What causes multiple myeloma? Is it nature or nurture? According to Attaya Suvannasankha, MD of Indiana University, it's both.
This is good news, because it means there is something we can do to improve our outcomes.
At the April HealthTree for Multiple Myeloma Indianapolis Round Table, Dr. Suvannasankha likened genetics in our bodies to a music library of thousands of songs and a DJ who puts the songs together to make a beautiful playlist. But what happens if the DJ doesn't do his job?
For patients it can mean more than a piercing rock song interrupting a soothing stream of classical music. If the genetics DJ mixes things out of order or doesn't show up to put the playlist together, it can foster an environment where cancerous cells can develop and grow, throwing everything out of whack.
There are two components to genetic changes. The first are actual genetic changes that can happen to DNA, where the changes typically can't be reversed. The second type of genetic changes are called "epigenetics", or how the gene expresses itself, not changes to the gene itself.
Epigenetics are factors that can influence cells and can be reversible. Like two wheels on a bike, genetics and epigenetics work together to eliminate or allow genetic changes that can cause disease.
So what can influence epigenetic factors for us? Here are a few:
- Psychological state
- Social interactions
- Alternative medicine
- Therapeutic drugs
- Financial status
- Drugs or drug abuse
- Toxic chemicals
- Disease exposure
- Seasonal correlations
- Excessive stress
You may notice that many on this list are under our lifestyle choices that are under our control.
Environmental issues also play a role. Known exposures to the following have been linked to the development of multiple myeloma:
- Agent Orange
- Burn pits
- Camp Lejeune water
- Military occupational specialties (MOS) hazards
- Power plant leaks
- 911 World Trade Center exposure
It's not always a one-time heavy exposure that can cause epigenetic changes, but can be a longer-term low-dose exposure that changes things over time, which is harder to identify and study.
To further the study of epigenetics, Dr. Suvannasankha is creating an Indiana University multiple myeloma registry that is banking DNA to perform studies on this fascinating topic that could uncover causes of myeloma and invites patients to join (Indiana patients only). You can find that registry here.
Because epigenetic changes can be reversed, your exercise, good diet, social activity and healthy living choices are all good activities to make a profound difference on your myeloma and keep that DJ creating and running your playlist smoothly.
about the author
Myeloma survivor, patient advocate, wife, mom of 6. Believer that patients can help accelerate a cure by weighing in and participating in clinical research. Founder of HealthTree Foundation (formerly Myeloma Crowd).