function to survey throughout the body with active oxygen radicals so that can sterilize bacteria and as well attack own cells or tissues, then to die for a short life. Therefore, those cells attack not only bacteria and virus, but also our own cells indiscriminately. The clot of dead neutrophile leukocytes is called as pus. In general in acute inflammation, neutrophile leukocytes play a main quick role and contribute to rapid reaction either to recovery or to death. This consequence is the physiological circumstances. When the immature blood cells drop out the consequences of any blood differentiation, these cells are called as neoplastic cells, or leukemic cells.

On the other hand, mature types of lymphocytes and macrophages in leukocyte group play major roles in maintaining harmony or balance of immune systems, also contribute to protection of the body so that the process must be cured completely. Lymphocytes are composed of T lymphocytes and B lymphocytes. Macrophages and T lymphocytes play a major role in supporting cellular immune system. On the hand, macrophages and B lymphocytes as well as plasma cells, the most mature cell type of B lymphocytes, play a major role in humoral immune system in terms of antibody production to protect against any kind of non-self substances. Those cells are also important in natural healing power to control immune reactions or inflammation in terms of keeping balance of the immune system.

Lymphocytes and macrophages as well can drop out of the physiological consequence leading to leukemic state. For instances, malignant lymphoma of the B lymphocyte series or T lymphocyte series are observed in patients with those diseases. Mature type of B lymphocytes are called plasma cell and this type of the B lymphocytes can drop out of the physiological consequence leading to multiple myeloma with monoclonal production of specific antibody molecule against a certain angiten, namely monoclonal immunoglobulin as mentioned above.

In the next essay I would like talk about plasma cells and its malignancy (multiple myeloma).


Yuzo Endo, M.D., Ph.D.

Yuzo Endo, M.D., Ph.D.
Hamamatsu University School of Medicine

1969.9: Graduated from Medical School, University of Tokyo Consultant pathologist in Hamamatsu University, Medical School, and Fujimoto General Hospital. Medical Consultant in conventional and integrative medicine.

Back number