Doctor insights on:
Medicine For Multiple Myeloma
Does personalized medicine apply to diagnosis of typical conditions like multiple myeloma? What tests are needed?
I had not heard of "kahler's disease" until seeing multiple questions on healthtap. It is multiple myeloma (mm). "multiple" is from the often seen "multiple" bone lesions (especially in advanced disease). Mm is a cancer of plasma cells [highly specialized b white blood cells (lymphocytes)] that produce antibodies. Sx are crab: hypercalcemia, renal insufficency, anemia, ...Read more
What drugs are the standard of care in the us for multiple myeloma? What drugs are the standard of care in france, germany and canada? Why differe
Complex: Too complex to answer definitively in 400 characters. 1) country differences depends on different forms of "fda" & often cost/value calculations in other countries. 2) "standard" is really standards (plural) of care, which depends on untreated/relapsed, bmt candidate (possibly), & individual considerations (eg renal fn, oral vs. Iv, age, lifestyle, etc). This complexity reflects rapid change. ...Read more
I have multiple myeloma and am enduring chemotherapy with a new drug (to the nhs) revlimid (lenalidomide). Are there any drug/supplements to harness my immune sys?
Follow MDs advice: Lenalidomide is an immunomodulatory drug (imid), so it is "harnessing your immune system". I would re-word the question as what drugs should I take to optimize my myeloma treatment? Lenalidomide (revlimid) is a very effective drug alone or with other drugs. Myeloma patients are at high risk of infection with or without therapy. Anti-viral drugs (acyclovir, valacyclovir) can reduce risk of shingles. ...Read more
Rarely: There are a few families where it appears hereditary. Having said this, there are families where more than one individual has the disease and the thought is that this may be due to an environmental cause. ...Read more
just means multiple bone marrow tumors. A simple description like that does not take modern technology (though it would not be picked up early). Indeed, it has been known since ancient times. There have been a lot of discoveries along the way that explains what it is and how it arises. Here's an article on its history:
http://www.ncbi.nlm.nih.gov/pubmed/21509678 ...Read more
Blood/Urine/Imaging: Usually workup involves blood and urine tests (spep / upep - serum and urine protein electrophoresis). The preferred initial imaging study is the skeletal survey (x-ray of multiple sites of the body including skull, axial skeleton, and proximal long bones). Bony lesions are usually lytic. ...Read more
Multiple myeloma: Medial survival in myeloma many years ago was only 1-2 years. Nowadays, with many effective therapy such as lenalidomide, bortezomib, transplant -median survival has increased up to 7 years. Newer medications such as pomalidomide and cerfilzomib hopefully would be approved soon and more medication in pipelines are lining up - all of these would likely to increase the median survival longer. ...Read more
No simple answer: Multiple myeloma has been associated with ionizing radiation (atomic bomb level), herbicides, petroleum products, analin hair dyes, autoimmune disease but there is no clear cut association. There are a few families which show an inheritance pattern along with other lymphomas. ...Read more
The tests for Multiple myeloma include:: Albumin, Basic metabolic panel, Bone marrow biopsy, Complete blood count, Ionized calcium, Lactate dehydrogenase, MRI, Skeletal survey, C reactive protein, Protein electrophoresis, 24 hour urine protein electrophoresis, Free kappa lambda light chains, Beta 2 microglobulin. ...Read more
Depends...: This answer depends. That might not be as satisfying but is true. For a 90yo pt it is palliative -- keeping crab symptoms away with minimal discomfort fro m tx. A new study from dr. Campagnaro in ecog will evaluate. For most, "control" as a chronic disease. For some cure. If young, we like to obtain a "deep" response w/ complete response (cr) & now looking at minimal residual disease (mrd) by flow. ...Read more
MM and age: Mm is a disease of older adults. The median age at diagnosis is 66 years; only 10% and 2% of patients are younger than 50 and 40 years, respectively. ...Read more
Plasma cell cancer:
Multiple myeloma is a cancer of plasma cells (pcs). Pcs are the specialized b lymphocytes that produce antibodies. When there is a cancer or one (mono-) clone (= monoclonal, m) PC population they can product m-proteins. Symptoms include crab - hypercalcemia, renal (kidney) insufficiency, anemia, bone disease; also infection and pain.
More: http://www.Cancer.Net/cancer-types/multiple-myeloma. ...Read more