Key takeaways

  • Black Americans are more likely to develop multiple myeloma and are often diagnosed at a younger age. The reasons are not fully understood but may involve biological and genetic factors.
  • MGUS, a noncancerous condition that can precede multiple myeloma, is 2 to 3 times more common in Black Americans and may help explain the increased risk.
  • When care is equitable, survival rates are similar. Differences in outcomes are often linked to delayed diagnosis and unequal access to specialists and newer treatments.

Multiple myeloma is a cancer of the plasma cells in the blood and bone marrow. It’s considered relatively uncommon, accounting for just under 2% of all cancers. However, Black Americans are more likely to develop multiple myeloma compared with white Americans. It’s also more common in men.

In addition to having a higher risk, Black Americans are also more likely to be diagnosed at a younger age than other races. While multiple myeloma is usually more likely to be diagnosed in people in their 70s, Black Americans are diagnosed, on average, 5 to 10 years earlier than most.

The exact reason isn’t fully understood. There are some theories, most of which appear to be related mainly to biology and genetics.

Before multiple myeloma develops, plasma cells can undergo certain changes that may ultimately lead to myeloma. These changes are more common in Black Americans.

There might also be environmental and social factors that delay diagnosis. However, these theories don’t completely explain the higher risk.

Monoclonal gammopathy of undetermined significance (MGUS) isn’t cancer. Instead, it’s a condition in which an abnormal protein is found in the blood.

MGUS usually doesn’t cause symptoms, and it doesn’t always cause health problems. However, in a small percentage of people, it can progress to multiple myeloma over time.

MGUS is about 2 to 3 times more common in Black Americans, which can help explain why multiple myeloma is also more common in this population.

It’s important to note that most people with MGUS never develop cancer. Still, knowing it’s there can allow healthcare teams to monitor for changes and detect progression to myeloma.

Multiple myeloma isn’t considered curable, but there are effective treatment options that can significantly extend survival.

When Black people with multiple myeloma are able to receive the same treatments and have similar access to getting these treatments as their white counterparts, their survival rates are generally about the same. This means that Black people should respond just as well to treatment when care is equitable.

However, differences in outcomes do occur. These are often linked to delays in diagnosis, decreased access to specialists, and limited availability of newer therapies for Black people with the condition.

Advanced multiple myeloma can lead to severe complications, such as kidney failure, bone fractures, and severely low blood counts. Detecting multiple myeloma early allows treatment to begin sooner, which may prevent some or all of these severe complications.

Symptoms, such as fatigue, bone pain, or weight loss, may be attributed to the natural aging process, which can delay diagnosis. For people with a higher risk of developing myeloma, prompt evaluation of their symptoms to find the cause may lead to an earlier diagnosis and more effective treatment outcomes.

No, the recommended treatments for multiple myeloma are the same for everyone, regardless of race or ethnicity. Black people will benefit from these therapies when they have access to appropriate care.

However, Black people have historically been less likely to receive the latest and most effective treatments. They’re also less likely to enroll in clinical trials, which can help advance and improve treatments for multiple myeloma.

There’s still a lot of work to be done to improve equity in the diagnosis of and the treatment and long-term outcomes for multiple myeloma in Black people.

Dr. Julie Scott is an oncology certified nurse practitioner. She practices clinically in a community medical clinic. Additionally, she serves as an adjunct faculty member in a master’s in nursing program at a local university.