Multiple myeloma, rare blood cancer: Bruce Springsteen's wife's diagnosis spotlights the illness

Patti Scialfa, Bruce Springsteen’s wife and a member of the E Street Band, recently shared that she was diagnosed in 2018 with a type of blood cancer called multiple myeloma.

She revealed her illness in the documentary "Road Diary: Bruce Springsteen and the E Street Band," which premiered at the Toronto Film Festival on Sept. 8. 

The production gives a behind-the-scenes look at the famed musician and the long-standing band during their latest tour.

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"This affects my immune system, so I have to be careful what I choose to do and where I choose to go," Scialfa, 71, said in the film when discussing her illness.

"Every once in a while, I come to a show or two and I can sing a few songs on stage, and that’s been a treat," she continued. 

Scialfa joined the E Street Band right before the 1984 "Born in the U.S.A." tour. She later married Springsteen in 1991 and was inducted into the Rock and Roll Hall of Fame in 2014.

Fox News Digital reached out to Scialfa for comment.

What is multiple myeloma?

Multiple myeloma, a cancer of the cells in the bone marrow, is diagnosed in more than 35,000 people in the U.S. each year, according to the American Cancer Society.

Plasma cells grow in the bone marrow, which has been described as a "factory" of blood. 

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In a healthy person, the cells produce proteins called antibodies that are directed against germs to fight infection, according to Dr. Cristina Gasparetto, a hematologic oncologist and professor of medicine at Duke University School of Medicine.

Multiple myeloma occurs when plasma cells grow "out of control," the ACS states.

That causes abnormal antibodies to be secreted in the blood, which can damage the bones and other organs.

"[The disease] is called ‘multiple’ because there are frequently multiple patches or areas in the bone where it grows," Dr. Joseph Mikhael, chief medical officer of the International Myeloma Foundation in California, told Fox News Digital.

Symptoms of the disease

"Most of the signs and symptoms of myeloma are rather general, with the top three being excessive fatigue, bone pain and anemia," Mikhael said.

Some patients, however, may not have any symptoms when they are diagnosed.

The most common symptoms can be summed up in the acronym "CRAB," which stands for high calcium levels in the blood, renal (or kidney) insufficiency, anemia and bone destruction, experts say.

Bone pain is the hallmark of the disease, as the myeloma cells grow within the bone, which may lead to elevated levels of calcium in the blood, Gasparetto told Fox News Digital.

"Symptoms of having high calcium include increased thirst, dehydration, fatigue, muscle pain and sometimes confusion," she added.

The antibodies produced by the myeloma cells are eliminated through the kidneys, which can cause obstruction and/or direct damage to the organs.

"The patient will notice some foamy urine, due to the presence of an abundant amount of an [abnormal] protein called Bence-Jones proteinuria," Gasparetto said.

Methods of diagnosis

The first step is typically to administer specific blood and urine tests, which reveal abnormally high protein levels excreted by the tumor cells – often referred to as an "M spike," experts told Fox News Digital.

"We measure this protein at the time of diagnosis, during therapy to assess response, and thereafter to monitor progression or relapse," Gasparetto said.

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Bone pain may also prompt imaging, which would reveal any skeletal abnormalities.

The initial results are then confirmed with a bone aspiration and biopsy.

"With the bone marrow aspiration, we remove a small amount of fluid from the bone marrow, and with the bone marrow biopsy, we remove a small piece of bone," Gasparetto said.

A pathologist then analyzes the sample to determine the severity of the disease.

The final diagnosis is based on a combination of all these tests — blood work, bone marrow aspiration and biopsy, imaging studies and urinalysis, experts told Fox News Digital.

Risk factors for the disease

Myeloma does not typically run in families, but there is a slightly increased incidence when a family member has the disease, Mikhael told Fox News Digital.

Many cases may be due to random genetic changes that occur later in life, experts say.

"For the vast majority of cases, we do not know the cause of myeloma," Mikhael said. "It is more common as we age, with the average age of diagnosis approximately 69."

African-American and Latino American patients are diagnosed at a younger age, on average at around 64 or 65.

Individuals of African descent are twice as likely to have myeloma, statistics show.

Firefighters who have been exposed to fires are more at risk, and other types of chemical exposures are also connected to myeloma, including Agent Orange and excessive radiation, Mikhael noted.

There may also be a greater risk for people who have a higher increased body mass index, as well as in people who have certain blood conditions, such as monoclonal gammopathy of undetermined significance (MGUS), which involves an abnormal protein in the blood without the organ damage caused by multiple myeloma.

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In most cases, multiple myeloma cannot be prevented, according to Dr. Mikkael Sekeres, chief of the division of hematology of Sylvester Cancer Center at the University of Miami.

Treatment options

The American Cancer Society recommends that myeloma patients see an oncologist for a personalized treatment plan based on their age, overall health and severity of the disease.

Some therapies may include monoclonal antibodies and drugs called immune modulating agents, which boost the immune system to help the body fight cancer.

"Multiple myeloma can [also] be treated with chemotherapy — up to three or four drug regimens for a few months, followed by maintenance therapy," Sekeres told Fox News Digital.

Eligible patients may pursue a bone marrow (stem cell) transplant, which can lead to prolonged remissions, the doctor added.

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The cancer is not cured with conventional therapy, but most patients respond well to treatment, according to Mikhael.