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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Myeloma Diagnosis? Think Long-term
It may be difficult for a myeloma patient to think long-term. If you’re like me, just hearing the word “cancer” caused you to think short term aka death. And it probably didn’t help when they said your blood cancer was incurable.
Most every clinical trial measures in months or a few years. Oftentimes, one treatment is only months better than another treatment. Much of the talk of MM is in months or a few short years.
But my guess is that you want to live more than a few short years. And a growing number of newly diagnosed MM patients are living longer than 8-10 years.
So how do you think long-term as a newly diagnosed MM patient? Why should you think long-term?
First and foremost, understand that oncology thinks short term. No surprise as their focus is living five years from your diagnosis. This means that myeloma therapies, generally speaking, are short term in design.
The second important concept is to understand is what Dr. Vincent Rajkumar calls the Cure vs. Control Debate. In short, aggressive “potentially curative” therapies are highly toxic. Less aggressive therapies can control your MM. More chemotherapy means a greater risk of short and long-term side effects.
“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.”
If your goal is to “maximize response rates” and you are more comfortable thinking short term, that’s fine. However, the article linked below expresses a fact of aggressive chemotherapy. And that is that long-term damage to the heart can occur during treatment but not show up for years.
This is what happened to me. I was diagnosed with chemotherapy-induced cardiomyopathy fully 15 years after my ASCT.
What does long-term thinking mean for a newly diagnosed myeloma patient? If, for example, your induction therapy takes you from diagnosis to complete remission or very good partial remission, consider harvesting stem cells but waiting to have an autologous stem cell transplant.
An ASCT has been shown to lead to, on average, a longer progression-free survival (PFS) but not necessarily a longer overall survival. And ASCT is aggressive treatment increasing your risk of short and long-term side effects. Long-term side effects like heart damage discussed below.
If your induction therapy is successful, the added toxicity of an ASCT is questionable. By not having an ASCT you can spare your heart of all that toxicity.
No matter what therapy plan you choose, consider including evidence-based non-conventional therapies such as:
- anti-mm nutrition
- anti-mm supplementation and
- lifestyle therapies
Email me at David.PeopleBeatingCancer@gmail.com with your questions about conventional or non-conventional MM therapies.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Cancer therapy may impair cardiorespiratory fitness for years after treatment
Key takeaways:
- Cancer therapy may reduce cardiorespiratory fitness, as measured by peak VO2, for years after treatment.
- Exercise therapy may benefit patients undergoing cancer therapy.
Cancer treatment, primarily chemotherapy, is associated with impaired cardiorespiratory fitness years after treatment has ended and regardless of cancer subtype, according to a meta-analysis published in JACC: CardioOncology.
“Cardiorespiratory fitness, measured by peak oxygen consumption (VO2 peak), provides an objective indicator of overall cardiovascular capacity. In patients with cancer, low VO2 peak is associated with a higher symptom burden and an increased prevalence of long-term treatment-related cardiovascular disease risk factors and is a strong, independent predictor of cancer, cardiovascular and all-cause mortality…”
“…The aim of this systematic review and meta-analysis was to evaluate the effects of systemic anticancer treatment on VO2 peak in adults with cancer.”
The systematic review and meta-analysis incorporated 44 studies, of which 27 were prospective trials including 1,234 cancer survivors (median age, 52 years) and 17 were cross-sectional studies including 1,372 cancer survivors (median age, 54 years) and 1,923 controls without cancer (median age, 56 years).
The primary endpoint was the change in cardiorespiratory fitness as measured by change in peak VO2 before and after systemic anticancer treatment. Secondary endpoints included posttreatment differences in peak VO2 between cancer survivors and controls without cancer in addition to physiological determinants of peak VO2.
Overall, 91% of the studies focused on cancer treatment with chemotherapy…
Systemic anticancer treatment was associated with an average decrease in peak VO2 of 2.13 mL/kg1/min1 from before to after treatment (95% CI, 2.76 to 1.5), and there were no significant differences reported based on cancer type, according to the study.
During a median follow-up of 2 years after completion of cancer therapy, researchers reported peak VO2 was on average lower among patients treated for cancer compared with controls without cancer (weighted mean difference, 6.39 mL/kg1/min1; 95% CI, 7.6 to 5.18).
Among various physiological determinants of peak VO2, reduced arteriovenous oxygen difference was associated with reduced peak VO2 (beta = 2.55; 95% CI, 2.05-3.06; P< .001) and the researchers reported no significant association between cardiac output and peak VO2 (beta = 0.88; 95% CI, 1.95 to 0.18; P = .1).
“This is the first study to extensively characterize the magnitude of systemic therapy-related impairments across various cancer settings,” the researchers wrote. “Given the established association between impaired VO2 peak and adverse clinical outcomes in cancer patients, these findings support the recommendation for exercise therapy aimed at preserving and improving VO2peak during and following cancer treatment.”
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