Dr Fenella Willis
Consultant Haematologist, St Georges Hospital London
New initiatives aim to increase early diagnosis of myeloma, the little-known blood cancer that claims too many lives.
Myeloma is a cancer that lies low. Early symptoms are vague and myeloma has one of the highest rates of delay in diagnosis.[LF1] Around a third of cases are diagnosed in A&E – one of the highest rates across all cancer types, and 30 per cent of those diagnosed as an emergency die within three months.
“Myeloma is an incurable but treatable blood cancer originating in the bone marrow. It presents GPs with a challenge,” says Dr Fenella Willis, Consultant Haematologist at St Georges Hospital London.
“It is relatively rare; only about 5,500 new cases are diagnosed annually. GPs may go years between seeing cases and the early symptoms are non-specific. Symptoms include pain (often in the back), fatigue and recurrent infections.[LF2] [KJ3]
“Over half of myeloma patients visit their GP at least three times before diagnosis and one in five sees their GP five or more times before referral to a haematology consultant. Delayed diagnosis is associated with increased risk of complications such as bone disease and kidney failure.”
Yet, improved drugs – some with average response rates of over 80 per cent – and the use of stem cell transplantion, mean that many patients now have greatly improved prospects, provided they are diagnosed in a timely way and are fit enough to undergo such treatments.
Willis says: “20 years ago, three years was a positive outcome for a newly-diagnosed myeloma patient. Today over a third can expect to live for 10 years or more, with longer disease-free intervals. Earlier diagnosis can save lives so the aim now is to raise awareness so more cases are diagnosed earlier.”
Myeloma UK, has developed a new Myeloma Diagnosis Pathway: a tool to help primary healthcare professionals spot and act on suspicious symptoms.
To help achieve this, the charity, Myeloma UK, has developed a new Myeloma Diagnosis Pathway: a tool to help primary healthcare professionals spot and act on suspicious symptoms.
“Once GPs suspect myeloma, they can use the national cancer diagnosis referral, so patients must be seen by a consultant haematologist within two weeks and, if diagnosed, start treatment within 62 days,” says Willis.
Myeloma UK has also set up a Myeloma Early Diagnosis Working Group, bringing together haematologists, immunologists, primary care researchers and GPs to identify the issues that lead to delayed diagnosis and define potential solutions and actions.
“We are looking at all aspects of the Myeloma Diagnosis Pathway, including improving communication between GPs, laboratories and consultant haematologists” says Willis.
This year’s Myeloma Awareness Week, from 21-27 June, includes activities to highlight the importance of timely diagnosis and enhanced awareness.
There are signs that things are improving already. “The percentage of cases diagnosed in A&E is falling and early diagnosis rates are rising,” she says. “There is still work to do, but we are already seeing significant improvements.”
For more information about the Myeloma Diagnosis Pathway visit www.myeloma-academy.org.uk/mdp
