“…there exists no evidence to suggest that early intervention in Soldering Multiple Myeloma, even when limited to patients at highest risk of progression to active MM, leads to improved overall survival.”
The subject line should read “Delay Conventional Treatment Until Progression.” I say this because the article linked below, while it makes several excellent points, is referring to FDA approved, conventional therapies. More importantly, the sooner you expose your pre-MM or full-blown MM the sooner you will develop “multidrug resistance” aka MDR. Please don’t take my word for it, as your oncologist this question.
Further, the article linked and excerpted below explains that while some SMM patients might be considered high-risk, they might not develop frank MM for years. Speaking as a person who has lived with MM since my diagnosis in early 1994, the main goal for MMers is to manage their MM for as long as possible. All MMers relapse eventually. I work to remain in CR but I fully understand that my MM can relapse any time.
And last but not least, chemotherapy is toxic. Beginning chemotherapy will expose your body to toxicity and therefore side effects. When many of us think of the side effects caused by chemotherapy, we think of our hair falling out, becoming fatiqued, temporary side effects. Please believe me when I say that there are possible long-term and late stage side effects from chemotherapy.
Fortunately, there are evidence-based, non-toxic therapies shown to reduce the risk of full-blown MM. I work with many people diagnosed with different forms of pre-MM (MGUS, SMM and SBP) who have lived for years with pre-MM M-spike of less than 3 and do so by taking evidence-based, non-conventional MM therapies.
Have you been diagnosed with smoldering multiple myeloma? If so, are you experiencing any symptoms? If you would like to learn more about evidence-based, non-toxic MM therapies, scroll down the page, post a question or comment and I will reply to you ASAP.
Thank you
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Recommended Reading:
“The optimal approach to management of smoldering multiple myeloma (SMM) remains one of the most debated topics in myeloma today.1,2…
In 2016, the diagnostic criteria for myeloma was revised to include biomarkers that predicted for a very high risk of progression, 80% at 2 years, a risk level that the myeloma community felt comfortable with intervention given the potential catastrophic end-organ damage that can occur in patients at the time of progression to myeloma.7…
The first question is whether we should treat all patients with SMM, and the answer is clearly no. Long-term follow-up of patients with SMM has clearly shown that nearly half of patients do not progress in the first 5 years, and more importantly, one-third of patients remain progression-free at 10 years and have a progression risk that is comparable to MGUS (ie, 1% per year).2,9 Such a strategy will clearly lead to treatment of a large number of patients who may never have required an intervention. The current treatments, while not as toxic as the older treatments, still carry a considerable amount of short- and long-term risks…
Another important reason for not adopting this as standard practice is the potential for harm. The current treatments, while not as toxic as the older treatments, still carry a considerable amount of short- and long-term risks. Long-term treatment with lenalidomide has been associated with an increased risk of second cancers, at least in the setting of posttransplant maintenance.
Steroids have been associated with a variety of long-term consequences, including diabetes, lipid abnormalities, osteoporosis, and risk of infection, among others. Bortezomib and thalidomide are both associated with neuropathy that can be quite symptomatic and sometimes not reversible…
In summary, there exists no evidence to suggest that early intervention in SMM, even when limited to patients at highest risk of progression to active MM, leads to improved overall survival. This, along with the concern about long-term toxicity, argues against early treatment of patients with SMM. However, this is a compelling hypothesis that needs to be investigated, and patients with SMM should be considered for clinical trials examining early intervention when possible.”
