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.

Revlimid, Myeloma, Secondary Cancer

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“…various types of therapies (eg, oral alkylating therapy, myeloablative therapy used in conjunction with ASCT, radiotherapy, and revlimid (lenalidomide) to be associated with an excess of secondary cancer after multiple myeloma”

The term “secondary cancer” is complicated. It includes both a cancer caused by a cancer survivor’s therapy (chemo or radiation) and a completely different cancer that is unrelated to a survivor’s first cancer, first treatment.

Because I am a long-term multiple myeloma survivor who underwent a lot of chemotherapy and radiation when I was diagnosed with MM, I am a prime candidate for a treatment-related secondary cancer.

When MM patients finish their initial cancer treatment, they all do two things.

  • First, they jump for joy.
  • Second, they do everything they can to return to a normal life.

Unfortunately, their lives will never be the same. Once a MM survivor always a MM survivor.

As I mentioned above, I live in fear of a second primary cancer. The articles linked and excerpted below talk about new primary cancers caused by previous treatment and new primary cancers not caused by previous toxic therapies such as chemotherapy and radiation. I live in fear of both types of second primary cancers.

Thats the bad news. The good news is that my fear helps me live a very anti-cancer lifestyle. I eat cleanly, I exercise (moderately) seven mornings a week, I supplement, I do everything I know to reduce my risks of being diagnosed with a second primary cancer.

Which is really the bottom-line for me. Previous therapies for my MM, whether it was radiation, cyclophsphomide, busulphan, or melphalan, all increased my risk of a secondary-cancer. My risk increases annually. My anti-MM lifestyle also helps me avoid a secondary-cancer.

To learn more about preventing secondary cancers, scroll down the page, post a question or comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Multiple Myeloma Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Second malignancies after multiple myeloma: from 1960s to 2010s

“Based on small numbers, recent reports from 3 randomized trials have consistently demonstrated more hematologic malignancies in patients treated with lenalidomide as maintenance (vs placebo). This fact has prompted concern and highlighted the association between multiple myeloma and second malignancies.

Furthermore, an excess of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) after multiple myeloma has been known for over 4 decades. Most prior studies have been restricted because of small numbers of patients, inadequate follow-up, and limitations of ascertainment of second malignancies…

Recently, an excess risk of AML/MDS was found among 5652 patients with IgG/IgA (but not IgM) monoclonal gammopathy of undetermined significance, supporting a role for disease-related factors.

Furthermore, there is evidence to suggest that polymorphisms in germline genes may contribute to a person’s susceptibility to subsequent cancers, whereas the potential influence of environmental and behavioral factors remains poorly understood…

Taken together, mostly based on small numbers, prior studies have found various types of therapies (eg, oral alkylating therapy, myeloablative therapy used in conjunction with ASCT, radiotherapy, and lenalidomide) to be associated with an excess of second malignancies after multiple myeloma. Yet the exact underlying mechanisms remain to be determined, and several studies to elucidate the underlying mechanisms are ongoing…”

Secondary Cancer Risk Found With Multiple Myeloma Maintenance Therapies

“Patients with multiple myeloma may develop myelodysplastic syndrome-associated cytogenetic abnormalities (MDS-CA) after treatment with maintenance lenalidomide or thalidomide after melphalan exposure, increasing the risk for clinical MDS/acute leukemia, according to the results of a retrospective study published online in Blood…”

Second Primary Cancer

second primary cancer (SEH-kund PRY-mayr-ee KAN-ser)A term used to describe a new primary cancer that occurs in a person who has had cancer in the past. Second primary cancers may occur months or years after the original (primary) cancer was diagnosed and treated. Certain types of cancer treatment, such as chemotherapy and radiation therapy, may increase the risk of a second primary cancer. Having certain inherited gene mutations (changes) and being exposed to certain cancer-causing substances, such as tobacco smoke, may also increase the risk of a second primary cancer.”

When Cancer Strikes Twice

“Cancer can, and sometimes does strike twice. It famously happened to Justice Ruth Bader Ginsburg of the Supreme Court, who was successfully treated for colon cancer in 1999 and then for pancreatic cancer in 2011…

Depending on age, up to one in four cancer survivors is likely, sooner or later, to develop a second new cancer that is neither a recurrence nor spread of the original. Yet many survivors fail to take advantage of well-established ways to keep future cancer at bay or take steps to detect new cancer when it is still early enough for a cure…

The matter is hardly trivial. The population at risk is huge and growing. As a result of better cancer screening and treatment and continued aging of the population, the number of cancer survivors in the United States has increased fourfold in the last 30 years, reaching 15.5 million by 2016, and is expected to climb to 26.1 million by 2040…

In a recent report in JAMA Oncology by researchers at the University of Texas Southwestern Medical Center in Dallas, approximately 25 percent of Americans 65 and older and 11 percent of younger adults who were previously treated for cancer were subsequently found to have one or more new cancers in a different site. Depending on the type of original cancer and the person’s age, the risk of developing a second unrelated cancer ranged from 3.5 percent to 36.9 percent. The study covered 765,843 new cancer diagnoses made between 2009 and 2013 and recorded in a population-based national registry, the Surveillance, Epidemiology and End Results (SEER) program…

In many cases, the development of a second cancer resulted from the same risk factors that most likely precipitated the first malignancy. These factors include tobacco use, obesity, and infection with human papillomavirus (HPV). For example, a smoker who has been successfully treated for lung cancer may later develop bladder cancer, which is also related to smoking, as well as a second lung cancer. An HPV infection, which most often causes cervical cancer, can also cause cancers of the vagina, penis, rectum, and throat. And obesity is a known risk factor for at least 13 kinds of cancer, including cancers of the uterus, esophagus, stomach, liver, kidney, colon and pancreas.

Although much less common nowadays than in years past, sometimes the chemotherapy or radiation treatments used to control the first cancer cause genetic or other changes that lead to a new cancer. Examples include leukemia that can be induced by chemotherapy or radiation therapy, or uterine cancer caused by the drug tamoxifen used to treat breast cancer...

Too often, Dr. Hudson’s team wrote, once they finish cancer treatment and its immediate aftermath, survivors fail to receive appropriate care from their primary care doctors. They said patients needed “a better understanding of what cancer follow-up care is, its lifelong duration, and the potential for varying degrees of monitoring.” Many of the participants in their study “were unaware that cancer follow-up care extends beyond surveillance for recurrence.”

The Epidemiology of Second Primary Cancers

“One of the most serious events experienced by cancer survivors is the diagnosis of a new cancer. Second- or higher-order cancers now account for ∼16% of incident cancers reported to the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. Subsequent neoplasms may not necessarily be attributable to prior cancer treatment but may also reflect the effect of shared etiologic factors, environmental exposures, host characteristics, and combinations of influences, including gene-environment and gene-gene interactions…

Conclusions: Important opportunities for future research include the prospective identification of patient subgroups that might be at heightened susceptibility of developing therapy-associated second cancers to modify planned treatments or select alternative management strategies. For the burgeoning population of cancer survivors treated successfully with past regimens, including those therapies that have been subsequently refined, continued quantification of late effects, including second cancers, remains highly relevant in terms of raising clinician and patient awareness, for informed counseling, and for the development of risk-adapted long-term management strategies….”

Therapy-Related Secondary Cancers

“Radiation has long been associated with the development of primary cancers and, when used as treatment, imparts a risk for the development of a second cancer. Typically, second tumors occur within or at the margin of the radiated field. Bone and soft-tissue sarcomas are the most frequent SMNs following radiation therapy, but skin, brain, thyroid, and breast cancers also can occur. Radiation doses less than 30 Gy tend to be associated with thyroid and brain tumors, whereas doses greater than 30 Gy can evoke secondary sarcomas...

Leukemia as a secondary cancer can occur following treatment with chemotherapy. Although acute myelogenous leukemia is the most common type of therapy-related leukemia, acute lymphocytic leukemia (ALL), chronic myelogenous leukemia (CML), and myelodysplastic syndrome (MDS) have also been reported. Chemotherapy-induced myeloid leukemias are relatively resistant to subsequent therapy and have a cure rate of only 10% to 20%.

Evidence is accumulating concerning the mechanisms of leukemogenesis DNA topoisomerase-II inhibitors and alkylating agents. Table 159-3 summarizes the features of these chemotherapy-related leukemias. Alkylating agents include cyclophosphamide, ifosfamide, cisplatin, carboplatin, chlorambucil, busulfan, melphalan, nitrogen mustard, and procarbazine…Topoisomerase-II inhibitors include the epipodophyllotoxins, etoposide, and teniposide, as well as the anthracycline doxorubicin and, presumptively, epirubicin.

Alkylating agents increase the risk of leukemia almost 5-fold, but that risk increases to almost 24-fold in patients receiving the highest doses. Doxorubicin, together with high-dose alkylating agents, increases that risk further








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