fbpx

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.

Click the orange button to the right to learn more about what you can start doing today.

End Stage Multiple Myeloma- Then Death

Share Button

 “These real‐world data could be used to help develop strategies for improving survival in patients with Multiple Myeloma and to support management tailored to the stage of disease.”

Is death an adverse event aka side effect of multiple myeloma? I’ll admit that the studies linked below may be difficult for multiple myeloma (MM) patients to read. Learning about how end-stage multiple myeloma patients die can be hard to handle. I felt a bit overwhelmed myself when I first came upon the studies.

Once I got into it however, I realized that the info contained in the studies might actually help newly diagnosed MM patients understand their cancer and pursue appropriate lifestyle therapies.

The point of this post is that there is more to multiple myeloma therapies that “standard-of-care” chemotherapy regimens. SOC is great to stabilize the advanced patient. However, just because your oncologist tells you that you are end-stage, it does not mean that you have no options.

I can say this because my oncologist told me that I was end-stage…in September of 1997. 

First and foremost, newly diagnosed MM patients should understand that almost a third of patients die before or during their first line of therapy.

I have to conclude that this is because MM is often diagnosed late. A late MM diagnosis can mean extensive bone or kidney damage or a serious infection has occured and the patient has few therapy options.

Secondly, the study points out that response to conventional therapies is highly “variable.” This means that some MM patients enjoy 10 year remissions while some patients relapse during their first year of remission.

Lastly, the study glibly states that “most deaths at later lines where due to progressive disease.” While this statement is vague, I have to conclude that once MM patients have become relapse/refractory (RR), they reach multi-drug resistance (MDR) and stop responding to conventional chemotherapy and their multiple myeloma progresses without control.

Conventional oncology can’t cure multiple myeloma. MM patients should use every evidence-based therapy at their disposal. If you have been diagnosed with MM, job number one is to find and consult with a MM specialist.

To learn more about evidence-based, non-conventional therapies for MM, scroll down the page, post a question or comment and I will reply to you ASAP.

Thanks,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


Understanding mortality in multiple myeloma: findings of a European retrospective chart review

“Objectives-This study aimed to provide real‐world data on the characteristics and treatment of patients with multiple myeloma (MM) at the time of death.

Methods- The study was a retrospective patient chart review across France, Germany, Italy, Spain and the UK during 2016, and included patients who had died in the 3 months before the index date.

Results- Data from 786 patients were reviewed. At the time of death:

  • 37% of patients were receiving active treatment,
  • 12% were in a treatment‐free interval and
  • 51% were receiving only supportive care.

Death before and during active first‐line treatment was not uncommon (6% and 24% of patients, respectively) but these deaths were often not solely due to disease progression; factors such as renal failure and infection frequently played a role (in 30% and 20% of patients at first‐line, respectively).

Most deaths at later lines were due to progressive disease. Cox model results suggested that early deaths were associated with:

  • advanced disease stage,
  • high‐risk cytogenetics, and
  • poor response and relapse profiles.

Conclusions- These real‐world data could be used to help develop strategies for improving survival in patients with MM and to support management tailored to the stage of disease.”

Meaningful changes in end-of-life care among patients with myeloma

“Discussion-

In this large cohort of older patients with myeloma, almost half enrolled in hospice, and among these, approximately 17% enrolled within 3 days of death. Although hospice enrollment significantly increased between 2000 and 2013, with rates almost doubling, there was no significant rise in late enrollment, suggesting that the increase in hospice use was meaningful…

The rise in hospice use among myeloma decedents is consistent with prior studies among patients with various malignancies in the USA.,, …

The current analysis allowed us to explore potential unique barriers to timely enrollment, such as transfusion- and dialysis-dependence…

Patients who survived more than a year after their diagnosis were more likely to use hospice in a timely fashion and were also less likely to receive aggressive medical care close to death.

This is consistent with prior data showing that survival duration is an important determinant of having a home versus hospital death. The relationship between survival time and EOL care may reflect increased patient experience with-and thus the desire to avoid-the burden of additional intensive treatments.

Moreover, a longer time between diagnosis and death offers more opportunities to engage in advance care planning. Importantly, clear and consistent discussions regarding prognosis and EOL decision-making early in the disease trajectory are necessary if we are going to improve the quality of EOL care across all survival ranges…

In conclusion, our data suggest that along with vast improvements in treatment and survival, there has also been meaningful progress in EOL care for patients with myeloma in the USA.

These patients are not only enrolling more often in hospice, but the increase in use is not driven by late enrollment. Still, there remains ample opportunity for further improvement, particularly among patients who survive less than one year, are dialysis-dependent, or transfusion-dependent. Possible solutions include earlier goals of care discussions, bridge palliative care services, and modification of the hospice model to enable transfusion support.”

Leave a Comment:

16 comments
Add Your Reply