There are plenty of blogs out there that report new developments in traditional and alternative cancer therapy and research. My friend Pat Killingsworth has an excellent one here.
My blog normally doesn't do that, but in a response to the previous comment, "J" noted a recent (as in yesterday) article in the Myeloma Beacon that talked about how a test called a polymerase chain reaction or PCR can be used to detect residual cancer cells after a stem cell transplant, and this article is important enough to comment on.
The real point of the article, which can be found here, is that maintenance therapy with Velcade, Dex, and Thalidomide "may be effective in further reducing the number of tumor cells surviving in the marrow after ACST to levels only observed with allogeneic stem cell transplantations." That is: cure.
Here's where I point out that my original hematologist said, matter-of-factly, "I don't believe in maintenance therapy." He pointed out at the time that City of Hope did not, that MAYO did not, etc. I heard this from another doctor recently who thought it was "inconvenient" to take six months out of one's life for all this treatment and then be chained to a doctor's office weekly for three years. Meanwhile, BB has been honing maintenance therapy with these agents since 2003, and now uses Revlimid instead of Thalidomide which the article said could further improve the already clear benefits of maintenance therapy.
Fifteen months ago, hardly anybody was doing maintenance therapy. And now, we see that it probably saves lives. The world is coming around. BB is right.
Now, unfortunately, even BB's protocol only cures about 60% of patients -- that leaves a lot who need other therapies to beat the disease. And I remain heartened by the continued focus on developing new drugs for these and other MM sufferers.
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After a Diagnosis of myeloma in 2008, I did my due diligence. I looked at several options for treating my MM, talked with physicians, program directors and patients at several leading MM centers. I'm not a medical professional and there was (is) a steep learning curve to undertake, but I am confident that I've made a good decision (for me)to go through Total Therapy at UAMS. I am also convinced that maintenance therapy is mandated for the outcome that I seek: CURE. Is it overkill? I don't know. But I'd rather not leave the job half done. This isn't a game. I'm staking my life on my decisions. Sean
ReplyDeleteNick, It is interesting to read how we all look at the same information. When I read the Beacon press release, my mind went in another direction. The clinical trial showed that 3% already were 'cured' according to the PCR test right after transplant. Another 18% were after four cycles of maintenance VTD. My thoughts were that this PCR test could save many from 'overuse' of drugs. So a patient that had a transplant and the PCR test came back with no signs of MM, there would be no need to treat them with expensive drugs and their side effects. Also, for those undergoing maintenance therapy, could the test be a way to determine when to stop, saving money and quality of life?
ReplyDeleteAnother question is, is anyone using this test in the US, or is this study and the PCR test valid at all? Maybe someone could ask the doctors on the Forum about this test and if it is valid.
I always seem to have so many questions. I do think there are doors being unlocked to MM everyday.
Nick, this article brought many questions to my mind. Is anyone using the PCR test in the US, and is it a valid test? The study showed that 3% of patients are already in MR(molecular remissions) after transplant and another 18% are in MR after four cycles of VTD. Could this test be used to prevent overuse of expensive and toxic drugs? We would no longer have to treat everyone after transplant, and could stop maintenance treatment much sooner for many. These might be questions for the doctors on the forum, or if anyone has asked their doctor about it and could post their results.
ReplyDeleteOur doc also doesn't "believe" in maintenance therapy, but his "belief" is based on maintenance therapy for many other cancers, which is indeed becoming the norm.
ReplyDeleteWe have found that the daunting task of "maintenance" therapy has been amazingly easy to fit into our life and are very happy to give Dave every opportunity to be in the long term survival group, that just a few short years ago was considered "medically insignificant". I felt when we headed to LR, that I wanted to be in the then medically insignificant group because it would be personally significant to Dave and I.