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.

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Multiple Myeloma- Diagnostic Criteria

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Prognosis for Multiple Myeloma- What you need to learn from your MM diagnostic criteria- your stage, symptoms, possible CRAB symptoms…

Diagnosing multiple myeloma (MM) is notoriously difficult. This is why the diagnostic criteria for MM is so elaborate. Your oncologist will test your blood, bone marrow, urine, and image your bones as carefully as possible.

When I was diagnosed with multiple myeloma in early 1994, I’m pretty sure I was the youngest person to be diagnosed with our incurable blood cancer. Newly diagnosed MM patients have gotten younger ever since. All I could think about was about aggressive chemotherapy and radiation to kill my MM. I wanted to crush my MM…

All I thought only about killing my MM.  I wish I knew then what I know now…

Living with an incurable blood cancer is not about toxic therapies designed to crush MM. Living with MM is a long-term chess match or marathon.

I’ve learned that MM diagnostic criteria tells the patient what he/she needs to know to understand their prognosis for MM. In other words, your:

  • immunoglobulins 
  • freelight chain testing
  • beta-2 microglobulin
  • imaging studies (MRI, PET/CT, X-Ray, etc.) combined with your
  • bone marrow biopsy report,
  • Serum Protein Electrophoresis (m-spike, monoclonal proteins),
  • FISH (Fluorescence in situ hybridization) to identify possible genetic abnormalities will outline your prognosis for MM

are all diagnostic criteria that can tell you something about your therapy plan going forward. For example, if you have kidney involvement, treating your MM with aggressive, toxic therapies might also damage your kidneys.

It is your diagnostic criteria that will help you and your oncologist determine your therapy plan.

I was early stage multiple myeloma when I was first diagnosed. Induction therapy followed by cytoxan followed by an autologous stem cell transplant was way too much toxicity for me to handle.

Please see the side effects program discussed below.

According to the article linked and excerpted below, “Only about 1 in 7 new cancer drugs approved in the US displace existing standard-of-care, a new analysis shows.” While many new chemotherapy regimens have been approved over the past dozen or so years for the treatment of MM, the majority of new therapies are stronger versions of previously approved therapies. 

The core of conventional multiple myeloma chemotherapy regimens are:

  • Immunomodulatory Agents (Imids)  Pomalidomide is stronger than lenalidomide which is stronger than Thalidomide
  • Protease Inhibitors- Carfilzomib is stronger than Ixomib which is stronger than Bortezomib
  • Corticosteroids- Dexamethasone

Don’t misunderstand me. More chemotherapy regimens offers more therapy choices to the MM patient. This process generally allows the MM patient more remissions. But generally not longer OS aka overall survival. Once the patient relapses repeatedly, his/her monoclonal proteins become more and more resistant to chemotherapy.

In my experience since my diagnosis in 1994, I have come to believe that the key issue is for the newly diagnosed MM patient to understand his/her diagnostic criteria and multiple myeloma prognosis. More advanced MM means more aggressive therapies are needed. Early stage MM means a lot less chemotherapy is needed.

Please read the “Treatment of Multiple Myeloma: Cure vs. Control” linked below. If you understand your diagnostic criteria, you will be able to apply the ideas discussed in the cure vs. control article and therefore understand your prognosis for multiple myeloma.

Controlling multiple myeloma with low dose chemotherapy combined with evidence-based non-toxic, non-conventional therapies is what I believe is the therapy plan for a longer overall survival combined with a higher quality-of-life.

Controlling MM combined with evidence-based complementary and integrative therapies I believe, allows the best prognosis for your multiple myeloma.

Scroll down the page, post a question or comment and I will reply to you ASAP.

Hang in there,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

PeopleBeatingCancer- Side Effects Program

Few New Cancer Drugs Replace Current Standards of Care

“Only about 1 in 7 new cancer drugs approved in the US displace existing standards of care, a new analysis shows.

Of more than 200 agents evaluated, most (42%) received approval as second-, third-, or later-line therapies.

“While there is justified enthusiasm for the high volume of new cancer drug approvals in oncology and malignant hematology, these approvals must be evaluated in the context of their use,” the authors note in a report published online March 15 in JAMA Network Open. Later-line drugs may, for instance, “benefit patients with few alternatives but also add to cost of care and further delay palliative and comfort services” compared to first-line therapies, which may alter “the treatment paradigm for a certain indication…”

To investigate, David Benjamin, MD, with the Division of Hematology and Oncology, University of California, Irvine, and colleagues evaluated all 207 cancer drugs approved in the US between May 1, 2016, and May 31, 2021…

The researchers found that only 28 drugs (14%) displaced the prior first-line standard of care for an indication…

A total of 32 drugs (15%) were approved as first-line alternatives or new drugs. These drugs were approved for use in the first-line setting but did not necessarily replace the standard of care at the time of approval or were first-of-their-class therapies…

A total of 61 drugs (29%) were approved as add-on therapies for use in combination with a previously approved therapy or in the adjuvant or maintenance settings. These drugs “can only increase the cost of care,” the study team says…

Most new approvals (n = 86) were for use in second-, third- or later-line settings, often for patients for whom other treatment options had been exhausted…”

Treatment of Myeloma: Cure vs Control

“Although not often openly acknowledged, “cure vs control” is the dominant philosophical difference behind many of the strategies, trials, and debates related to the management of myeloma. Should we treat patients with myeloma with multidrug, multitransplant combinations with the goal of potentially curing a subset of patients, recognizing that the risk of adverse events and effect on quality of life will be substantial? Or should we address myeloma as a chronic incurable condition with the goal of disease control, using the least toxic regimens, emphasizing a balance between efficacy and quality of life, and reserving more aggressive therapy for later?

To be sure, if cure were known to be possible (with a reasonable probability) in myeloma, it would undoubtedly be the preferred therapeutic goal of most patients and physicians. But this is not the case. Myeloma is generally not considered a curable disease…

Cure vs control is debated because the strategies currently being tested are not truly curative but rather are intended to maximize response rates in the hope that they will translate into an operational cure for a subset of patients…

In the 1990s, high-dose therapy with autologous stem cell transplant (ASCT) became part of standard practice when it was found to prolong survival compared with conventional chemotherapy.Subsequently, bisphosphonates were found to be effective in decreasing the incidence of bone lesions.,

In the past decade, thalidomide, bortezomib, and lenalidomide, emerged as effective agents for the treatment of myeloma, producing spectacular results in combination with other known agents in terms of response rate, CR rate, progression-free survival (PFS), and (more recently) overall survival.

Numerous combinations have been developed, resulting in a veritable alphabet soup of clinical trials, and drug combinations are vying with each other for the highest response rate (and prominence).,

The results obtained with new combinations have indeed been remarkable and have prompted a relatively new philosophy of treating myeloma with the goal of potential cure rather than disease control. These philosophical differences underpin the various clinically relevant debates regarding myeloma currently confronting patients and physicians.

In fact, it is not uncommon to find that well-meaning investigators interpret the same clinical trial data in opposite ways because they ascribe to different philosophies (cure vs control). Although this commentary focuses on myeloma, the cure-vs-control debate may be relevant to other similar chronic malignant and nonmalignant disorders.

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