Antiangiogenesis agents that target the VEGF receptor have additional side effects, including fatigue, diarrhea, biochemical hypothyroidism, hand-foot syndrome, cardiac failure, and hair changes.
Hi David- My husband was diagnosed June 2019 and January 2020 had a stem cell transplant. He is presently on Revlimid. He is very weak and tired after having a bout with pneumonia. Also losing too much weight because he doesn’t feel like eating. I am looking for supplemental treatment or supplements to help him regain his strength and endurance. Can you direct me to some alternative treatments?
Several things. I am sorry to read of your husband’s MM diagnosis.
I will assume that your husband is on “maintenance revlimid” following his ASCT last January. Maintenance therapy is part of the standard-of-care therapy plan for MM.
Also, I am guessing that your husband’s blood cell counts are low. While this is normal for patients following an ASCT and a state of myelosuppression (low blood cell counts) can accompany maintenance therapy, your/his challenge is that his pneumonia may have compounded his low energy due to his already living with low blood cell counts.
Your husband’s previous MM treatment, his induction regimen (VRd?), autologous stem cell transplant and maintenance chemotherapy is the reason for his low blood cell counts. His low blood cell counts inhibited his body’s ability to fight the flu. His fatigue is the reason why he does not feel like eating. Less food leads to losing weight.
At this point in my reply, I have to make a general comment that the standard-of-care for MM patients is, in general, too much chemotherapy. Too much chemo, too much toxicity will continue to lead to side effects.
To remedy the situation aka increase your husband’s energy you can choose several different therapy plans.
1) Consider taking a chemo holiday. The best way to heal any/all side effects from chemotherapy is to discontinue chemotherapy. This choice may be difficult because your oncologist may resist it. Research as to the efficacy of maintenance therapy is mixed. Some studies say the patient may enjoy a longer remission and overall survival and some studies do not.
2) Another choice would be to reduce your husband’s dose of maintenance revlimid. Lower dose of chemotherapy means less toxicity. Less toxicity, means less myelosuppression. For example, if your husband’s current Rev. dose is 25 mg, cut back to 15 mg. If he is currently taking 15 mg, cut back to 5 mg or 10 mg.
Cutting back the dose is pretty straightforward. Oncologists generally don’t like to deviate from the “standard-of-care” at all but your husband it the MM patient and ultimately decides what he does with his body. Keep in mind that this therapy plan takes more time, is slower to yield results than taking a chemo vacation is.
3) A third choice would be to lower his dose of revlimid and add anti-angiogenic nutrition and supplementation. Revlimid as a class of chemotherapy is an angiogenesis inhibitor. See the article below to learn more about angiogenesis inhibitors.
Revlimid and thalidomide are toxic angiogenesis inhibitors. There are non-toxic angiogenesis inhibitors that don’t have the side effects that come with chemo.
I will include the nutrition guide below. Please watch the TED TALK given by Dr. Bill Li- good explanation of angiogenesis.
The challenge that you will face with “…supplemental treatment or supplements to help him regain his strength and endurance” is that all involve anti-oxidants. Your oncologist will probably say that anti-oxidants in general will interfere with Revlimid. I will attach the antioxidant guide below as well.
Personally I believe that antioxidants, whether in the form of curcumin, omega-3 fatty acids, or combinations such as multivitamins, help MM patients like your husband. Conventional oncology believes otherwise. See the studies linked below.
One last general comment about nutrition. My experience is that oncology is okay with nutrition. I will link a blog post below about smoothies vs. juicing. I am a fan of smoothies. Tasty, nutrition dense, great way to get nutrition and calories in your husband.
Let me know if you have any questions. Hang in there.
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Recommended Reading:
Do angiogenesis inhibitors have side effects?
Side effects of treatment with VEGF-targeting angiogenesis inhibitors can include hemorrhage, clots in the arteries (with resultant stroke or heart attack), hypertension, impaired wound healing, reversible posterior leukoencephalopathy syndrome (a brain disorder), and protein in the urine. Gastrointestinal perforation and fistulas also appear to be rare side effects of some angiogenesis inhibitors.
Antiangiogenesis agents that target the VEGF receptor have additional side effects, including fatigue, diarrhea, biochemical hypothyroidism, hand-foot syndrome, cardiac failure, and hair changes.
Further, I prefer smoothies because I can add nutrition easily and effectively. Not only can I add fruits and veggies but I can add
I didn’t have this sort of freedom when I tried juicing. Adding protein powder is easy to do and according to the last study linked below, helps me maintain muscle mass.
Fast, easy, nutritious and filling. Juicing is nutritious but it removes the fiber that is included in smoothies. In short, for cancer patients, smoothies beat juicing.
While smoothies chock full of vitamins/minerals/fiber etc. is an excellent start to your day, consider those therapies that have kept me in complete remission from my multiple myeloma since 4/99.
