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Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission

Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.

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CIPN Therapy BEFORE Velcade

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This his the first post I have written that talks about CIPN therapy before  velcade, not CIPN therapy shown to help CIPN once it starts. Because the FDA approved induction therapy is Velcade, Revlimid and dexamethasone (VRd), virtually all NDMM patients will undergo velcade aka bortezomib.

Chemotherapy-induced peripheral neuropathy is one of the most prevalent and certainly most painful of all MM side effects What’s worse, there are few effective therapies to manage this potentially debilitating side effect.


What therapies exist for CiPN?

Medications

  1. Anticonvulsants: Drugs like gabapentin and pregabalin can help reduce neuropathic pain.
  2. Antidepressants: Tricyclic antidepressants (e.g., amitriptyline) and serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine have shown efficacy in treating neuropathic pain.
  3. Topical Agents: Capsaicin cream and lidocaine patches can provide localized pain relief.
  4. Opioids: These may be used for severe pain but are generally considered a last resort due to the risk of addiction and other side effects.
  5. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These can be used for pain relief but are generally less effective for neuropathic pain.

Non-Pharmacological Therapies

  1. Physical Therapy: Exercises and physical therapy can help improve muscle strength, balance, and coordination. CIPN therapy before  velcade…
  2. Occupational Therapy: Helps patients adapt to their symptoms and maintain their daily activities.
  3. Transcutaneous Electrical Nerve Stimulation (TENS): This therapy uses electrical impulses to relieve pain.
  4. Acupuncture: Some studies suggest that acupuncture may help reduce neuropathic pain.

Lifestyle and Supportive Measures

  1. Nutritional Supplements: Supplements like alpha-lipoic acid, acetyl-L-carnitine, and omega-3 fatty acids may provide some benefit.
  2. Healthy Diet: Maintaining a balanced diet can support overall health and potentially reduce symptoms.
  3. Avoiding Alcohol and Smoking: Both can exacerbate neuropathy symptoms.
  4. Foot Care: Proper foot care is essential to prevent injuries, especially for those with numbness.

Alternative and Experimental Therapies

  1. Cannabinoids: Some evidence suggests that cannabinoids may help alleviate neuropathic pain.
  2. Glutamine: An amino acid that might help reduce symptoms.
  3. Cryotherapy: Cold therapy applied during chemotherapy infusions to prevent CiPN.

Management and Prevention Strategies

  1. Dose Modification: Adjusting the chemotherapy dose or schedule may help manage symptoms.
  2. Drug Holidays: Temporarily stopping chemotherapy to allow nerves to recover.

Let me be clear. There is no guarantee that NDMM patients will develop the side effect called CIPN. My point is that a substantial percentage of NDMM patients develop extremely painful CIPN and I research shows that all NDMM patients will benefit from exercise before they begin active therapy.

If you are a newly diagnosed MM patient, please begin pre-habilitation and include either/or neuromuscular training or whole-body vibration that is to say CIPN therapy before  velcade.

If you are a NDMM patient interested in learning more about evidence-based conventional and non-conventional MM therapies email me at David.PeopleBeatingCancer@gmail.com

Thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Preventive Effect of Neuromuscular Training on Chemotherapy-Induced Neuropathy

Main Outcomes and Measures  The primary end point was the incidence of CIPN. Secondary end points included subjective neuropathy symptoms, balance control, physical activity levels, quality of life, and clinical outcome. For cross-stratum evaluations, the Mantel-Haenszel test (MH) was used, and within individual strata, Fisher exact test was used for analysis.

Results   A total of 158 patients (mean [SD] age, 49.1 [18.0-82.0] years; 93 [58.9%] male) were randomized into 1 of 3 groups: 55 (34.8%) in SMT, 53 (33.5%) in WBV, and 50 (31.6%) in treatment as usual (TAU).

The incidence of CIPN in participants was significantly lower in both intervention groups compared to the control group (TAU): (SMT, 12 of 40 [30.0%; 95% CI, 17.9%-42.1%] and WBV, 14 of 34 [41.2%; 95% CI, 27.9%-54.5%] vs TAU, 24 of 34 [70.6%; 95% CI, 58.0%-83.2%]; P = .002 for intention to treat–MH).

Improvements in favor of SMT compared to TAU were found for balance control bipedal with eyes open; bipedal with eyes closed; monopedal, vibration sensitivity, sense of touch, lower leg strength, pain reduction, burning sensation, chemotherapy dose reductions, and mortality.

Conclusion and Relevance  This randomized clinical trial provides initial evidence that neuromuscular training decreases the onset of CIPN.

Physical exercise prevents nerve damage caused by chemotherapy

“Certain physical exercises may prevent nerve damage caused by chemotherapy among individuals being treated for cancer, results of a randomized study published in JAMA Internal Medicine showed…

“But this side effect (CIPN) not only affects their quality of life, it also influences their medical therapy as it can cause therapy alterations, [including] dose reductions or even termination,” she added. “Furthermore, it can impact their ability to work, the necessity for assistance in their activities of daily living, impact sleep quality, as well as cause additional health costs and medication…”

Background, methodology

CIPN is a clinically relevant adverse effect for some patients after chemotherapy that can negatively impact a patient’s quality of life for weeks, months or even years.

A current lack of options to treat CIPN can cause patients to change cancer therapies, sometimes also reducing survival…

Researchers conducted a prospective clinical trial to determine whether sensorimotor training and whole-body vibration training could reduce symptoms and decrease the onset of CIPN of patients undergoing treatment with oxaliplatin or vinca alkaloids…

Of the 158 total patients, 55 (34.8%) received sensorimotor training and 53 (33.5%) received whole-body vibration training twice a week for 15 to 30 minutes per session, while another 50 (31.6%) received standard treatment…

Results

Study participants who received either sensorimotor training (12 out of 40, 30%; 95% CI, 17.9-42.1) or whole-body vibration training (14 of 34, 41.2%; 95% CI, 27.9-54.5) had a significantly lower incidence of CIPN compared with the control group (24 of 34, 70.6%; 95% CI, 58-83.2).

Patients who received vinca alkaloids and performed sensorimotor training benefited the most among those in the study…

In per-protocol analysis, researchers noted more pronounced results in patients who achieved greater than 75% participation in the intervention…

Noted improvements in favor of sensorimotor training over standard treatment included

  • balance control,
  • vibration sensitivity,
  • sense of touch,
  • lower leg strength,
  • pain reduction,
  • burning sensation,
  • chemotherapy dose reductions and mortality.

 

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