myeloma is the malignant proliferation of plasma cells involving more than
10 percent of the bone marrow. Bone pain related to multiple lytic lesions
is the most common symptom. However, many patients are
diagnosed incidentally while being evaluated for unrelated problems, and
one third of patients are diagnosed after a pathologic bone fracture. MM,
the second most common haematological malignancy,
remains an incurable disease. New approaches to develop better tools for
improving patient prognostication and monitoring treatment efficacy are very
Continuous bone destruction is the hallmark of multiple myeloma. The spine is the most afflicted skeletal organ, and vertebral fractures significantly contribute to its poor outcome. The principal underlying pathologic mechanism causing bone disease in multiple myeloma is a shift in the balance of bone formation and bone resorption toward bone resorption.
Multiple Myeloma treatment
Chemotherapy with melphalan-prednisone is the standard treatment for multiple myeloma. Other treatment modalities include polychemotherapy and bone marrow transplantation. Only 50 to 60 percent of patients respond to therapy.
Treatment of patients with multiple myeloma has advanced over the past few decades. The role of high-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) in the treatment of multiple myeloma continues to evolve. The choice of induction therapy has moved from conventional chemotherapy to newer regimens incorporating the immunomodulatory derivatives (IMiDs) thalidomide or lenalidomide, and the proteasome inhibitor bortezomib. These drugs combine well with traditional therapies and with one another to form various doublet, triplet and quadruplet regimens.
Stem Cell treatment
Autologous stem cell transplantation is currently considered the standard of care for younger patients with newly diagnosed multiple myeloma based on several randomized trials that have shown it is superior to conventional chemotherapy. However, the introduction of novel agents like thalidomide, bortezomib, or lenalidomide may improve the results of standard-dose therapy. For instance, in combination, melphalan / prednisone / thalidomide may yield a good response comparable with those achieved with ASCT. However, recent research disputes that the effectiveness of the thalidomide addition as therapeutically beneficial.
Natural treatment with supplements, herbs and vitamins
As of 2016 I am not aware of a proven effective alternative therapy for MM that has been officially tested in long term human clinical trials.
J Steroid Biochem Mol Biol. 2014 Dec 10. Are low ultraviolet B and vitamin D associated with higher incidence of multiple myeloma? The purpose of this study was to determine whether an inverse association exists between latitude, solar ultraviolet B (UVB) irradiance, and incidence rates of multiple myeloma.Methods Associations of latitude and UVB irradiance with age-standardized incidence rates of multiple myeloma were analyzed for 175 countries while controlling for sex-specific obesity prevalence, cigarette consumption, and alcohol consumption using multiple linear regression. Incidence rates of multiple myeloma were greater at higher latitudes (R2 for latitude for males. In regression models for males and females, UVB irradiance was independently inversely associated with incidence rates. Age-adjusted incidence rates of multiple myeloma were higher in countries with lower solar UVB irradiance. Further investigation is warranted in individuals of the association of prediagnostic serum 25(OH)D with risk.
Curcumin can sensitize tumors to different chemotherapeutic agents including doxorubicin, 5-FU, paclitaxel, vincristine, melphalan, butyrate, cisplatin, celecoxib, vinorelbine, gemcitabine, oxaliplatin, etoposide, sulfinosine, thalidomide, and bortezomib. Chemosensitization has been observed in cancers of the breast, colon, pancreas, gastric, liver, blood, lung, prostate, bladder, cervix, ovary, head and neck, and brain and in multiple myeloma, leukemia, and lymphoma.
Life Sci. 2015. Melatonin, bone regulation and the ubiquitin-proteasome connection: A review. Recently, investigators have shown that ubiquitin-proteasome-mediated protein degradation is critical in regulating the balance between bone formation and bone resorption. The major signal transduction pathways regulating bone formation are the RANK/NF-κB pathway and the Wnt/β-catenin pathway. These signal transduction pathways regulate the activity of mature osteoblasts and osteoclasts. In addition, The Wnt/β-catenin pathway is one of the major signaling pathways in the differentiation of osteoblasts. The ubiquitin ligases that are reported to be of major significance in regulating these pathways are the ubiquitin SCFB-TrCP ligase (which regulates activation of NF-κB via degradation of IkBα in osteoclasts, and regulates bone transcription factors via degradation of β-catenin), the Keap-Cul3-Rbx1 ligase (which regulates degradation of IkB kinase, Nrf2, and the antiapoptotic factor Bcl-2), and Smurf1. Preclinical studies show that melatonin also influences bone metabolism by stimulating bone growth and inhibiting osteoclast activity. These actions of melatonin could be interpreted as being mediated by the ubiquitin ligases SCFB-TrCP and Keap-Cul3-Rbx, or as an inhibitory effect on proteasomes. Clinical trials of the use of melatonin in the treatment of bone disease, including multiple myeloma, using both continuous and intermittent modes of administration, are warranted.
I was diagnosed with multiple myeloma a ago and have gone
through chemo and stem cell transplant and need an other stem cell infusion
because my bone marrow is not responding as it should platelet count and red
blood cell counts are down for which I get transfusions however they are only
working for a little while. Would the product
curcumin be of any advantage?
It is not easy to know. I have not seen any clinical human research regarding the use of curcumin or turmeric for this condition but this spice may offer benefits.
Perhaps resveratrol could help sensitize the tumor cells to chemotherapy drugs?
Oncol Rep. 2012. Sulforaphane synergistically enhances the
cytotoxicity of arsenic trioxide in multiple myeloma cells via stress-mediated
Sulforaphane, a dietary isothiocyanate found in cruciferous vegetables, inhibits TNFα-induced Iκβ proteasomal degradation and synergistically enhances the cytotoxicity of arsenic trioxide (ATO), an agent with clinical activity in MM. Our results suggest that sulforaphane deserves further investigation in combination with ATO in the treatment of MM.
My wife, age 35, was recently diagnosed with Multiple
Myeloma, she has a number of lesions, rib, skull and perhaps hip... she will
begin a series of treatments within a couple of weeks (chemo + other) that will
eventually lead to a stem cell transplant in about 4 months. Wondering if you
had a recommendation on the supplements that we could give her when she is
undergoing the treatment or after that will help to put this cancer into
remission... I have heard good things about AHCC... but not sure if it can be used
along side chemo.
I am not aware at this time of a specific natural treatment for this condition or whether AHCC would be of help.
I have smoldering multiple myeloma discovered 5 years
ago when my absolute neutrophil count became very low and I had a bone biopsy (neutrophils
had been declining since 1999). I take 8,000 mg of turmeric with
Bioperine daily. Do you know: should the turmeric tablets be taken with or
without food? or on empty stomach? Also they recommend oil with turmeric tabs --
so I use capsules of cod liver oil, borage, vita E, vita A, CoQ10, flaxseed,
lecithin, vita D3. I have so far avoided chemo and other treatments that
oncologists try to recommend to smolderers (like prednisone, zometa). Do you
know of Margaret's Corner? margaret blogspots dot org?
It is difficult to predict, based on the limited knowledge we have thus far, whether taking the turmeric with food is more beneficial that without. One option is to alternate, sometimes taking it with a meal, and other times on an empty stomach. I have not heard of Margaret's Corner.
Multiple Myeloma symptom
Signs and symptoms of multiple myeloma include bone pain, bone fractures, weakness, anemia, infection (often resulting from pneumococcal infection), hypercalcemia, spinal cord compression, or renal failure. Sometimes, on a routine blood test, a large gap between the total protein and the albumin levels suggests a problem (ie, protein minus albumin equals globulin). The multiple myeloma cell produces monoclonal immunoglobulins that may be identified on serum or urine protein electrophoresis.
The average survival rate for all stages of multiple myeloma is about three years.
Multiple myeloma must be differentiated from other causes of monoclonal gammopathy, including monoclonal gammopathy of undetermined significance, heavy chain disease, plasmacytoma and Waldenstrom macroglobulinemia.
Multiple Myeloma cause
Firefighters appear to have higher-than-average rates of several types of cancer including prostate and testicular cancers, as well as the immune system cancers non-Hodgkin's lymphoma and multiple myeloma.
The industrial solvent benzene increases a person's risk. American Journal of Industrial Medicine, 2008.
A diagnosis known as smoldering multiple myeloma cna be considered when symptoms and signs point to something between monoclonal gammopathy of undetermined significance and overt multiple myeloma. Smoldering myeloma is generally defined as greater than 10% plasma cells in the marrow and an M serum protein of greater than 3g/dL. In most cases, serum creatinine and calcium levels are normal in smoldering myeloma.
Dr. Sahelian, I am a former patient of yours and should have stuck with you but got caught up in the conventional medicine machine and just now am getting off of 14 medications; however my question is in regards to the alternative health centers. My son has been diagnosed with multiple myeloma, has had a stem cell transplant and the cancer has returned. I ask you because you are an alumni of Thomas Jefferson Med. Ctr. And they are the # 2 research center on this disease in the world, second only to University of Arkansas at Little Rock and followed by UCLA. My son is now trying Alternative Medicine and I would like your opinion.
Thomas Jefferson is an excellent medical center, but much depends not necessarily on the hospital but who the actual treating doctor is. I am not familiar with effective alternative treatments for multiple myeloma and am sorry I cannot offer any helpful advice in this matter. I truly wish your son an optimal outcome. These are very difficult times for you and your family.
I am a physician and multiple myeloma patient. I noticed
you had some writings on berbamine and wondered if you could provide further
information. I am also acutely interested in cepharanthine. It appears both
compounds can help combat neutropenia, thrombocytopenia, and combat multi-drug
resistance, all problems I am dealing with.
Unfortunately I do not have much clinical experience treating MM with these nutraceuticals so I do not know at this time whether they would be of benefit.
My mom was diagnosed with multiple myeloma this past June. Her oncologist told us her case is extremely aggressive. She started in chemotherapy and in November she was told she was in remission. She was given a maintenance chemodose but we have sadly learned that the cancer has come back. My mom has been suffering since June. She has not been able to handle the chemo well at all. She is in total misery all the time. She can't eat. She can't walk without a walker. Before the diagnosis she was the healthiest 65 yr old imagineable. She has decided she no longer wants to live in total discomfort. She does not want to pursue any more chemotherapy or testing. She is done feeling so sick and miserable all the time. I don't blame her. No one should suffer and have no quality of life. I am desperate to find her something that will help, something that will give her some quality so that she can hopefully enjoy life and thrive once again for as long as possible.
Feb. 11, 2014 -- Tom Brokaw, respected journalist in television news, is battling multiple myeloma that attacks white blood cells in bone marrow, NBC News announced.