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Diagnosed with SMM, SPB, or MGUS?

Learn how you can stall the development of full-blown Multiple Myeloma with evidence-based nutritional and supplementation therapies.

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Early Chemotherapy does NOT help Smoldering Multiple Myeloma

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Based on the current evidence, early treatment didn’t significantly affect mortality and response rate…

The diagnosis of an incurable cancer like multiple myeloma is awful. Patients feel as if they lose control over their health.

So when an oncologist offers therapy to possible slow down pre-multiple myeloma from becoming full-blown multiple myeloma the newly diagnosed smoldering multiple myeloma (SMM) patient may jump at the idea.

I know. I did everything my oncologist told me to do when I was first diagnosed. Unfortunately conventional therapies did little for me. However I have lived in complete remission from my multiple myeloma since 1999 by living an evidence-based, non-toxic, anti-myeloma lifestyle based on nutrition, supplementation, bone health, mind-body therapies and more.

According to the study linked and excerpted below, chemotherapy for the pre-MM patient (SMM) does not effect OS or overall survival. Yes, chemo delays disease progression. Unfortunately, chemotherapy is toxic, even at low doses and brings with it “gastrointestinal toxicities, constipation and fatigue or asthenia” and possibly other side effects. Remember,  according to the analysis linked and excerpted below, early chemotherapy does not increase overall survival (OS) in SMM. 

To learn more about evidence-based therapies to prevent the progression of pre-myeloma to full-blown myeloma, please watch the short video below:

The study below is a meta-analysis meaning that the authors aggregated numerous studies to arrive at their conclusions.

Have you been diagnosed with smoldering multiple myeloma? Are you experiencing any symptoms such as bone pain, anemia or kidney problems? Scroll down the page and post a comment or a question. I will reply ASAP.

Thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


Early versus Deferred Treatment for Smoldering Multiple Myeloma: A Meta-Analysis of Randomized, Controlled Trials

Results-Overall, 5 trials including 449 patients were identified. There was a markedly reduced risk of disease progression with early treatment (Odds Ratio [OR] = 0.13, 95% confidence interval [CI] = 0.07 to 0.24). There were no significant differences in mortality and response rate (OR = 0.85, 95% CI = 0.45 to 1.60, and OR = 0.63, 95% CI = 0.32 to 1.23, respectively). More patients in the early treatment arm experienced gastrointestinal toxicities (OR = 10.02, 95%CI = 4.32 to 23.23), constipation (OR = 8.58, 95%CI = 3.20 to 23.00) and fatigue or asthenia (OR = 2.72, 95%CI = 1.30 to 5.67). No significant differences were seen with the development of acute leukemia (OR = 2.80, 95%CI = 0.42 to 18.81), hematologic cancer (OR = 2.07, 95%CI = 0.43 to 10.01), second primary tumors (OR = 3.45, 95%CI = 0.81 to 14.68), nor vertebral compression (OR = 0.18, 95%CI = 0.02 to 1.59).

Conclusions– Early treatment delayed disease progression but increased the risk of gastrointestinal toxicities, constipation and fatigue or asthenia. The differences on vertebral compression, acute leukemia, hematological cancer and second primary tumors were not statistically significant. Based on the current evidence, early treatment didn’t significantly affect mortality and response rate. However, further much larger trials were needed to provide more evidence.”

Treatment of Smoldering Multiple Myeloma: Ready for Prime Time?

“The current standard of care for smoldering multiple myeloma (SMM) is observation until there is end-organ involvement. With newer and more effective treatments available, a question that is increasingly asked is whether early intervention in patients with SMM will alter the natural history of their disease. Herein, we review the evolving definition of SMM and risk stratification models. We discuss evidence supporting early intervention for SMM—both as a preventative strategy to delay progression and as an intensive treatment strategy with a goal of potential cure. We highlight ongoing trials and focus on better defining who may require early intervention…

Conclusions

Evidence supporting early intervention is emerging, but without any demonstration of an improvement in the overall survival, patients with high-risk SMM are best managed in the clinical trials setting until we have more data. Concurrently, there is a need to better understand the significant heterogeneity in SMM and to identify the patients who benefit the most from early treatment from those who can safely defer treatment.”

 

Leave a Comment:

11 comments
Why Treat Smoldering Multiple Myeloma W/Toxic Chemo Now? - PeopleBeatingCancer says a couple of years ago

[…] Early Chemotherapy does NOT help Smoldering Multiple Myeloma […]

Reply
Why Treat Smoldering Multiple Myeloma Now?!?! - PeopleBeatingCancer says a couple of years ago

[…] Early Chemotherapy does NOT help Smoldering Multiple Myeloma […]

Reply
Risk of Progression for Smoldering Multiple Myeloma is Reduced...at what cost? - PeopleBeatingCancer says 3 years ago

[…] Early Chemotherapy does NOT help Smoldering Multiple Myeloma […]

Reply
Doris says 7 years ago

Rob….recently diagnosed with smm but originally was told I was Stage II with suspect lesions in my skull. Was scheduled for treatment in 5 days. My second opinion doctor at Vanderbilt decided he wanted MRIs of head, spine and pelvis. Diagnose changed to smm and no treatment and thankful of it!!! At first testing in 2/2015, IgG was 3758. June 9th was 3778. They are not concerned and I will have blood work every 3 months, 24 hr. urine collection at 6 mos. and other tests as required. I was told turmeric is good to take and people have said the IgG come down…they say. I exercise, eat right, do not smoke or drink. My husband passed 12-13-14 of pancreatic cancer and I was his caregiver. Have had a lot of stress since 2/2015 but have it under control now. Who is best source to talk about natural products, etc. in regards to smm and trying to control it? I am on no cancer medications. Thank you for any information you can give me.

Reply
    David Emerson says 7 years ago

    Hi Doris-
    I am sorry to read about your husband. I think that caregiver is as difficult as managing cancer. I hope your stress is under control. After reading my reply below, let me know if you have any questions.

    Thanks, David Emerson
    Director PBC

    I can’t tell from your post if you are asking Rob or me your question. I will offer a reply and Rob might as well. I hope that’s okay with you. As a long term myeloma survivor myself I will offer my own anti-mm regimen.

    1) Exercise- yes, this is important. The studies I have read about exercise and the cancer survivor (you and me both) talk about regular exercise as being more important than working out a lot at any one time. In other words I work about 3 hours a week but I do this in 6 x 30 min. sessions. I am a 55 year old mmer who lives with some collateral damage from previous therapies.

    2) Nutrition- as little sugar, red meat, alcohol, etc. as possible without killing myself.

    3) Nutritional supplementation- yes, curcumin ( I take and recommend super biocurcumin as it is more bioavailable)
    Green tea extract,\
    Vitamin D3-
    Wobenzyme N- (systemic enzymes)

    Reply
Rob says 7 years ago

Hi David,

I’ve been enjoying reading your newsletter and many of the links. Very helpful.

Im still almost symptom free after 6 years from diagnosis of mm. Yes rest, exercise, and the three items you mentioned are part of my regime (green tea, curcumin, and wobenzyme – recently started the latter after your advice). Bisphosphonate has been part ofv the intake since diagnosis.

You mentioned: “On a related note, I am a mmer who was diagnosed in ’94. I am happy to provide you evidence-based studies and articles that cite anti-myeloma therapies- both conventional, non-conventional. Also, I have studied and written about the importance of surgical methods for mmers (usually spine related issues) as well as bone building therapies- again surgery, or bisphonates as well as bone strengthening vitamins and supplements.”

Could I take you up on that offer please? Evidence based studies and articles and info on surgery etc would be helpful, and Im planning to review my regime and see if I can cut back on the number of pills and liquids Im taking (about 31 items now!).

Thanks for your help,

Rob

Reply
Rob says 7 years ago

Dear David,

Many thanks for your email, and the information of the things you are taking.

I take a whole bunch of stuff daily, which includes green tea and Tumeric (curcuma), but wobenzym is new to me. When I finally get to stay in my home base awhile, I’ll rationalise my regime, and include wobenzym.

But you might check Inositol and Ip6. I take both daily and have from diagnosis. I think it is helpful : http://www.ncbi.nlm.nih.gov/pubmed/14608114

Im encouraged by your view that you might make it through to die of old age, despite smm. I have viewed it as a slippery slope and I could tip over the edge anytime. But I am not bothered by that unduly, we all have to pass on sometime. Be nice to see my Grandkids grow up tho.

Kind regards,

Rob

Reply
Rob says 7 years ago

Dear David,

Thank you for your courteous response. And no I am not offended, and perhaps my nitpicking was unnecessary, and gratuitous. Just that with over 500 types of cancer, advancing a strong position, which I took your newsletter to propose, that surgery was best for cancer (all cancer?), could lead to some people seeking that option inappropriately. Not many people would have you span of awareness I suspect. So I would have something in the lead sentence to the effect that “Surgery is still the best option for many cancers where it can be applied….” Or somesuch.

I was attempting to be jocular in saying “all generalisations are false including this one”, referring to that very statement. I was not referring to your statement/s. Though there is an element of common truth in my silly statement.

David I am an Australian, aged 73, and was diagnosed with mm at the smoldering stage six years ago. So far, thank God, it has been stable at that level. I am writing to you from Pakistan, a somewhat dangerous place with millions of very poor farmers scratching out a living from the desert. I have been doing this kind of work for most of my life and have also been involved in academia.

When I was diagnosed, I read widely on mm and as a result have been hitting myself with a cocktail of things. I take a weekly dose of Bisphosphonate (recommended by my Oncologist in Brisbane, Australia (my home, sometimes). As well as various suppliments, I take a daily dose of a liquid that is made up by my Naturopath, which he calls Oxybeedone D. It contains ozone bubbled though an aqueous suspension of vitamins D and B. In addition I take a daily high dosage of Dr Rath’s cellular health formula (I take the capsules, 4 x 3 time /d). See http://www4.dr-rath-foundation.org/pdf-files/cancerresearch.pdf, and other material by Dr Rath.

I also take Inositol hexaphosphate (at about 3 am when my stomach is presumably empty). I believe these things are at least part of the reason that my mm appears to be kept at bay. I also exercise daily, and get enough rest.

David, thank you for your kind offer of some material on research regarding mm etc. I would be most interested to read same. I am certainly not aware of surgical procedures pertaining to mm apart from the ubiquitous marrow transplant and stem cell work. Perhaps spinal repair is after vertebra damage/collapse is what you’re referring to?

David I appreciate the time you have taken, and the motives of your excellent work. I apologise for the somewhat curt tone in my brief message. Perhaps Im too conditioned by criitcal peer reviews of my written stuff!

Kind regards,

Rob

Reply
    David Emerson says 7 years ago

    Rob-

    No problem. I sounds as though your job is interesting. Demanding but interesting. Further, it does seem that your therapies have done a good job of keeping you as a smmer. A have come to believe that low tech therapies like exercise and rest are two of the most effective therapies. I do both.

    Please run these supplements by your Naturopath. I take curcumin, green tea extract, and wobenzym N daily. All capsules, not too expensive. I take low doses as I have been taking each for quite sometime now. And I intend to continue taking each for years to come.

    Studies about curcumin, green tea and systemic enymes (wobenzyme N)-

    Curcumin- http://www.ncbi.nlm.nih.gov/pubmed/?term=multiple+myeloma%2C+curcumin

    Green tea- http://www.ncbi.nlm.nih.gov/pubmed/?term=multiple+myeloma%2C+green+tea

    Wobenzyme- http://www.ncbi.nlm.nih.gov/pubmed/?term=multiple+myeloma%2C+wobenzyme

    I view mm differently but I see no reason why you should remain smm and die of old age decades from now.

    Good luck and thanks,

    David Emerson

    Reply
Rob says 7 years ago

David,

Apropos of your latest newsletter, as you know, all generalisations are false including this one (Ed.Note- referring to surgery to debulk tumors). I have Multiple Myeloma, invariably fatal, incurable. I wish I could have a lumpectomy, but surgery, even marrow replacement, is only a deferment of the inevitable.

And since Im in my 70’s even that option is not available. Can you be a bit less general about what works in future please?

Rob

Reply
    David Emerson says 7 years ago

    Hi Rob-

    Thanks for your feedback.

    By asking me not to generalize about the potential efficacy of surgery for cancer patients are you saying that since you have a blood cancer (as do I- mmer too) that you cannot undergo surgery and therefore I shouldn’t generalize about surgery for cancer patients?

    Or are you saying that since your cancer is “incurable” that I shouldn’t generalize about the potential efficacy of surgery as a form of cancer therapy?

    I’m just trying to understand what your email is saying. Either way, My intention was to provide evidence-based information to those cancer patients who were considering surgery in an effort to increase their chances for successful surgical outcomes.

    I apologize if I have offended you in any way.

    On a related note, I am a mmer who was diagnosed in ’94. I am happy to provide you evidence-based studies and articles that cite anti-myeloma therapies- both conventional, non-conventional. Also, I have studied and written about the importance of surgical methods for mmers (usually spine related issues) as well as bone building therapies- again surgery, or bisphonates as well as bone strengthening vitamins and supplements.

    Let me know.

    David Emerson

    Reply
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