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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Co-morbidities complicate myeloma management. This is true mainly because chemotherapy and radiation are toxic and can give the MM patient health problems on their own. If the MM patient already has, for example, heart problems, cardiotoxic therapies such as velcade can cause serious problems for the patient’s heart.
Prevalence: Up to 20–40% at diagnosis
Cause: Light chain cast nephropathy, hypercalcemia, dehydration, NSAID use
Impact: Strongly affects prognosis and treatment choices
Prevalence: ~70–80%
Manifestation: Lytic lesions, fractures, osteoporosis
Cause: Myeloma cells stimulate osteoclasts and inhibit osteoblasts
Prevalence: ~60–70%
Mechanism: Bone marrow infiltration, chronic disease, renal insufficiency (↓ EPO)
Prevalence: ~15–30%
Mechanism: Bone resorption due to osteolytic lesions
Symptoms: Fatigue, confusion, constipation, arrhythmia
Prevalence: Very high risk during first few months after diagnosis
Mechanism: Hypogammaglobulinemia, dysfunctional immune cells
Types: Bacterial (esp. pneumococcal), viral (VZV, CMV), fungal in some cases
Prevalence: Common due to age and possible therapy toxicity
Includes: Hypertension, ischemic heart disease, atrial fibrillation
Consideration: Especially important when initiating proteasome inhibitors or IMiDs
Prevalence: 10–20%, varies by population
Relevance: Steroid therapy (e.g. dexamethasone) can worsen glycemic control
May be pre-existing or develop due to disease or treatment
Causes: Amyloidosis, diabetes, drug-related (e.g., bortezomib, thalidomide)
Prevalence: ~10–15% of myeloma patients
Organs involved: Heart, kidneys, GI tract, nerves
Signs: Proteinuria, restrictive cardiomyopathy, macroglossia
In my experience as a MM survivor and MM cancer coach, oncologists are not good at telling NDMM patients the side effects of the chemotherapy regimens they are prescribing. Therefore, the pressure on the MM patient to explain any and all co-morbidities to your oncologist. Therefore when the oncologist is considering a regimen, he/she will be aware of potential health issues.
Another possible therapy plan to consider is a low dose approach to therapy. In general, a 5 mg dose of revlimid is less toxic than a 10 mg. or 15 mg. dose.
Email me at David.PeopleBeatingCancer@gmail.com with questions about your MM therapies- both conventional and non-conventional.
Hang in there,
High proportion of patients with multiple myeloma suffer from comorbidities which may alter clinical management. Therefore, our aims were to evaluate the prevalence of comorbidities and their impact on survival.
We included patients diagnosed with multiple myeloma 1990-2013 in Sweden and all diagnoses from each patient from 1985. A total of 13 656 patients with multiple myeloma were included in the study, thereof 7404 (54%) had comorbidity at diagnosis.
The risk of death was increased for those with one comorbidity at diagnosis compared to those without any comorbidity (hazard ratio = 1.19; 95% confidence interval:1.14-1.25); this risk was higher for those with two (1.38; 1.30-1.47) and three or more comorbidities (1.72; 1.62-1.83).
Furthermore, the risk of death was increased in patients with prior history of
This large study shows that over 50% of multiple myeloma patients have a comorbidity at diagnosis and survival decreased with increasing numbers of comorbidities. This emphasizes the importance of comorbidities when evaluating patients and deciding on treatment strategies for individuals with multiple myeloma.
Co-morbidities myeloma Co-morbidities myeloma