Doctors and scientists have made great progress in treating multiple myeloma. They have helped people with the disease keep it under control and live longer, healthier lives. Despite this, the condition still affects some groups unequally. These populations face differences in care.

Multiple myeloma is a type of blood cancer. It occurs when white blood cells (plasma cells) accumulate in the bone marrow until they crowd out healthy cells. Because healthy plasma cells normally produce antibodies that attack germs, you are more exposed to infections.

Researchers have not closely studied multiple myeloma in Hispanics. In the first and largest review of this group, researchers found that Hispanics are more likely to have it. They tend to have a less severe form of myeloma than whites, but have a shorter life expectancy.

There is much more research on the impact of multiple myeloma on black people and it reflects some of the findings from the Hispanic community. Researchers have found that the disease is more common in people of African descent.

Black Americans are twice as likely to have the disease and die from it as white Americans. Like Hispanics, blacks also suffer from multiple myeloma at a younger average age (66 years) and have a less severe form of the condition.

There are many possible reasons for racial and ethnic differences in multiple myeloma. Scientists are looking at genes, family health and whether parents can pass the disease to their children. At this time, there is not much evidence to show that these are the main causes of these differences.

Researchers are also studying the role of a different but related condition. Monoclonal gammopathy of undetermined significance, or MGUS (pronounced “EM-guss”), is a noncancerous condition. But it could be a sign of multiple myeloma. Anyone who has ever had active myeloma has also had MGUS. And if you’re black, research shows you’re twice as likely to get it as someone white.

But the reasons for these differences go beyond biological causes. Experts say racial and ethnic differences in multiple myeloma come down to access to equitable health care.

Although multiple myeloma is more common in black and Hispanic people and causes more deaths, “if you treat the groups equally, the result is the same,” says Yvonne Efebera, MD, director of the Cellular Therapy and Blood Transplant Program and OhioHealth Marrow in Columbus, Ohio.

There is no cure for multiple myeloma, but with proper treatment, 70% of people with the disease live 10 years or more, compared to 20% to 30% in the early 2000s. This includes access to things like health insurance, cancer drugs, clinical trials, and specialists.

“Equal access to health care and reducing that gap is huge,” explains Efebera. She says uninsured people often put off treatment “until they are in too much pain and can no longer continue.” “Then they end up in the emergency room.”

A 2013 study also found that newly diagnosed white people with private insurance have more access to new treatments than people of color who use government-funded health programs Medicaid and Medicare.

A separate study echoed these results, showing that white people with more resources, such as money and education, benefit more from the new treatments. As a result, they live longer.

In recent years, the treatment of multiple myeloma has advanced significantly. While this means more treatment options, not everyone may receive them equally.

Stem cell transplant is a standard treatment for multiple myeloma. Doctors replace diseased bone marrow with healthy bone marrow using stem cells taken from the blood. Thanks to this type of treatment, many people who suffer from the disease live longer.

Unfortunately, there are disparities in who receives stem cell transplants. Hispanics have the lowest transplant rates, between 8% and 17%. Black people with multiple myeloma are 40% to 50% less likely to receive stem cell transplants than white people. Studies show that doctors delay referring black people with multiple myeloma for stem cell transplants by more than a year.

Efebera has investigated stem cell transplants in multiple myeloma. She says that when underserved communities with this condition receive stem cell transplants, “there is no difference” in their survival and remission rates.

He wants to see racial barriers to stem cell transplants broken down and encourages doctors to set aside prejudices and refer all qualified patients to transplant centers. “Treat the patient as you would treat his own family (his sister, brother, mother, father) and give them the best option available.”

Clinical trials help researchers determine whether new or existing treatments are safe and work well. The people who volunteer for them are a critical part of this process.

Certain groups, such as racial minorities, are often underrepresented in multiple myeloma clinical research. One study looked at enrollment in clinical trials for studies on the disease over two decades. The researchers found that only 18% of people who participated in the studies were black, Hispanic or other non-white races.

Racial minorities are also less likely to join studies that look at the response of genes to drugs, a field of research called pharmacogenomics. These studies can tell researchers whether a drug works the same way in different groups.

Underrepresented minorities may not learn about clinical trials from their doctor or other sources. Cultural, geographic or financial barriers also affect who participates in them. Other obstacles include a lack of diversity in clinical trial investigators and in cancer treatment in general.

This is something Efebera says the healthcare community should work to change. “Patients (African American, Hispanic or Asian) feel comfortable when they have someone who looks like them. “They smile more, they are happy and they continue their treatment.”