What Do Myeloma Patients Die From?

Portrait of sad bald senior man looking at camera

What Do Multiple Myeloma Patients Die From? “…the majority of MM patients ultimately relapse or progress, and die of disease related conditions such as severe infections, renal failure or toxicity^3,4.”

The email exchange below points to an issue that is central to the myeloma experience yet is never discussed by conventional oncology.

And that issue is the fact that many myeloma patients die, not from their incurable blood cancer but from damage caused by the therapy that is supposed to cure them- or at least put the patient into remission.

I fully understand that newly diagnosed patients must undergo chemotherapy, radiation or surgery. In most cases there is no way around one or more of these toxic therapies. The issue is how much toxic therapy.

Let me explain.

Conventional therapies can cause all of the “common causes of death” below. Multiple myeloma or I should say monoclonal proteins, can also cause those causes of death as well.

The challenge then, is to walk a fine line between the damage caused by the patient’s myeloma and the damage caused by toxic therapies given to myeloma patients in hopes of controlling multiple myeloma.

I believe the basis for walking the fine line between the two is

The cure vs. control debate aka taking a low-dose approach to therapy once the patient is stabilized and
Evidence-based but non-toxic therapies such as nutrition, supplementation, and lifestyle therapies.

The most common causes of death for multiple myeloma survivors are:

Myelosuppression (Infection, pneumonia, etc,)
Renal Insufficiency (kidney failure)
Bone Disease (bone damage, fractures, leading to death)
Heart Failure (heart damage leading to death)
Blood Clots (DVT, hyper-viscosity)

Good afternoon, David. My name is Cheryl. My dad who is 74 years old, is at a very tough point in his multiple myeloma cancer journey. He has done multiple rounds of chemotherapy and yet they have shared with him that he is not eligible for the stem cell transplant.

I am a nutritionist and very well-versed in natural approaches and I really try to determine the best ones specifically for this type of cancer.

There does not appear to be kidney damage or bone damage per se but they did certainly see more cancer in the bones in his last biopsy.

He’s already on many of the supplements that you have discussed on your website. I would like to have a conversation with you. Is there such thing as just having one consultation? How much would that be? Thank you so much. I look forward to hearing back from you. Cheryl

Follow-up email several days later…

Hi David- My dad is so weak right now and he is suffering from chronic diarrhea. He just turned so fast – literally in the past 6 weeks.

Hi doctors are recommending Daratumumab (Darzelex) for his last treatment option. I don’t like the side effects I’m seeing on that one when I read. He’s already really fatigued but they feel it will target the MM cells.

We are just weighing whether that is the best or to just let him be comfortable.

My heart just feels broken.

Any insight on that med is appreciated. Can it truly help someone in this condition …??

Thank you, David. Very much

Another email a few days later…

Hi David- my dad passed away last Monday.

I feel heart broken and shock.

I deeply appreciate your willingness to help.

Be well, David.

Hi Cheryl-

I must begin my reply by saying that I don’t believe the 74 year old MM survivor should undergo an ASCT. Too much toxicity. I have worked with many elderly MM survivors who enjoy a higher quality of life by undergoing low-dose therapies coupled with one of the many evidence-based integrative therapies.

On the one hand, yes, daratumumab aka darzelex can manage your dad’s MM be it

stable disease
partial remission,
complete remission, etc.

On the other hand, your dad will face the possibility of more side effects. Even the average MM patient can experience side effects. The 74 year old MM patient who has already undergone many other chemotherapies, and who is already wracked by previous short, long-term and last stage side effects will certainly feel the effects of this chemotherapy treatment.

Let me be clear. Like every other treatment your dad has undergone, daratumumab is both cytotoxic to MM and causes side effects.

Let me ask you this. Instead of more chemotherapy, could your dad take a break and try to rebuild his strength, rebuild his immune system?

In my experience, oncologists prescribe toxic therapies at the expense of the MM patient. I understand why oncology does this, I’m simply asking if a break from toxic therapy might be a short term solution for your dad right now?

Has your dad ever had any Carfilzomib? Several non-toxic supplements have been shown to enhance the efficacy of Carfilzomib while they also fight MM and reduce toxicity.

Yes, we can have just one consultation. You and your dad will get more out of the consultation if you can email me your dad’s most recent diagnostic information- blood, urine, imaging. Can you send me this information?

To Learn More about Early Palliative Therapy- click now

Let me know what you are thinking.

thank you,

David Emerson

MM Survivor
MM Cancer Coach
Director PeopleBeatingCancer

A systematic classification of death causes in multiple myeloma

“However, the majority of MM patients ultimately relapses or progresses, and deceases of disease related conditions such as severe infections, renal failure or toxicity^3,4. Nonetheless, the increasing life expectancy of the MM population might translate into an increase in causes of death (COD) unrelated to MM…”

The most common causes of death for multiple myeloma survivors are:

Myelosuppression (Infection, pneumonia, etc,)

Renal Insufficiency (kidney failure)

Bone Disease (bone damage, fractures, leading to death)

Heart Failure (heart damage leading to death)

Blood Clots (DVT, hyper-viscosity)

Leave a Comment:

6 comments

k says last year

my husband is in the final stages of MM. It progressed to secondary plasma cell leukemia. i just brought him home Friday, we are now under the care of Hospice. he has fought a VERY long and hard fight,
14 years. my heart is breaking. i don’t know what to expect and i’m afraid to ask………..what’s next?

David Emerson says last year

Hi MM Caregiver-

I am sorry to read of your husband’s situation. I agree with your decision to 1) come home and 2) work with hospice. 14 years is well beyond the averages. Yes, you two have fought a long, hard fight.

“What’s next” for you and your husband will depend largely on his current situation. Meaning, much will depend on his kidney health, bone health, blood health, etc. For example, Iif your husband’s myeloma has light chains that have affected his kidney function in the past, that may continue to negatively affect him. That kind of thing.

I should also say that I don’t know what affect his plasma cell leukemia will have.

My experience and studies say that you both are managing your situation as well as you possibly can.

David Emerson

Linda Barber says last year

My husband had been diagnosed with smouldering Multiple Myeloma a little less than 2 years ago. He awoke in Oct. 2022 and threw up, had a fast heartbeat. Long story short. . . he coded in ER 3 times over a 5 hour period. He died the third time. He was treated for sepsis, kidneys were failing, his numbers were all over the place. They did not try to intubate. He could talk etc after his first code although he was having pain all over body. Hands and feet were freezing. They had no ICU room available. He was a medical malpractice attorney – the best in Eastern TN for sure so he had all sorts of testing in last 3 months due to increased fatigue but his oncologist did not think his SMM had changed to MM. He had worked hard like he always had until the day he died. They did not intubate him. He had a heart Cath a month prior and Dr. who did it said “I wish I had your heart.” So heart was good. He was in good shape and didn’t smoke or drink. I asked for autopsy and that idiot said it was heart attack.. But he would not do autopsy. I do think they should have intubated him and RN had recommended that on his first code. His oncologist said his “numbers were fine. He did not think it was MM but I think it may have been due to kidney failure sepsis etc. All the symptoms that ki!! people with MM. John did not tell me anything about his illness but he was having lots of tests. That night he said Autonomic Nervous System to me and nurse so I think he must have read about that as what may happen in final stage of MM. My last resort is to hire a specialist to review his records. I don’t know what happened that night. One of male nurses was crying and said very angrily, These People! I tried to get him to tell me what the matter was but he wouldnt. That bothers me. Any ideas anybody?

David Emerson says last year

Hi Linda-

I am sorry for your loss. Clearly, you are facing many challenges. Good luck,

David Emerson

David Efird says a couple of years ago

When is time to call hospice?

David Emerson says a couple of years ago

Hi David-

While there is no specific answer (or I should say that the answer differs in each case), I can say that research documents increased therapies once the MM survivor becomes refractory repeatedly. In other words, MM survivors eventually reach RR status and the natural inclination is to try more therapies. This often leads to a greatly reduced quality of life.

I’m sorry I can’t offer specifics.

Hang in there,

David Emerson

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What Do Myeloma Patients Die From?

Follow-up email several days later…

Another email a few days later…

A systematic classification of death causes in multiple myeloma

Leave a Comment:

6 comments

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