Multiple Myeloma

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How Race Affects Blood Cancer Risk

Dr. Adrienne Phillips Weill Cornell Medicine

Why Black Americans Get Some Blood Cancers More Often Than White Americans

  • Overall, blood cancers are less common among African Americans
  • But certain types, including multiple myeloma, are more prevalent among this group of people
  • Genes and environmental exposures might contribute to the increased risk

When it comes to both getting cancer and surviving it, huge racial disparities exist in the United States. Black men have the highest cancer incidence of any racial group, and black people have the shortest survival time once they are diagnosed with cancer, according to the American Cancer Society.

The disparities also extend to certain types of blood cancer. “Overall, blood cancers tend to be less common among African-American populations, but distinctly, multiple myeloma is the one blood cancer that’s seen at two times as high a rate in African Americans compared to other ethnicities,” Dr. Adrienne Phillips, medical oncologist at Weill Cornell Medicine, tells SurvivorNet.

Certain types of non-Hodgkin lymphomas, including T-cell lymphomas, are also more common among African-American populations, she adds. For example, cutaneous T-cell lymphoma, which affects the skin, is more likely to be diagnosed in African Americans than in Caucasians.

How Race Affects Blood Cancer Risk

One out of every five people who are diagnosed with multiple myeloma is African American, which is out of proportion to the overall population numbers. People of color are also more likely to be diagnosed with this cancer at a younger age.

Why are African Americans at higher risk for some blood cancers? “We’re not exactly sure,” Dr. Phillips says. “It’s probably multifactorial — a combination of genetic risks and environmental exposures.”

One possibility is genes that are passed down from generation to generation of African-American families that make them more susceptible to getting blood cancers. Certain genetic defects — for example, a swap in the chromosomes called a translocation — are found more often in African Americans with myeloma than in other racial groups.

There is also some evidence that exposures — for example to radiation in the workplace — might increase blood cancer risk. Exposure to certain viruses might also be involved. “There’s one virus called HTLV-1 or human T-lymphotropic virus type one, that seems to be more common in Caribbean populations,” Dr. Phillips says. “That’s one reason that we see a certain subtype of T-cell lymphoma called adult T-cell leukemia/lymphoma more commonly in African-American patients, and Caribbean-American patients specifically.”

Research is under way to identify which exact genes and environmental exposures might make African-American people more susceptible to cancer, she adds.

Disparities in Care

A lack of awareness also contributes to racial disparities in blood cancers such as multiple myeloma. Many people in African-American communities, and even their doctors, don’t realize that this disease is a threat. So when they show symptoms, they don’t get tested and diagnosed soon enough to have good outcomes.

Access to health care, and health insurance to cover the cost of cancer tests and treatments, is another problem in minority populations. Only around half of African Americans under age 65, and less than one-third over age 65, have private health insurance.

A lack of access and insurance are why, even though blood cancer survival rates have improved overall, they haven’t progressed among African Americans. The good news is that, with timely care and treatment, African Americans can have the same positive treatment results as people of other races.

No matter what your race, it’s important to be aware of your cancer risks and discuss them with your doctor. Also be vigilant for symptoms of myeloma and other blood cancers, which can include:

  • Weakness
  • Fatigue
  • Shortness of breath
  • Swollen glands
  • Rash-like skin changes
  • Fevers
  • Weight loss
  • Bone pain or unexplained fractures

Report any new or unusual symptoms to your doctor. If you don’t get a comprehensive exam and an answer for your symptoms from the first doctor you see, ask for a second opinion from another provider.


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Dr. Adrienne Phillips is an associate professor of clinical medicine at Weill Cornell Medical College and associate attending physician at the New York-Presbyterian Hospital. Read More