Diagnosed with SMM, SPB, or MGUS?

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Smoldering Multiple Myeloma- KRD or Non-conventional?

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“Cancer treatment can be debilitating, but there may be ways patients can better prepare themselves for the challenges to come…”

Hello David-  I believe I was diagnosed with monoclonal gammopathy of undetermined significance (MGUS) at least 2 years ago which progressed, I think, to smoldering multiple myeloma (SMM) on records from my appointment in July 2018.  I will meet with my oncologist tomorrow to discuss treatment of kyprolis, revlimid, dexamethasone (KRD) for the 1st time, having been monitored for MGUS and SMM for the past couple of years.

This results from recent PET scan.  I experience no symptoms.  I’m otherwise healthy on NO medications.  I’ll be 74 in April, and will plan to impliment some general aspects of Gerson therapy to compliment therapies in your Pre-MM cancer coaching program.

I’m very motivated to avoid side effects.  I’m generally active, and feel fine as a matter of routine.  I’m inclined to not start conventional KRD treatment course right away.  I’d appreciate any comments you have based on this limited information. Thank you very much. Peter

Hi Peter-

Several things for you to think about. I will ask a few questions and then give you my thinking below. I am not a professional, not an oncologist, etc.
First and foremost, have you been formally diagnosed with either MGUS or SMM? If so, when was your diagnosis? Has your oncologist confirmed that your MGUS has progressed to SMM? Do you have blood diagnostics that I can look at?
Secondly, you say you have no symptoms- no bone pain, no nerve pain, fatigue, nothing?
Lastly, it is true that studies confirm that chemotherapy (KRD in your case) can reduce the risk of pre-MM (mgus or smm are both pre-MM, not full MM) to full-blown MM. The challenge that pre-MM patients must deal with is:
  1. the risk of side effects that come with chemotherapy (as you seem to be considering),
  2. the real possibility that chemo will reduce your quality of life (chemo may make you feel awful…)
  3. the fact that once a person begins active therapy, he/she starts down the road to multi-drug resistance.
Please feel free to talk to, ask your oncologist about the above issues tomorrow at your appointment tomorrow. These issues are well-known, well-established…
Regarding evidence-based, non-toxic MM therapies. The pre-MM cancer coaching program is a collection of studies, therapies that have been shown to reduce the risk of pre-MM from becoming full-blown MM. Nothing special, nothing weird. Just the idea that supplementing specific anti-oxidant, anti-angiogenic supplements can either halt a person’s pre-MM or reduce it.
Please understand that conventional oncology is allowed by law only to prescribe conventional, FDA approved therapies. It is common for a MM patient to ask his/her oncologist about a well-studied, well-researched supplement like curcumin. And for the oncologist to either dismiss the supplement or say that curcumin may interfere with chemo.
Regardless of what transpires at tomorrows appointment, consider undergoing evidence-based, non-toxic therapies shown to reduce the risk of pre-MM from becoming full MM. One of two things can happen:
  1. your pre-MM can remain stable and you don’t progress to MM or
  2. your pre-MM can progress to MM and you will have “prehabilitated” and should respond better to any chemotherapy you choose to undergo. Please see the article about prehabilitation below.
If you would like to talk further, I can make an argument for undergoing low-dose chemotherapy at your stage. In other words, KRD is a triplet of chemotherapy and therefore a LOT of toxicity. At a pre-MM stage and at 73, you are overdoing it. In my opinion anyway.
By the way, no meds at 73 means you are healthy, you are doing well.
David Emerson
  • MM Survivor
  • MM Coach
  • Director PeopleBeatingCancer

Recommended Reading:

How ‘Prehabilitation’ Can Benefit Cancer Patients

“Cancer treatment can be debilitating, but there may be ways patients can better prepare themselves for the challenges to come…

The benefits of exercise in helping cancer patients deal with fatigue, mood swings, and other issues experienced during and after treatment are well documented…

  • Consult with your providers before you start any exercise or other prehab program.
  • Walk, walk, walk — an easy aerobic exercise that anybody can do.
  • Strengthen your muscles through core training, which may make it easier to recover after surgery or other treatment.
  • Make sure you’re eating and sleeping well…”


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