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.
“MM can cause cardiac comorbidities such as cardiomyopathy and heart failure caused by cardiac amyloidosis and/or anemia. Some of the treatments used in MM can also affect cardiovascular health…”
According to research, heart failure is both a multiple myeloma symptom and a multiple myeloma side effect. MM proteins can damage the heart in the same way that they can damage kidneys. Further, many chemotherapy regimens are cardiotoxic. Chemotherapy itself can also damage the patient’s heart.
As if those two reasons weren’t enough for newly diagnosed MM patients, multiple myeloma often occurs in people over the age of 70. This population that often demonstrates existing heart failure.
Key points to make in the research listed below-
Furthermore, MM is a heterogeneous disease with considerable variation in presentation and comorbidities, making comparisons between clinical trials in patients with MM particularly difficult.
Real-world patient populations differ from those in clinical trials. The former are likely to be older and have more comorbidities, and this should be taken into account when considering the rates of cardiovascular AEs reported in this review.
In contrast, patients in clinical trials are likely to have mandated levels of renal, hepatic, and cardiac function. Many of the new agents were approved in recent years, such that long-term, real-world, safety data on these emerging treatments are not yet available.
The accumulation of amyloid light-chain (AL) immunoglobulin is estimated to lead to clinical amyloidosis in 12–15% of patients with MM during the course of their disease, and up to 30% of those with MM have subclinical amyloid deposits34.
Cardiac involvement is estimated to be present in 50% of all AL amyloidosis cases35,36.
I was diagnosed with early stage MM in 2/94. I underwent induction chemotherapy, high-dose cytotoxin and an autologous stem cell transplant all in 1995. I underwent heart diagnostic testing midway through 1995 and received a clean bill of health.
In late 2010 I developed chronic atrial fibrillation (Afib) and chemotherapy-induced cardiomyopathy (CIC). My experience demontrates that severe heart damage, Afib and CIC, can take years to become apparent, years to manifest itself.
Clearly heart failure can be a serious health challenge for MM patients. What’s the solution? Just like the other MM symptom, side effect challenges to a patients bones, kidneys and blood, it is critical for MM patients to continually undergo evidence-based but non-toxic heart health therapies.
As the top study below explains, conventional oncology may not understand the seriousness of heart damage as MM symptom and MM side effect. Your oncologist is only as good as the information he/she reads.
It is up to you, the MM patient to understand the need for and benefit of both conventional and non-toxic, non-conventional therapies.
Those health challenges that are both MM symptoms and side effects are difficult to understand and treat. If you have any questions about your heart, kidney, bone or blood health, scroll down the page, post a question or comment and I will reply to you ASAP.
“An important goal of early-phase clinical trials is to discover a drug’s possible side effects. But despite FDA guidelines seeking to standardize this reporting, a University of Colorado Cancer Center study finds significant variation in how drug side effects are reported, potentially making some drugs seem safer or less safe than they really are…
“Sometimes you only report an adverse event that happens in, say, 10 percent or more of patients on a trial. However, if you split related side-effects into lots of little sub-groups, perhaps no one event reaches this 10 percent threshold and nothing gets reported…”
What the group found was wide-ranging variation in the ways trial investigators report drug side effects…
Additionally, patients are supposed to report all symptoms when they are on a clinical trial andthen it’s up to trial investigators to decide, in their opinion, whether a symptom is likely due to the drug or just happens to be another symptom the patient is experiencing at the time.
“Determining if a side effect is treatment-related or not is subjective. If you rely on this, you get rid of some of the background noise of coincidental symptoms. However, you can also miss more subtle side effects,” Simons says…
“Given the increased speed of drug licensing, early phase trial data is essential in helping us form accurate impressions of a new drug. Recognizing and addressing the variation in how side effects are reported would improve the accuracy of these impressions in the future,”Simons says.”
“Multiple myeloma (MM) is a plasma cell malignancy that accounts for 10% of hematological cancers. It predominantly affects elderly people; median age at diagnosis is 70 years. Consequently, many patients with MM have cardiovascular comorbidities or risk factors.
MM can cause cardiac comorbidities such as cardiomyopathy and heart failure caused by cardiac amyloidosis and/or anemia. Some of the treatments used in MM can also affect cardiovascular health…
In this review, we survey the cardiac complications commonly reported in patients with MM…
During the course of their disease, patients with MM are usually exposed to several treatments, often in combination, that may each increase the risk of cardiovascular adverse events (AEs). As a consequence, assessing cardiovascular risk and controlling cardiovascular complications are becoming integral to the routine management of patients with MM...
Due in part to the rapidly evolving treatment landscape, up-to-date real-world evidence on safety in patients with MM is limited…
Furthermore, MM is a heterogeneous disease with considerable variation in presentation and comorbidities, making comparisons between clinical trials in patients with MM particularly difficult...
Pathophysiology of myeloma, and baseline and disease-related cardiovascular complications-
MM is associated with a specific set of clinical manifestations often referred to as the CRAB features (elevated calcium levels,renal insufficiency, anemia, and bone lesions)37, some of which can also increase the risk of cardiovascular comorbidities.
For example:
hypercalcemia is linked to the development of arrhythmias38,
renal insufficiency has been shown to increase the risk of cardiovascular disease by two to four times39, and
a study on atherosclerosis risk in the community suggested that iron deficiency (anemia) is an independent risk factor affecting cardiovascular disease outcomes in patients aged 45–64 years40.
Anemia can also lead to arrhythmia, cardiomyopathy, and high-output heart failure41,42.
A study from the USA found that 63% of individuals newly diagnosed with MM had a history of cardiac events4; and pooled European data from six randomized trials showed that 69% of patients with MM had cardiovascular comorbidities at diagnosis44…
Consequently, cardiac dysfunction may occur if protein homeostasis is not maintained, potentially leading to heart failure64. Furthermore, evidence suggests that the ubiquitin–proteasome system is dysfunctional during myocardial ischemia.
Experiments in transgenic mice have demonstrated that proteasome inhibition in cardiac myocytes contributed to the development of heart failure during systolic overload65, and it is postulated that the degree of cardiac injury may be correlated to the level of proteasome inhibition64.
Cardiac AEs have been reported following treatment with each of the available proteasome inhibitors, but are most commonly associated with carfilzomib treatment13,50,55,66.
Hello David,
I live in the UK,my husband age 65years was rushed into a Cardiac ward with acute Heart Failure one week ago.
He was found to have Myeloma as previously undiagnosed problem.
He was discharged home yesterday and we are waiting for an outpatient appointment with a Heamatologist.
He has had no previous Cancer and no previous heart problems.I’m fact for his age he has always maintained excellent and robust health.He is not Diabetic or overweight and always kept himself fit and well.
He has never smokes and drinks no more than 6 units of alcohol per.week.
I was hoping you may be able to advise me.We have only known of this condition for one day and it is Christmas and I cannot seem to obtain any further information.
I very much look forward to hearing from you if at all possible.
Kind regards,
Olwen.
I am sorry to learn of your husband’s diagnosis of MM. MM is a relatively rare blood cancer so it is no surprise that it is difficult for you to learn much about this cancer.
The key is to begin the process, determine your husband’s therapy plan based on his diagnostic testing. In other words, stage 1 MM is fundamentally different from stage 3. Any heart involvement may complicate his therapy plan going forward.
I will say that your husband is young as newly diagnosed MM (NDMM) patients go and his good health, both will increase his prognosis.
All to say, see the hematologist, have all the diagnostic testing (BMB, CBC, Metabolic panel, etc.) and let’s talk again. I will be able to make specific suggestions based on your husband’s stage, symptoms, goals, etc.
It may be difficult for you but try to take a deep breath and you and your husband try to enjoy your holiday.
Hang in there, I look forward to talking to you more,
my mom is 74 with MM for 2 years now. she also recently was diagnosed with AFIB. we recently were in the ER with elevated Heartrate up to 160.. and fluid in her lungs. can the MM be attacking her heart?
I am sorry to read of your mom’s health challenges. Several possible issues for your mom. You mom’s MM may be causing her heart damage (amyloidosis) or her heart could be reacting to velcade (the V in RVD) or may be even revlimid.
The primary issue is that your mom should be considered “elderly” and therefore should not be undergoing the standard-of-care, FDA protocols.
To give you a complete answer, I should review her diagnostic info (stage, freelight chain assay, immunoglobulins, etc.). It is easy for me to criticize your oncologist without knowing the specific issues.
