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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When to Stop Myeloma Treatment

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Deciding when to stop myeloma treatment is an important decision in the life of a MM patient. According to research, as many as 30% of NDMM patients alter or discontinue their induction treatment dues to side effects.


What percentage of newly diagnosed myeloma patients discontinue treatment due to adverse events?

…studies generally indicate that a significant proportion of NDMM patients experience treatment discontinuation or dose modification due to adverse events. In clinical trials and real-world settings, discontinuation rates due to adverse events have been reported in the range of 10% to 30%. For example:

  1. Proteasome inhibitors (like bortezomib) and immunomodulatory drugs (like lenalidomide) have been associated with a discontinuation rate of about 15-25% due to adverse events.
  2. Carfilzomib, another proteasome inhibitor, has reported discontinuation rates around 13-17% in newly diagnosed patients in some studies.
  3. In the case of triplet or quadruplet therapies (combinations), discontinuation rates due to toxicity can be higher, ranging from 20-30%.

This video explains the brief history of doublet, triplet and quadruplet induction therapy with NO mention of the risk of discontinuing induction due to adverse events. 


I am a myeloma survivor who’s conventional treatments:

  • Induction Therapy
  • Autologous Stem Cell Transplant
  • Surgery
  • Radiation 

did little to prolong my life, post diagnosis, yet caused more than a dozen long-term side effects. It was a non-conventional therapy that put me into CR but that’s another blog post.

My point is that adverse events aka side effects, are rarely discussed by your oncologist yet should be. Consider taking a low-dose approach to your therapy plan.

If you are concerned about your own treatment-related side effects and would like to learn more about taking a low-dose approach to your own MM therapy plan, email me at David.PeopleBeatingCancer@gmail.com

Thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Patient-Reported Adverse Events and Early Treatment Discontinuation Among Patients With Multiple Myeloma

Findings  In this survey study with 1058 participants in the ECOG-ACRIN E1A11 trial, with newly diagnosed multiple myeloma, when captured during treatment, a single question from the Functional Assessment of Cancer Therapy (“I am bothered by side effects of treatment” (when to stop myeloma treatment) was significantly associated with subsequent discontinuation of treatment due to adverse events.

Meaning  These findings suggest that brief, single-question assessments accurately reflect patients’ ability to tolerate treatment and may be an efficient way to assess risk for treatment discontinuation due to adverse events or compare tolerability of different treatments…

Conclusions  In conclusion, in this survey study, we report the GP5 item’s ability to capture treatment tolerability among a sample of patients with multiple myeloma. Our results indicate that patients who report high AE bother on the GP5 had higher odds of discontinuing treatment early.
This study suggests that GP5 may be a useful, succinct way to track whether cancer patients tolerate their treatment and may identify patients vulnerable to tolerability-associated early discontinuation.

Treatment and Disease-related Complications in Multiple Myeloma: Implications for Survivorship

“Abstract

New treatments have transformed multiple myeloma into a chronic disease. Hence, optimal management of treatment and disease-related complications remains a critical component of survivorship care.

Survivorship care models in cancers requiring a fixed-duration therapy may not be applicable to myeloma as patients are exposed to multiple lines of continuous therapy along the disease trajectory.

Infections and secondary cancers, which are the most common therapy-related causes of death in myeloma, need special consideration. Identifying patients at a high risk of toxicities will facilitate individualized treatment selection and designing clinical trials for protective strategies targeting those patients, for example, prophylactic antibiotic or immunoglobulin replacement for primary prevention of infections in high-risk patients.

Long-term follow up of ongoing trials and epidemiologic data will be help identify the nature and trajectory of rare toxicities with a long latency like secondary cancers. Patients who are frail, have persistent renal insufficiency, and refractory to multiple lines of therapy need special attention. In this review, we discuss the incidence, risk-factors, and management of treatment and disease-related complications in myeloma, discuss knowledge gaps and research priorities in this area, and propose a survivorship care model to improve health-care delivery to a growing pool of myeloma survivors…”

when to stop myeloma treatment

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