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Corel Medical Series: Cancer
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c28.dxr
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00080_Field_SRC.c28.A.10.txt
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determining the viscosity (thickness) of the serum is necessary. Measuring of the M-protein in the serum and
urine is a good way to determine whether the disease is getting worse or is responding to chemotherapy . The
level of the M-protein is a direct measure of the tumor mass.
• A 24-hour urine specimen is essential. The total protein is determined and electrophoresis is performed,
making it possible to measure the amount of monoclonal light chain (of kappa or lambda origin). This is called
Bence Jones protein and should be detected by immunologic techniques.
• Bone marrow examination is essential for diagnosis, allowing the physician to determine the number of plasma
cells (myeloma cells) in the marrow and their appearance. It also provides a measure of normal red cell, white
cell and platelet production.
Imaging
• X-rays of the skull, the entire spine, pelvis, upper legs and upper arms are necessary to detect lytic lesions,
bone thinning (osteoporosis) or fractures. Skeletal abnormalities occur in 75 percent of patients at diagnosis.
• Bone scans with technetium-99 can be done but are not as effective as conventional x-rays for detecting lesions
and are not recommended.
• CT or MRI scans may be helpful when the patient has skeletal pain and negative x-rays.