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Extramedullary Myeloma Treatment
Extramedullary myeloma treatment is different enough from conventional treatments for multiple myeloma that it requires special mention.
I know this because I originally presented with what may have been an extramedullary plasmacytoma in my neck in early 1994. The plasmacytomna was surgically removed and I then had a course of local radiation.
Unfortunately, the radiation caused two different long-term side effects. Side effects that could easily have been minimized or prevented entirely with a basic understanding of evidence-based non- conventional thinking.
What is extramedullary myeloma?
Anytime a person undergoes radiation around their head and neck, radiation fibrosis can occur. In my case radiation fibrosis caused:
- Xerostomia and
- Dysphagia
Research has shown that hyperbaric oxygen therapy can heal scarring caused by radiation. In my case, I did not know about either radiation-induced side effect until several years had passed.
Several years of weekly acupuncture sessions have largely healed the xerostomia and years of physical therapy for my swallowing muscles have allowed a somewhat normal daily function of my throat.
I am not saying that local radiation should not be included in your extramedullary myeloma treatment. I am saying that you will experience a higher quality of life if you can minimize the adverse events caused by radiation fibrosis.
Email me at David.PeopleBeatingCancer@gmail.com if you would like to learn more about any aspect of your multiple myeloma.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Radiotherapy Cuts Myeloma Risk in Rare Head and Neck Cancer
“TOPLINE:
In patients with extramedullary plasmacytoma of the head and neck, radiotherapy and surgery provide comparable survival outcomes, but radiotherapy significantly reduced the risk for progression to multiple myeloma, a new meta-analysis found.
METHODOLOGY:
- Extramedullary plasmacytomas are rare, aggressive tumors that can progress to multiple myeloma. Radiotherapy and surgery are commonly used alone or in combination to treat these rare tumors, which typically develop in the head and neck. However, there is no clear consensus on the most effective approach.
- Researchers conducted a meta-analysis of 12 studies which involved 742 patients (median age, 59.1 years; 71% men) with extramedullary plasmacytoma of the head and neck who underwent either radiation therapy (n = 505) or surgery (n = 237).
- Median radiation dose was 50 Gy (42.5-50.7 Gy), and 86.6% of patients received doses of 45 Gy or higher.
- Seven studies were conducted in North America (58%), three in Europe (25%), and two in China (17%).
- The main outcomes were overall survival, disease-free survival, local recurrence rates, and progression to multiple myeloma.
TAKEAWAY:
- Based on data from seven studies, overall survival outcomes did not differ significantly between patients who received radiation therapy and those who underwent surgery at 5 years (hazard ratio [HR], 0.83; 95% CI, 0.52-1.31) or at 10 years (HR, 1.1; 95% CI, 0.80-1.52).
- Based on data from 5 studies, disease-free survival outcomes did not differ significantly between the two treatment groups at 5 years (odds ratio [OR], 0.68; 95% CI, 0.41-1.11). However, disease-free survival at 5 years favored radiotherapy when one study was excluded in the sensitivity analyses (HR, 0.55; 95% CI, 0.31-0.96). And based on data from four studies, disease-free survival outcomes were also similar between the two treatment groups at 10 years (HR, 0.88; 95% CI, 0.55-1.42).
- Of eight studies that assessed recurrence, local recurrence rates were also not significantly different between the two treatment options (OR, 0.65; 95% CI, 0.20-2.06).
- However, based on data from six studies, patients who received radiation therapy were 63% less likely to progress to multiple myeloma (OR, 0.37; 95% CI, 0.15-0.94), possibly because radiotherapy led to “sufficient coverage over microscopic residual tumor, which can be missed in surgical excisions,” the authors suggested.
IN PRACTICE:
“Our meta-analysis confirms that radiotherapy may represent an optimal treatment strategy associated with a lower progression rate of multiple myeloma,” the authors wrote.