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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.

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

Kidney, Heart, Bone, etc. Co-Morbidities at Myeloma Diagnosis

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“Co-morbidities correlate with aging and make the elderly particularly vulnerable to toxicities of therapy. A key issue is therefore to choose the optimal therapy for these patients 6.”

Co-morbidities at cohort entry was registered in 40.9% of the patients... I’m not talking about the symptoms that can accompany multiple myeloma (MM). The study linked and excerpted below is referring to those health problems that older folks can already be living with.

To complicate things further, according to research the average newly diagnosed MM patient (NDMM) is 60 years of age. Further, 95% of NDMM is diagnosed at stage II or III.

If you are 69 years of age or older, if you have health issues such as cardiovascular disease (CVD), kidney failure, osteoporosis/osteopenia, dementia, etc. and/or if you have advanced MM (stage II or III), in my opinion, your oncologist has no business giving you the standard-of-care FDA approved protocol for NDMM patients, that is:

  • Induction therapy of R/V/D
  • Autologous stem cell transplantation
  • maintenance chemotherapy 

I am not an oncologist and you may not agree with my opinion. I say this because I am drawing on years of patient experience where aggressive chemotherapy regimens cause serious health complications for their hosts. Patients with:

  • co-morbidities (40%)
  • stage II or III MM (95%)

will, according to research, not respond well to SOC toxic therapies and will experience not only a shorter overall survival (OS) but also experience a much worse quality-of-life.

Let me give you a specific example. Let’s say you have kidney problems. No big deal, not uncommon. But a diagnosis of MM means chemotherapy. The SOC protocol is high-dose chemotherapy. If you have kidney problems you don’t want to undergo a therapy that may damage your kidney health further.

  • Many chemotherapy regimens are cardio-toxic aka can damage the heart. If you have any type of heart damage, you do not want to undergo a therapy that may weaken your heart muscle further. 
  • Many chemotherapy regimens can cause chemotherapy-induce cerebral dysfunction aka chemobrain. If you have even mild dementia, you to not want to cause more damage to your brain. 
  • Many chemotherapy regimes can weaken the patient’s bones. If you have osteoporosis or osteopenia, you do not want to weaken your bones further. 

Possible solutions are:

  • Get a second opinion.
  • If you have MM, work with a MM specialist.
  • Before you undergo chemo or radiation, Pre-habilitate. 
  • Learn about evidence-based, non-toxic, non-conventional therapies such as CoQ10, curcumin and anti-angiogenic foods. 

Please don’t rely on a general oncologist to understand all the possible chemotherapy side effects that can complicate co-morbidities. MM is a rare cancer at less than 2% of all cancer diagnosed in the U.S. annually. Even hematologist, oncologists may not have much experience with MM as it is 10% of all blood cancer diagnoses in the U.S. annually.

I understand the need for an F.D.A. approved standard-of-care protocol for all NDMM patients. However, this one-size-fits-all protocol does not fit all MM patients.

To learn more about evidence-based, non-conventional, non-toxic therapies such as nutrition, supplementation, and lifestyle, please 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- Galen Foundation

Recommended Reading:


The impact of comorbidity on mortality in multiple myeloma: a Danish nationwide population‐based study

“Cox proportional hazards regression models were used to evaluate the prognostic significance of comorbidity. The study included 2190 cases of multiple myeloma and 21,900 population controls.

The comorbidity was increased in multiple myeloma patients compared with population controls..

The registration of comorbidity was highly increased within the year preceding diagnosis of multiple myeloma , which was attributable to an increased registration of various diseases, in particular, renal disease.

The median follow‐up time from diagnosis of multiple myeloma for patients alive was 4.3 years.

Patients with registered comorbidity had increased mortality compared with patients without comorbidity…Multiple myeloma patients have increased comorbidity compared with the background population, in particular during the year preceding the diagnosis of myeloma…

Comorbidities correlate with aging and make the elderly particularly vulnerable to toxicities of therapy. A key issue is therefore to choose the optimal therapy for these patients 6. An increasing awareness of the vulnerability of the elderly has lead to recommendations for dose adjustment of treatment in patients with comorbid conditions 7

Four levels of comorbidity were defined:

  • 0 (“low”) for individuals with no recorded underlying diseases included in the CCI;
  • 1 (“moderate low”),
  • 2 (“moderate high”), and
  • ≥3 (“high”)…

Results- The study included a total of 2190 patients with symptomatic multiple myeloma in the period 2005–2012 in Denmark. The median age at diagnosis was 70 years (range 30–98 years), and 1204 (55%) were men. The median duration of follow‐up for patients alive was 4.3 years (interquartile range 2.4–6.3). Characteristics of the patients and population controls are described in Table 1

Comorbidity at cohort entry was registered in 40.9% of the patients. The overall comorbidity was increased in multiple myeloma patients compared with population controls… The prevalence of comorbidity was higher in patients over 65 years of age compared with the younger patients, for example, three or more comorbidities in 226 (15.9%) patients >65 years versus 47 (6.1%) patients ≤65 years…

Diagnosis         5‐year survival P
Any Charlson condition 23% 1.6 1.5–1.8 <0.0001
Myocardial infarction 22% 1.6 1.3–2.1 <0.0001
Congestive heart failure 20% 1.8 1.5–2.2 <0.0001
Peripheral vascular disease 12% 1.6 1.2–2.1 0.0005
Cerebrovascular disease 20% 1.6 1.3–1.9 <0.0001
Dementia 0% 2.8 1.7–4.8 0.0004
Chronic pulmonary disease 16% 1.7 1.4–2.1 <0.0001
Connective tissue disease 30% 1.2 0.9–1.6 0.16
Ulcer disease 13% 1.8 1.4–2.3 <0.0001
Mild liver disease 0% 1.8 1.0–3.1 0.04
Diabetes mellitus 17% 1.5 1.1–2.0 0.010
Hemiplegiaa 19% 0.90
Moderate and severe renal disease 24% 1.6 1.2–1.9 <0.0001
Diabetes mellitus with chronic complications 18% 1.5 1.2–2.1 0.003
Any tumor 26% 1.2 1.0–1.4 0.06
Leukemiaa 44% 0.90
Lymphoma 25% 1.2 0.7–2.0 0.55
Moderate and severe
Liver diseasea
50% 0.71

Discussion- In this large nationwide cohort study, we found an increased comorbidity in patients with multiple myeloma at time of diagnosis compared to population controls. This increase in comorbidity was mainly confined to the year proceeding diagnosis of myeloma. In both younger and elderly myeloma patients, comorbidity was associated with increased mortality…

The prevalence of comorbid diseases in our study is in accordance with the observations in a Swedish population‐based study based on the Swedish Cancer Registry where comorbidity was seen in approximately 40% of the multiple myeloma patients and with an Italian study based on a regional multiple myeloma registry 9, 19

An essential issue is the distinction between multiple myeloma complications and true comorbidity. A considerable part of the registered comorbidity within the last year prior to diagnosis might be related to the diagnostic process rather than reflecting true comorbidity in multiple myeloma. \

In a few cases, it might reflect the detection of multiple myeloma in patients in diagnostic workup for unrelated diseases which are subsequently registered as part of the comorbidity…

 

 

 

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