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- Frail Patients Benefit from Non-Toxic Therapies

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“In clinical trials for transplant-ineligible multiple myeloma patients, outcomes have largely been investigated in fit, rather than frail patients, the latter being typically excluded or highly underrepresented therein…”

I don’t need an algorithm to identify a frail, elderly multiple myeloma (MM) patient who may not benefit from toxic chemotherapy while leaving the patient with therapy-induced collateral damage (side effects).

Here’s why:

  • FDA clinical trials are populated by people under the age of 65-
  • According to the article below, disease-related symptoms and age-related decline put elderly MM patients at a real disadvantage when undergoing toxic chemotherapy.

The average age of the newly diagnosed myeloma patient is 69.

This statistic means that more than half of newly diagnosed MMers are NOT represented in clinical trials.

My conventional myeloma therapies of chemotherapy and radiation left me exhausted with damage to my heart, brain, eyes and nervous system. I was 35 years old at the time…

Please scroll down the page to learn about non-toxic therapies to support heart, brain and especially bone health. We MM survivors, regardless of age, can benefit from non-toxic therapies such as magnesium l threonate.

I am both a long-term MM survivor and MM cancer coach. I have remained in complete remission since April of 1999 by living an evidence-based, non-toxic, anti-MM lifestyle through nutrition, supplementation, bone health, etc. therapies. Myeloma is a complicated, difficult cancer for a 35 year old much less a person over the age of 70.

If you have been diagnosed with multiple myeloma and you are over 70 I believe that you would benefit from the evidence-based, integrative and complementary,  non-toxic therapies provided in the Multiple Myeloma Cancer Coaching Program.

Scroll down the page to ask a question or make a comment. I will reply to you ASAP.

Thank you,

David Emerson

  • MM Cancer Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


Identifying Frail Patients With Multiple Myeloma Improves Treatment Selection

“About one-third of patients with multiple myeloma are older than 75 years at diagnosis, and at least 30% are frail. This is “both due to disease-related symptoms and (age-related) decline in physical capacity, presence of comorbidities, frailty, polypharmacy, nutritional status, and cognitive impairment…

The treatment challenge is that regimens “investigated in clinical trials for transplant-ineligible patients have largely been investigated in fit, rather than frail patients, the latter being typically excluded or highly underrepresented therein,” the authors wrote.

Dr Zweegman and colleagues described how to identify frail patients with multiple myeloma and how to tailor treatment thereafter. They noted that over the past decade, the proteasome inhibitors bortezomib, carfilzomib, and ixazomib, as well as the immunomodulatory agents (iMiDs) thalidomide, lenalidomide, and pomalidomide “have significantly improved” patient outcomes.

“However, both in clinical trials and in daily clinical practice, elderly multiple myeloma patients have shown lesser benefit. This is mainly due to less stringent use of proteasome inhibitors and IMiDs, increased toxicity, and subsequent early discontinuation of therapy in elderly,” the authors noted.

When asked whether physicians in general practice either do not treat the elderly, do not add proteasome inhibitors/ImiDs, or whether they use a lower dose of novel agents because older patients included in clinical trials may be fitter than “real-world” patients, Dr Zweegman told Cancer Therapy Advisor, “yes, I do…although with less intensity treatment might well be feasible and should be offered…”

Two algorithms in particular can “easily identify intermediate-fit and frail patients:” the International Myeloma Working Group (IMWG)-frailty index and the Revised Myeloma Comorbidity Index (R-MCI).

In managing frail patients with multiple myeloma, Dr Zweegman noted that colleagues should “consider that the disease also causes frailty, so you might well improve quality of life by treatment…”


Magnesium and Brain, Heart, Nerve and Bone Health

“we show that increasing brain magnesium using a newly developed magnesium compound (magnesium-L-threonate, MgT) leads to the enhancement of learning abilities, working memory, and short- and long-term memory in rats”

I am a long-term cancer survivor and cancer coach. As of 2014, the American Cancer Society reported that there are 14.5 million of us. Most of us cancer survivors are over 50. Because of the long-term and late stage collateral damage done by conventional therapies most, if not all cancer survivors must think about maintaining our brain health.

Magnesium supplementation helps manage brain, heart, and bone health. Lucky for me as I live with chemobrain, chronic A-Fib, and nerve damage (peripheral neuropathy). Sarcasm doesn’t really work in my blog posts…

 The study linked and excerpted below cites Magnesium L Threonate supporting increased brain health in memory and learning.  I take is Life Extension NeuroMag to supplement with Magnesium L-Threonate because of the study below.

My example anecdotal but my chemobrain continues to improve, my chronic A-Fib inflicted heart continues to do its job (without medication) and I continue to remain cancer-free.

The Consumer lab.com evaluation of magnesium supplements that cites the benefits below requires membership log in

  • evaluated and approved by consumer lab.com for purity, absorbability-
  • plays an important role in brain cell functioning (minimizes my chemobrain…)
  • supports proper nervous system functioning
  • may prevent hearing loss from excessive noise
  • may decrease the risk of developing type 2 diabetes
  • may reduce the risk of stroke (I need this with chronic a-fib…)
  • may improve physical performance ( I need this with my nerve damage…)

Lastly,  magnesium has been shown to improve bone mineral density.

Enhancement of Learning and Memory by Elevating Brain Magnesium

“Summary: Learning and memory are fundamental brain functions affected by dietary and environmental factors. Here, we show that increasing brain magnesium using a newly developed magnesium compound (magnesium-L-threonate, MgT) leads to the enhancement of learning abilities, working memory, and short- and long-term memory in rats.

The pattern completion ability was also improved in aged rats. MgT-treated rats had higher density of synaptophysin-/synaptobrevin-positive puncta in DG and CA1 subregions of hippocampus that were correlated with memory improvement. Functionally, magnesium increased the number of functional presynaptic release sites, while it reduced their release probability. The resultant synaptic reconfiguration enabled selective enhancement of synaptic transmission for burst inputs. Coupled with concurrent upregulation of NR2B-containing NMDA receptors and its downstream signaling, synaptic plasticity induced by correlated inputs was enhanced. Our findings suggest that an increase in brain magnesium enhances both short-term synaptic facilitation and long-term potentiation and improves learning and memory functions.”

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8 comments
Revlimid / Lenalidomide Maintenance Therapy- Yes or No? - PeopleBeatingCancer says 3 years ago

[…] Multiple Myeloma- Frail Patients Benefit from Non-Toxic Therapies […]

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Dean A Komm says 3 years ago

I just turned 73 and was diagnosed with MM last fall. I have gone through induction therapy and I am now in remission. I have just ended all chemo and will be tested in two weeks to see if I am a candidate for stem cell transplant. I have just stopped revlimid and am having a rash on approx 30% of my body. I am healthy except for a lung condition which is a nontuburculosis bacteria. I was not being treated for that condition until I was diagnosed with MM. I now take two anibiotics a day. I am short of breath when walking for exercise and my MM doctor does not think MM is causing the shortness of breath so I assume it is caused by the lung bacteria. If If my doctor feels that I am a candidate for stem cell they plan to harvest stem cells at the end of Feb. The current plan is to postpone stem cell transplant until early summer because of COVID. I am conflicted regarding whether or not to proceed with the stem cell. If I am a candidate I am considering harvesting stem cells and evaluating my decision while waiting for early summer.
In your opinion is 73 too old to receive a stem cell transplant. The dr has told me that there are now many other drugs and stem cell is not the only way to proceed, but he has not discouraged stem cell transplant at this point. I am a plant pathologist and understand research so I am open to options. Please advise.

Reply
    David Emerson says 3 years ago

    Hi Dean-

    You’ve mentioned a number of issues so I will excerpt your post and address your questions.

    “I have gone through induction therapy and I am now in remission. I have just ended all chemo and will be tested in two weeks to see if I am a candidate for stem cell transplant.”

    Achieving remission after induction therapy is a great start. If you think of it, please let me know what stage of remission you are in

    2) “I have just stopped Revlimid and am having a rash on approx 30% of my body.”

    Skin rash is a common side effect of Revlimid therapy. Hopefully, discontinuing Revlimid will be enough for the rash to resolve. Ask your oncologist.

    3) “I am short of breath when walking for exercise and my MM doctor does not think MM is causing the shortness of breath so I assume it is caused by the lung bacteria.”

    It is possible that your induction therapy has caused myelosuppression which is causing your shortness of breath. Your bloodwork, red, white blood cells, platelet, levels will give you insight.

    4) “If If my doctor feels that I am a candidate for stem cell they plan to harvest stem cells at the end of Feb.”

    Harvesting your stem cells, regardless if you think you will have an ASCT or not, is a good idea. Your MM should be at a low point.

    5) “In your opinion is 73 too old to receive a stem cell transplant. The dr has told me that there are now many other drugs and stem cell is not the only way to proceed, but he has not discouraged stem cell transplant at this point.”

    The question is not if you are too old for an ASCT Dean. The question is what therapy plan will work best for you and your goals.

    Research shows that ASCT is a lot of toxicity aka causes short, long-term, late stage side effects considering the overall survival (length of life) you will gain.

    To look at this another way, your doctor is saying that novel therapies will produce less toxicity while enhancing length of life.

    This is based on studies of course, and depends on your goals, your thinking.

    My recommendation is for you to take things one step at a time. See where you are remission-wise, see if your skin rash resolves, see if you’ve sustained myelosuppression, and then, based on this, determine your next therapy steps.

    Your call of course but I would be interested in communicating with you again after you’ve determined your response, side effects, etc.

    Let me know if you have any questions. Hang in there,

    David Emerson

    Multiple Myeloma Remission
    https://www.myelomacrowd.org/multiple-myeloma-remission/

    “There are various levels of response patients can have to treatment: 

    Stable Disease (SD)

    Stable Disease is when a patient has had some response to treatment but less than 50% reduction in monoclonal protein levels. Their disease is not improving or getting worse. 

    Partial Response (PR)

    Partial Response is when a patient has had over a 50% reduction in their blood monoclonal protein and a reduction of M-protein in the urine of over 90%. If a patient had a plasmacytoma (a single lesion), a partial response would mean over a 50% reduction in tumor size. 

    Very Good Partial Response (VGPR)

    A Very Good Partial Response means that the monoclonal protein levels can be detected by the IFE (immunofixation test), but not by the electrophoresis test in the blood and urine. It also means that the M-protein has been reduced in the blood by over 90%. 

    Complete Response

    A Complete Response means that there is no detectable monoclonal protein in the body.  

    Stringent Complete Response

    Stringent Complete Response means that a patient has achieved a Complete Response and they also have a normal free light chain ratio and have no clonal cells in the bone marrow as measured by immunohistochemistry or immunoflourescence.
    Minimal Residual Disease Negative

    More sensitive testing is available that can detect lower levels of disease either by flow cytometry or by Next Generation Sequencing testing. If a patient is MRD negative, it means they have achieved a Stringent Complete Response and no myeloma cells can be detected in a sample of a million. This is a bone marrow biopsy test. 

    Risk of rash associated with lenalidomide in cancer patients: a systematic review of the literature and meta-analysis
    https://pubmed.ncbi.nlm.nih.gov/23769670/

    “Lenalidomide is indicated for treatment of multiple myeloma in combination with dexamethasone and as a single agent in myelodysplastic syndromes. The incidence and risk of rash has been inconsistently reported.

    Materials and methods: We conducted a systematic review and metaanalysis of the literature to determine the incidence and risk of developing rash. Relevant studies were identified from PubMed and abstracts presented at American Society of Clinical Oncology annual meetings. Incidence, relative risk, and 95% confidence intervals were calculated.

    Results: Ten trials were available for analysis, and the overall incidence of all-grade and high-grade rash was 27.2% and 3.6%, respectively. Lenalidomide was associated with increased risk of all-grade rash (P < .001). Conclusion: Further studies for prevention and treatment of this toxicity are needed to minimize effect on quality of life and dose intensity…”

    Reply
Myeloma Caregivers Need SUPPORT! - PeopleBeatingCancer says 4 years ago

[…] Multiple Myeloma- Frail Patients Benefit from Non-Toxic Therapies […]

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Multiple Myeloma in the Elderly- Minimize Toxicity-Increase Non-Toxic Therapies - PeopleBeatingCancer says 5 years ago

[…] Multiple Myeloma- Frail Patients Benefit from Non-Toxic Therapies […]

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Myeloma Maintenance Beyond Lenlidomide/Revlimid - PeopleBeatingCancer says 5 years ago

[…] Multiple Myeloma- Frail Patients Benefit from Non-Toxic Therapies […]

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Multidisciplinary Management of Multiple Myeloma in Older Adults - PeopleBeatingCancer says 5 years ago

[…] Multiple Myeloma- Frail Patients Benefit from Non-Toxic Therapies […]

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Relapsed Multiple Myeloma-Therapy Options? - PeopleBeatingCancer says 5 years ago

[…] Multiple Myeloma- Frail Patients Benefit from Non-Toxic Therapies […]

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