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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.

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Multiple Myeloma Response – MRD, sCR, CR, VGPR

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“Whether or not every patient with multiple myeloma needs to be “pushed” into a strict complete remission (CR) was debated here at the Lymphoma and Myeloma meeting…”

You’ve been diagnosed with multiple myeloma. Your oncologist told you that MM was an incurable blood cancer but it is very treatable. You are undergoing (or have completed) induction therapy and your oncologist tells you that you need more chemotherapy, that your multiple myeloma response is not adequate.

First and foremost, studies confirm that minimal residual disease (MRD) and stringent complete response (sCR) do, on average, mean a longer overall survival.

It’s important to follow that last sentence with the qualification that a MM survivor can enjoy a long, greater than average overall survival even if he/she does not achieve MRD or sCR after induction therapy.

Let me say that again. If a MM patient does not reach MRD or sCR after induction it does NOT mean that he/she will not have a long overall survival.

For example, if your induction therapy is causing chemotherapy-induced peripheral neuropathy (CIPN) and you are miserable, you may need to reduce or stop chemo altogether.

The primary purpose of induction therapy is to control your multiple myeloma. “Control” in your case, may be bringing your m-spike down from 5.o to .5. This would be an excellent response to induction therapy but not MRD or sCR.  If you are experiencing many side effects from your induction, you may want to take a therapy vacation and see how long your remission lasts.

The article below is a debate between two MM specialists who are arguing two sides of the CR, not CR debate.

According to Dr. Landgren, “The doctor has to deal with it, or not. Myeloma patients need CR for better long-term outcome in terms of OS. I don’t buy the argument that we should not treat because it’s harmful,”

According to Dr. Mikael,   “Of course, CR is good and should be the goal for most patients. However, there remains a subset of patients with more indolent myeloma who do not require CR for long-term survival. Identifying those patients is critical. Clinicians need to modify their expectations, not over-treat and estimate prognosis. “Choose the right weapon. Be careful not to over-treat,” 

Your stage at diagnosis, your age, your general health and any genetic abnormalities exhibited by your MM all will factor into your future therapy plan.

Please watch the video below to learn more about the evidence-based, integrative therapies to combat treatment side effects and enhance your chemotherapy.

To learn more about Stringent or Complete Response click now

Thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Multiple Myeloma Response Criteria

  • Stringent Complete Remission (sCR)
  • Complete Remission (CR)
  • Near Complete Remission (nCR)
  • Very Good Partial Response (VGPR)
  • Partial Response (PR)
  • Stable Disease (SD)
  • Progressive Disease (PD)
  • Relapse from CR

Myeloma: Should Complete Remission, However Strictly Defined, Be the Goal for All Patients?

“Whether or not every patient with multiple myeloma needs to be “pushed” into a strict complete remission (CR) was debated here at the Lymphoma and Myeloma meeting. Considering the issue was C. Ola Landgren, MD, Chief of the Myeloma Service at Memorial Sloan Kettering Cancer Center; and Joseph Mikhael, MD, Associate Professor of Medicine in Hematology/Oncology, at the Mayo Clinic in Arizona,

Three groups of multiple myeloma patients—those with monoclonal gammopathy of undetermined significance (MGUS)-like myeloma, those with indolent clinical myeloma, and elderly patients—do not necessarily need to achieve CR, according to the consensus of the audience of approximately 400, who were polled after the debate, two-thirds of whom consisted of physicians who see one to five patients a week, according to statistics from the meeting…

C. Ola Landgren: Yes, a Complete Response Should be the Goal for All Patients

“Complete remission, however strictly defined, should be the goal for everyone, Landgren said. “Good clinical response is important, and newer myeloma drugs provide better clinical responses. More patients are reaching deeper responses. This matters for patients. Clinical response to therapy impacts progression-free survival as well as overall survival…”

Joseph Mikhael: No, Not All Patients Need to Achieve CR

“Taking the opposing view, Mikhael said that he didn’t think that all myeloma patients need to achieve a strict complete response: “In general, people do better with a deep response. When people respond, we are happy. But we do not need to push every patient to move forward to get into strict CR.”

 

Leave a Comment:

25 comments
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[…] Myeloma Response – MRD, sCR, CR, VGPR […]

Reply
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Vicki carnes says a couple of years ago

I am supposed to be starting my stem cell transplant tomorrow, having outpatient chemo and being admitted the next day to the hospital for two weeks. I am a bit frightened of long-term effects. I’ve decided I could probably get through the next month or two if I thought at the end of the day my life will be better and longer. Hi do not know what the long-term side effects are. I guess they’re different for everyone but now I’m wavering on whether I should put this off until I know more or not. I’m wondering g what is considered cr?

Reply
Vicki carnes says a couple of years ago

I am supposed to be starting my stem cell transplant tomorrow, having outpatient chemo and being admitted the next day to the hospital for two weeks. I am a bit frightened of long-term effects. I’ve decided I could probably get through the next month or two if I thought at the end of the day my life will be better and longer. Hi do not know what the long-term side effects are. I guess they’re different for everyone but now I’m wavering on whether I should put this off until I know more or not

Reply
    David Emerson says a couple of years ago

    Hi Vicki-

    I replied to you via email.

    David Emerson

    Reply
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Irwin says 6 years ago

Think of it as a fight which in a way it is…….If you knock your adversary to the ground and weaken them……do you wait for them to regain their strength and and come back or do you go in for the kill and finish them off. I’m from the go in for the kill school and that is my plan going forward in my battle. I agree with Dr. Landgren, complete remission is the goal!!

Reply
    David Emerson says 6 years ago

    Hi Irwin-
    I appreciate your input.
    thanks,

    David Emerson

    Reply
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