Should Multiple Myeloma Patients Panic If They Do Not Achieve Complete Response After Their Induction Chemotherapy?
Dear Cancer Coach- I am a Multiple Myeloma patient 66 years old. Please help me. I’ll see my onc on the 16th of December. I need to make an important decision. Please may I have your opinion on the below listed letter I sent to him. I was diagnosed in 2011, two initial multiple myeloma chemotherapy regimens to include cyclophosphomide, dexamethazone, velcade and zometa.
Been off chemo since last April and feeling fine. All numbers are stable. 8.1 Hemoglobin. Kappa lights climbing slowly. Now at 923. He wants to put me on a one time shot for anemia and schedule Revlimid therapy. Thank you. Patricia
Hello Dr. I see I’ve been scheduled for Chemo. I’d like to review my numbers before any more chemo. If it’s Zometa, I’m ok with that. I’d like to remain off chemo if the numbers are ok. If I have to go back on chemo, I’d rather continue with the initial therapies until I can fully understand Revlimid and it’s benefits.
Common side effects of Revlimid:
Acute Infection of the Nose, Throat or Sinus Severe.
Decreased Blood Platelets Severe.
Decreased Neutrophils a Type of White Blood Cell Severe.
Decreased White Blood Cells Severe.
Fluid Retention in the Legs, Feet, Arms or Hands.
If I understand your email, you are concerned about the side effects that may come with additional chemotherapy. Because your email doesn’t contain many specific about the current state of your multiple myeloma I can only reply with two issues for you to consider.
- You are right to be concerned about the collateral damage that can come with chemotherapy.
- As the comments linked and excerpted below say, there is no indication that CR or VGPR after induction therapy leads to longer overall survivor (length of life).
My belief is that damage whether it is caused by a person’s multiple myeloma or if it is caused by a person’s therapy, is what is to be controlled. If your multiple myeloma is being managed and you are not in pain in any way, you are doing well.
Patricia, you are asking the right questions. If your onc is open and honest with you he should be able to either agree with your thinking or if not, be able to support his ideas with solid facts, solid reasoning.
Let me know if you have any questions.
To Learn More about Partial, Stable, Progressive Response to Myeloma Treatment- click now
Hang in there-
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
” Of course, the cause of my worry is not that patients have not achieved the magical complete response or minimal residual disease-negative status, but at how misinterpretation of data can lead to needless concern, unnecessary chemotherapy, increased side effects and cost of care, and even harm….”
Lastly, whether you choose more therapy or not, please consider supplementing with curcumin. This supplement has been show to enhance the efficacy of both chemotherapies as well as reduce the negative side effects. Moderate daily exercise, lots of rest, nutrition, all will help you manage your cancer.
The Most BioAvailable Curcumin Formulas
“Based on a review of these studies, it is evident that better bioavailability of formulated curcumin (CU) products is mostly attributed to improved solubility, stability, and possibly low first-pass metabolism”
A search of the Pubmed database for the word curcumin yields 601 studies spaning health topics from multiple myeloma and colorectal cancer, to chemotherapies that synergizes with CU, to Alzheimer’s Disease, arthritis and more. Based on years of reading studies and personal accounts, I think it is safe to say that CU supplementation is safe and relatively inexpensive.
I have read about myeloma patients taking daily doses of CU from 400 milligrams to 8 grams (1000 milligrams = 1 gram). By almost any measure, CU is a safe, inexpensive wonder drug.
The only challenge is that CU is famously difficult to absorb in the body. In other words, a person has to mix curcumin with some sort of fat (coconut oil, chocolate, etc.) or take a brand of curcumin capsule that is already formulated to be more “bioavailable” in order to derive the full benefit of CU.
The study linked and exerpted below reviews different formulations of CU. The study itself lists the three most bioavailable formulation/brand of CU and I’ve added an excerpt from a further review from Consumerlab.com that lists four additional bioavailable brands of CU.
“CU is a bright yellow chemical produced by some plants. It is the principal curcuminoid of turmeric (Curcuma longa), a member of the ginger family, Zingiberaceae. It is sold as an herbal supplement, cosmetics ingredient, food flavoring, and food coloring.“
“Curcumin is a widely studied natural compound which has shown tremendous in vitro therapeutic potential. Despite that, the clinical efficacy of the native CU is weak due to its low bioavailability and high metabolism in the gastrointestinal tract. During the last decade, researchers have come up with different formulations with a focus on improving the bioavailability of curcumin. As a result, a significant number of bioavailable curcumin-based formulations were introduced with the varying range of enhanced bioavailability.
The purpose of this review is to collate the published clinical studies of CU products with improved bioavailability over conventional (unformulated) CU. Based on the literature search, 11 curcumin formulations with available human bioavailability and pharmacokinetics data were included in this review. Further, the data on clinical study design, analytical method, pharmacokinetic parameters and other relevant details of each formulation were extracted.
Based on a review of these studies, it is evident that better bioavailability of formulated curcumin products is mostly attributed to improved solubility, stability, and possibly low first-pass metabolism. The review hopes to provide a quick reference guide for anyone looking information on these bioavailable curcumin formulations.
Based on the published reports,
exhibited over 100-fold higher bioavailability relative to reference unformulated CU. Suggested mechanisms accounting for improved bioavailability of the formulations and details on the bioanalysis methods are also discussed.”
According to Consumerlab.com:
“Novasol has the highest bioavailability (185 x compared to unforumulated CU), followed by Curcuwin (136 x), Longvida (100 x), Meriva (48 x), BCM-95 (27 x), Curcumin C3 Complex + Bioperene (20 x), and then Theracumin (16 x).”
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