A few years ago, I lived with the hope that my chemotherapy-induced peripheral neuropathy (CIPN) would disappear over time. Since I'd had Taxol every week for six months, the CIPN side effect was not unexpected. The availability of cold socks/gloves/caps at that time was much less than it is now, and I only learned about those options after that treatment had ended. Still, those techniques are no guarantee CIPN won't set in and stick around.
Although I knew I was developing the condition and was careful to inform both my doctor and the nurses about how the tingling was developing, I am sure I downplayed the seriousness of the situation because the last thing I wanted was to end treatment before our previously agreed upon date.
So, now I live with CIPN and while I have had prescriptions for gabapentin issued, I have resisted this choice for personal reasons including the idea that it is more effective for painful neuropathy than the type I experience, which is numbness and tingling. It's hard living with CIPN that seems to be progressing overall, but that sometimes ebbs with factors I haven't been super successful at duplicating when I need them.
Cold weather, which can extend from November through March where I live, is especially brutal for those living with this side effect. Bottomline, commonsense steps can help maintain comfort during cold weather. I can't claim to have found the solution for CIPN for anyone else – or even myself – but I do know some good tips for cold-weather management:
Move. Although movement is not a cure for CIPN, it does help relieve stiff and numb hands and feet. I remember sitting in a cold truck with my brother-in-law, who had severe neuropathy, and watching him clench and unclench his hands. This movement can provide immediate help by warming hands (and toes, clench those as well) by getting circulation moving when it is not possible to take other steps. Full-body exercise also works to improve overall circulation, so include that as well if you are able.
Keep feet dry. One of the problems with CIPN is that it's hard to know what your fingers and feet are actually feeling. There have been times when I've kept on shoes after being outside only to find, after I finally notice that my feet are more uncomfortable than usual, that my socks are damp. I've learned to remove my shoes as soon as I come inside, even if my feet feel OK, and switch to a new pair of socks after checking to make sure my feet are not damp. It's a commonsense move that is easy to forget.
Gloves and socks. Even the warmest coverings aren't going to stop my CIPN from acting up in cold weather, but it is much worse if I decide to go without gloves, for instance, because that's what I could do before cancer. Just put on the warm gloves and socks (and keep them dry).
Wear a warm coat. If you have CIPN, you might have noticed that if you become cold by underdressing for the weather, the degree of pain or numbness in your peripheral areas becomes worse. That happens because circulation isn't being maintained and it can become more difficult to move your fingers (or toes). For CIPN in hands, it's particularly helpful to make sure even your forearms remain warm.
Walk safe. I've fallen enough times, both in cold weather and warm, to want to stay upright. Leave the heels or slippery flats at home or in your purse to switch into once inside. Instead, wear shoes or boots with traction that might help prevent you from sliding into a fall and keep hands out of pockets (wear gloves or mittens!), which not only gives you a chance to catch yourself if you start to fall, but can also help to prevent fingers from cramping or "freezing" into a bent position.
Use caution outdoors. While I used to love to sled for hours with my son, I know that cold can slow circulation to hands and feet, aggravate CIPN, and may cause additional nerve damage. I'm not going to give up the things that I enjoy, but I will do what I can to prevent further nerve damage. So, I try to keep an extra pair of socks and gloves with me when I go out to minimize the chance that I'll be in damp or cold clothing for too long and I take breaks indoors or in a warm car.
Pamper yourself. I've found that while it can sometimes hurt to have my feet touched, gently massaging lotion onto them (and my hands) does wonders. It increases circulation, gives me a chance to notice if I've hurt my feet anywhere, and also puts my hands to work. These moments of indulgence matter and are good for movement and warmth.
LINK
Wednesday, January 23, 2019
Thursday, January 17, 2019
TUSCANINI INTRODUCES NEW LINE UP OF GOURMET ITALIAN PRODUCTS
Hi, gang- I was delighted to get a package full of products from TUSCANINI! As you can imagine, being married to an Italian, this stuff is right up my alley.
And it's GREAT! These will be staples in my kitchen. My Dominic loved these, as did I!
From the Rolling Hills of Tuscany...to Your Table, Say “Ciao!” to the Taste of Italy With These Premium Favorites:
Gourmet Balsamic Vinegar and Vinegar Glaze
Premium Pastas
Authentic Italian Tomato Sauces and Tomato Paste
Cold-Pressed Sparkling Beverages and Mineral Water
Versatile Apple Cider Vinegar
Recipes
Bayonne, NJ, JANUARY 8, 2018 – From the rolling hills of Italy, Tuscanini Foods is rolling out a new lineup of gourmet food products that bring the taste of Italy to your table for a truly authentic Italian dining experience.
This superior brand of foods is imported from Italy, famously identified for its traditions and age-old recipes. From the mountainous Dolomite region to the idyllic Sardinia Island, products are sourced from artisans that specialize in offering only the best quality ingredients.
The host of products from Tuscanini - from naturally sparkling cold pressed beverages to bronze cut Italian pasta - allow consumers to cook-up original homemade Italian favorites and provide delicious gourmet options for year-round cooking.
Distributed by NJ-based Kayco (www.kayco.com), a leader in specialty food products, Tuscanini (www.tuscaninifoods.com) products meet the highest standards of quality, craftsmanship and gourmet cuisine. All products are produced with natural ingredients, nothing artificial and are certified OU kosher.
The following authentic Italian imports are coming to grocery shelves in 2019:
Balsamic Vinegar (MRP $7.99 / 8.45 oz.)
This Balsamic Vinegar offers of ultimate Italian experience with its complex flavor and beautiful glass bottle and cork closure.
Balsamic Vinegar Glaze (MRP $7.99 / 8.5 oz.)
Rich and complex, these condiments hail from Modena, Italy, one of only two places in the world where true balsamic vinegar is produced under PDO classification. Tuscanini’s gourmet balsamic products are meticulously prepared from locally grown grapes and aged in traditional wood casks. Balanced with 6% acidity, they are superior for serious home cooks and restaurants.
Italian Pastas (MRP $3.99 / 16 oz.)
Dried pasta has been the mainstay of Italian cuisine for centuries. These 100% Durum Semolina pastas are bronze cut to create a porous, home-style texture that showcases the sauce in every bite. The high-end collection includes a variety of shapes: Gigli (ruffle-edged cones), Pennoni (a somewhat more substantial version of Penne), Trottole (“spinning top”), tricolor Conchiglie (seashells), and tricolor Fusilli (corkscrews).
Pasta Sauces (MRP $4.99 / 24.3 oz. jars)
These four authentic toppings evoke warm, sun-kissed Italian summers. Every jar of Tuscanini pasta sauce features 40 fresh tomatoes from the Parma region, harvested at the peak of ripeness. Traditional Pizza Sauce, Naopoletana Pasta Sauce, Classic Marinara Sauce, and Zesty Marinara Sauce pair perfectly with Tuscanini’s home-style Italian Pastas.
Tomato Paste (MRP $1.99 / 7.05 oz.)
Ripe, luscious tomatoes grown under the Tuscan sun are triple-concentrated for an intense burst of fresh flavor. Convenient, re-sealable tube lets you use only what you need with no waste. All-natural and non-GMO project certified.
Organic Sparkling Beverages (MRP $6.99 / 4-pack of 9.3 oz. bottles)
Tuscanini introduces two elegant new sparkling soft drinks inspired by leisurely Italian afternoons at an outdoor café. Made with only the choicest fruits hand-picked at peak harvest, these crisp Italian sodas are cold-pressed for maximum natural flavor. Available in Lemon and Blood Orange. Enjoy these all-natural refreshers straight from the bottle or over ice. USDA Organic certified.
Apple Cider Vinegar (MRP $5.99 / 16.9 oz.)
From the picturesque mountain region of Dolomite comes an unfiltered Apple Cider Vinegar brewed with “the mother culture” – a beneficial mix of proteins, acids, and bacteria prized for their healthy properties. This ancient condiment has become extremely popular with consumers and chefs alike. Made with only organic Italian apples, it delivers a great, well-balanced acidity in glazes, dressings, marinades, and more.
TRY THESE RECIPES:
Recipes:
https://www.kosher.com/recipe/balsamic-roasted-potatoes-and-shallots-6348
https://www.kosher.com/recipe/tomato-soup-with-cheddar-matzah-balls-recipe-3601
https://www.kosher.com/recipe/peperonata-6398
https://www.kosher.com/recipe/grilled-vegetables-with-balsamic-vinegar-recipe-4588
https://www.kosher.com/recipe/balsamic-salmon-over-pomegranate-and-golden-kiwi-arugula-salad-6452
And it's GREAT! These will be staples in my kitchen. My Dominic loved these, as did I!
From the Rolling Hills of Tuscany...to Your Table, Say “Ciao!” to the Taste of Italy With These Premium Favorites:
Gourmet Balsamic Vinegar and Vinegar Glaze
Premium Pastas
Authentic Italian Tomato Sauces and Tomato Paste
Cold-Pressed Sparkling Beverages and Mineral Water
Versatile Apple Cider Vinegar
Recipes
Bayonne, NJ, JANUARY 8, 2018 – From the rolling hills of Italy, Tuscanini Foods is rolling out a new lineup of gourmet food products that bring the taste of Italy to your table for a truly authentic Italian dining experience.
This superior brand of foods is imported from Italy, famously identified for its traditions and age-old recipes. From the mountainous Dolomite region to the idyllic Sardinia Island, products are sourced from artisans that specialize in offering only the best quality ingredients.
The host of products from Tuscanini - from naturally sparkling cold pressed beverages to bronze cut Italian pasta - allow consumers to cook-up original homemade Italian favorites and provide delicious gourmet options for year-round cooking.
Distributed by NJ-based Kayco (www.kayco.com), a leader in specialty food products, Tuscanini (www.tuscaninifoods.com) products meet the highest standards of quality, craftsmanship and gourmet cuisine. All products are produced with natural ingredients, nothing artificial and are certified OU kosher.
The following authentic Italian imports are coming to grocery shelves in 2019:
Balsamic Vinegar (MRP $7.99 / 8.45 oz.)
This Balsamic Vinegar offers of ultimate Italian experience with its complex flavor and beautiful glass bottle and cork closure.
Balsamic Vinegar Glaze (MRP $7.99 / 8.5 oz.)
Rich and complex, these condiments hail from Modena, Italy, one of only two places in the world where true balsamic vinegar is produced under PDO classification. Tuscanini’s gourmet balsamic products are meticulously prepared from locally grown grapes and aged in traditional wood casks. Balanced with 6% acidity, they are superior for serious home cooks and restaurants.
Italian Pastas (MRP $3.99 / 16 oz.)
Dried pasta has been the mainstay of Italian cuisine for centuries. These 100% Durum Semolina pastas are bronze cut to create a porous, home-style texture that showcases the sauce in every bite. The high-end collection includes a variety of shapes: Gigli (ruffle-edged cones), Pennoni (a somewhat more substantial version of Penne), Trottole (“spinning top”), tricolor Conchiglie (seashells), and tricolor Fusilli (corkscrews).
These four authentic toppings evoke warm, sun-kissed Italian summers. Every jar of Tuscanini pasta sauce features 40 fresh tomatoes from the Parma region, harvested at the peak of ripeness. Traditional Pizza Sauce, Naopoletana Pasta Sauce, Classic Marinara Sauce, and Zesty Marinara Sauce pair perfectly with Tuscanini’s home-style Italian Pastas.
Tomato Paste (MRP $1.99 / 7.05 oz.)
Ripe, luscious tomatoes grown under the Tuscan sun are triple-concentrated for an intense burst of fresh flavor. Convenient, re-sealable tube lets you use only what you need with no waste. All-natural and non-GMO project certified.
Organic Sparkling Beverages (MRP $6.99 / 4-pack of 9.3 oz. bottles)
Tuscanini introduces two elegant new sparkling soft drinks inspired by leisurely Italian afternoons at an outdoor café. Made with only the choicest fruits hand-picked at peak harvest, these crisp Italian sodas are cold-pressed for maximum natural flavor. Available in Lemon and Blood Orange. Enjoy these all-natural refreshers straight from the bottle or over ice. USDA Organic certified.
Apple Cider Vinegar (MRP $5.99 / 16.9 oz.)
From the picturesque mountain region of Dolomite comes an unfiltered Apple Cider Vinegar brewed with “the mother culture” – a beneficial mix of proteins, acids, and bacteria prized for their healthy properties. This ancient condiment has become extremely popular with consumers and chefs alike. Made with only organic Italian apples, it delivers a great, well-balanced acidity in glazes, dressings, marinades, and more.
TRY THESE RECIPES:
Recipes:
https://www.kosher.com/recipe/balsamic-roasted-potatoes-and-shallots-6348
https://www.kosher.com/recipe/tomato-soup-with-cheddar-matzah-balls-recipe-3601
https://www.kosher.com/recipe/peperonata-6398
https://www.kosher.com/recipe/grilled-vegetables-with-balsamic-vinegar-recipe-4588
https://www.kosher.com/recipe/balsamic-salmon-over-pomegranate-and-golden-kiwi-arugula-salad-6452
Thursday, January 10, 2019
New Contest: Vote for Dumbest PETA Campaign
PETAKillsAnimals.com Launches “Dumbest PETA Campaign” Contest
Winner will receive a 12-month subscription to meat delivery service Butcher Box
What’s worse: Trivializing the Holocaust, or making light of sexual violence? Those are just two examples from years of obnoxious media stunts by People for the Ethical Treatment of Animals (PETA).
Today, PETAKillsAnimals.com launched A CONTEST in which people can vote for what they think is PETA’s dumbest campaign ever. Voters are automatically entered for a chance to win a 12-month subscription to Butcher Box, a monthly meat delivery service.
There are ten campaigns to choose from in the contest going back decades. PETA’s campaigns include tasteless Holocaust comparisons, attempting to rebrand fish as “sea kittens,” and PETA’s recent headline-grabbing criticism of common idioms.
Will Coggin, managing director of PETAKillsAnimals.com, commented: “Over the years, PETA has come up with a lot of dumb campaigns that beg for press attention but don’t even do anything to help animals. That shouldn’t surprise anyone who knows PETA has killed over 40,000 animals at its headquarters.
This contest is a fun way to showcase some of PETA’s worst campaigns.
The winner, as they say, will be bringing home the bacon.”
***********************
I thought that this was cute, gang! Here's a link to the contest:
https://www.petakillsanimals.com/contest/
Wednesday, January 9, 2019
10 Things You Need To Know About Multiple Myeloma
Multiple myeloma is a treatable but incurable blood cancer that typically occurs in the bone marrow. It is a relatively uncommon cancer, affecting approximately 30,000 new people each year. 1 Difficult to diagnose until it is in the advanced stages, it is mainly treated with chemotherapy and stem cell therapies. But the survival rate is increasing, especially as advances in treatment are being discovered. Here are the ten things you need to know about the disease.
Please note: nothing can replace the care of your clinician or doctor. Please do not make changes to your treatment or schedules without first consulting your healthcare providers. This article is not intended to diagnose or treat illness.
1. What is multiple myeloma?
Multiple myeloma is a type of cancer that typically occurs within a bone due to the presence of malignant plasma cells. Under normal circumstances, plasma cells develop from B cells—a type of cell that the immune system uses to fight disease or infection. When B cells react to an infection or disease, they change into plasma cells, which are responsible for creating antibodies to help fight germs. These plasma cells are found mainly in bone marrow.
Sometimes, after plasma cells develop, they can begin to grow out of control and create a tumour called a plasmacytoma. These tumours generally develop within a bone but can occasionally be found in other body tissues. When a person develops more than one of these tumours, they have multiple myeloma.
2. Risk factors and causes
Unlike many other cancers, there are very few known risk factors associated with getting multiple myeloma. These factors are listed below.
Age: The majority of diagnoses are in people who are more than 45 years old (96 percent), and more than 63 percent of diagnoses are in people older than 65. Less than one percent of cases are in people younger than 35.2
Race: For reasons unknown, it is more than twice as common in African-Americans than in white Americans.
Gender: Men are at a slightly higher risk than women.
Family history: A person with a parent or sibling who has the disease is four times more likely to get the disease, too.
Obesity: Being overweight or obese increases the risk.
Having other plasma cell diseases: A person with solitary plasmacytoma (a single tumour), or someone diagnosed with monoclonal gammopathy of undetermined significance, which is a plasma cell disorder that does not normally cause problems, is more likely to later develop multiple myeloma.
Radiation: People exposed to are at a higher risk.
Workers exposed to ionizing radiation have been shown to have an increased risk of the disease as well, according to a study conducted at US Department of Energy facilities.
Workplace exposure: Some studies have shown that workers in occupations such as agriculture, leather, petroleum and cosmetology, and workers exposed to chemicals such as asbestos, benzene, and pesticides are at an increased risk.
Researchers do not have a clear understanding of what causes multiple myeloma, though they have made progress into better understanding how specific DNA changes can cause plasma cells to mutate. Studies show that abnormalities in genes called oncogenes, which promote cell division, develop early in the growth of plasma cell tumours. Studies also show that myeloma cells have abnormalities in their chromosomes; specifically, research has revealed that pieces of chromosome 13 are missing.
Research also shows that in approximately half of people diagnosed with multiple myeloma, a translocation has occurred. This is when “a part of one chromosome has switched with a part of another chromosome in the myeloma cell.” 4 Scientists have also discovered that people with plasma cell tumours have abnormalities in other bone marrow cells, which might cause too much plasma cell growth.
3. Symptoms
The early stages of multiple myeloma may not have any symptoms, and even when symptoms are present, they may be similar to those that occur with other conditions. Below are some of the common symptoms of the disease:
*Fatigue
*Bone pain and/or bone fractures
*Nausea/vomiting
*Increased thirst
*Increased/decreased urination
*Increased risk of infections
*Confusion
*Loss of appetite/weight loss
*Restlessness that is later followed by significant fatigue and weakness
*Problems with kidney function
4. Positive results from targeted therapies
There are many drugs available to treat multiple myeloma, with chemotherapy and autologous stem cell transplants (when stem cells are collected from the patient) the most common, but several of the most recent and exciting treatments to become available are two medications called daratumumab and ixazomib, and a form of treatment known as immunotherapy.
Darzalex (Daratumumab): In November 2015, the FDA granted “accelerated approval” for daratumumab injections in the treatment of multiple myeloma. The drug may only be used by individuals who have already undergone at least three other types of therapy.
Darzalex is part of a category of drugs called monoclonal antibodies. It works by binding to a protein called CD38, which is typically found on the surface of myeloma cells. Once it is attached to the cell, the drug attacks the cell while simultaneously signaling to the immune system to fight against the cells.
Almost one-third of clinical trial participants (with a median of five previous therapies) responded positively to the drug. Daratumumab can be purchased via our products page.
Ixazomib: Recently approved by the FDA, this completely oral treatment is used in combination with standard myeloma drugs to treat people who have already undergone at least one previous therapy. Clinical study results showed that the drug taken in combination with lenalidomide and dexamethasone increased “progression-free survival (PFS) in patients with relapsed/refractory multiple myeloma.” You find more information about Ixazomib on our products overview.5
Immunotherapy: Immunotherapy is when a person’s immune system is used to treat an infection or disease. In a recent study, scientists discovered that 70 percent of people with multiple myeloma who were treated with immunotherapy had a “significant clinical response” to the disease. 6 In the study, 14 of the 20 participants with an advanced form of multiple myeloma had a “near-complete or complete response three months after treatment; median progression-free survival was 91.1 months, while the overall survival lasted 32.1 months.” 7 Further, no significant side effects were reported. This is an important advance, given that current treatments such as chemotherapy and autologous stem cell transplants have low long-term responses and an average survival rate between three and five years. 8 *Update January 2018 – Empliciti (elotuzumab), is a type of immunotherapy that was approved in the US, Europe, and Australia, but has still not been approved in many other parts of the world and is therefore not directly available there. For more information head to our medicines overview page.
Despite advancements in the treatment of multiple myeloma, not all medicines are available in the same countries at the same time. This can be due to delays in initial approval by one regulatory body and approvals within a certain country — if the manufacturer has filed for approval in that country. There is no global, harmonised approval system and it’s up to manufacturers to decide where to go to market first (also known as applying for market authorisation). Regulatory bodies also differ in speed, which can cause delays.
Almost any country in the world allows individuals to import elsewhere approved medicines for personal use, which may give multiple myeloma patients access to new-to-market medicines. If you are seeking a medicine not yet available in your country, head to our home page to find out how our team can help.
5. Tom Brokaw is living with the disease and has written a book about it
NBC News anchor Tom Brokaw was diagnosed with multiple myeloma in August 2013 following a bout of severe back pain. Though he originally wanted to keep the diagnosis private, he eventually announced his fight against the disease. His memoir, A Lucky Life Interrupted, was published last year and details his journey following his diagnosis. In it, Brokaw discusses the challenges he faced from the disease: weight loss, the inability to sometimes walk without help, the side effects from his medications, and the moment when he learned that the disease was affecting 60 percent of his blood. After 16 months of treatment, his cancer went into remission.
6. How it’s diagnosed
Several different diagnostic tests must be used to confirm a multiple myeloma diagnosis because it is challenging to diagnose based on a single laboratory result. A physical evaluation will be done alongside a review of the individual’s history, symptoms, blood and urine tests, and a bone marrow biopsy. Other tests might include an MRI, CT scan, PET scan and X-rays.
In order to definitively diagnose multiple myeloma, a person must meet at least one major and one minor or three minor criteria. Those criteria are:
Major criteria:
*Plasmacytoma (based on a biopsy)
*The existence of 30 percent plasma cells in a bone marrow sample
*Increased levels of M protein in either blood or urine
Minor criteria:
*10 percent to 30 percent plasma cells in a bone marrow sample
*Osteolytic lesions
*A minor elevation in M protein levels in blood or urine
*Low levels of antibodies (that are not produced by cancer cells) in the blood.
7. Stages and classifications
The criteria as discussed above helps doctors determine not only whether a person has the disease, but also under which classification the disease falls.
Those classifications are:
*Monoclonal gammopathy of undetermined significance (MGUS)
*Asymptomatic myeloma, which is then divided into two subcategories:
*Smoldering myeloma
*Indolent myeloma
*Symptomatic myeloma
Once the classification is known, a doctor will then determine which stage of the disease exists, which will help establish the prognosis and treatment options.
The most common way to diagnose the stage of the disease is through the International Staging System (ISS), which is based on two different blood test results: the beta 2-microglobulin (β2-M) and the albumin. There are three stages of classification under the ISS:
Stage I: β2-M less than 3.5 mg/L and albumin greater than or equal to 3.5 gm/dL
Stage II: Either β2-M greater than 3.5 mg/L but not greater than 5.5 mg/dL and/or albumin less than 3.5 g/dL
Stage III: β2-M greater than 5.5 mg/L
The Durie-Salmon Staging System is an older system of diagnosis. This uses four measurements to determine which stage of the disease exists: 1) the amount of hemoglobin in the blood; 2) the amount of calcium in the blood; 3) the production rate of M protein; and 4) the number of bone lesions. The disease’s stage is then further subdivided based on kidney function.
The three stages of the disease as determined by the Durie-Salmon Staging System are: Stages I, II and III. Each of these stages is then subdivided into either Stage A or Stage B based on whether kidney function is affected. (Stage B means there is significant kidney damage.)
Stage I: Though a person with Stage I often shows no symptoms of the disease because there are fewer cancer cells present in the body, other signs will be present, such as: amount of red blood cells within or a little below the normal range, a normal amount of calcium in the blood, low levels of M protein in the urine or blood.
Stage II: More cancer cells are present in the body than in Stage I. An individual who does not fit into either Stage I or Stage III is said to have Stage II.
Stage III: There are many cancer cells present. Other characteristics of this stage include; hypercalcemia, high levels of M protein, anemia, and significant bone damage.
Note: In any stage, if kidney function is affected, the prognosis will be worse.
8. It’s treatable, not curable
The most common multiple myeloma treatment has typically been chemotherapy followed by stem cell transplants. Because the disease is not curable, this method of treatment aimed to create longer and longer stretches of time during which it did not progress. Now, however, significant advances in research have dramatically changed not only the prognosis but the treatment that is offered. In fact, treatments have advanced so much that there is an increasing discussion among the scientific community as to whether a stem cell transplant should be done after diagnosis or if it is better to wait until a relapse.
Scientists are currently experimenting with different combinations of medications to increase the survival rate. For example, efforts are being made to combine certain drugs that not only have diminished side effects but that also “lengthen stretches of progression-free survival (PFS). 9 Other drugs are being studied to see how they can work with the body’s immune system to fight the disease.
“It’s a massive convergence of our understanding of biology, the technology becoming available to understand myeloma cells and how they respond, the genetic subtypes of myeloma, the ability to engage both the patient community and researcher, to transfer data and information,” says Walter Capone, president and CEO of the Multiple Myeloma Research Foundation, in an article with Cure. 10
9. There’s an international support network
The International Myeloma Foundation—while not an official sponsor of the more than 150 multiple myeloma support groups around the world—conducts yearly conferences for support group leaders. Information on support groups according to an individual’s geographical location can be found on the IMF website.
10. The survival rate continues to increase
According to Cancer Research UK (which used data from 2010-2011), 78 percent of men diagnosed with the disease survive for at least one year and 50 percent survive for five years or longer. For women, that number is 75 percent for one year and 44 percent for at least five years or longer. 11
In the United States, researchers reported that a “newly diagnosed myeloma patient 15 years ago, for example, was about one-third as likely as someone without myeloma to live another five years.” 12 Those same researchers found that “By the end of the 2000s, in contrast, that same myeloma patient would be 45 percent as likely as someone without myeloma to live another five years.” 13 According to the American Cancer Society, the median survival rate for Stage I is 62 months; Stage II: 44 months; and Stage III, 29 months. 14
With advances in treatment, as well as ongoing clinical studies, those prognoses continue to increase. In fact, the prognosis today of someone diagnosed with the disease is nearly triple what it once was. 15
http://vhealthpluse.com/10-things-you-need-to-know-about-multiple-myeloma/?fbclid=IwAR0txI0qbJbtT4IcSGmxGErdx2Oj8_liAZbAIc8sW0Fl40jgdYv8MdpGGwE
Please note: nothing can replace the care of your clinician or doctor. Please do not make changes to your treatment or schedules without first consulting your healthcare providers. This article is not intended to diagnose or treat illness.
1. What is multiple myeloma?
Multiple myeloma is a type of cancer that typically occurs within a bone due to the presence of malignant plasma cells. Under normal circumstances, plasma cells develop from B cells—a type of cell that the immune system uses to fight disease or infection. When B cells react to an infection or disease, they change into plasma cells, which are responsible for creating antibodies to help fight germs. These plasma cells are found mainly in bone marrow.
Sometimes, after plasma cells develop, they can begin to grow out of control and create a tumour called a plasmacytoma. These tumours generally develop within a bone but can occasionally be found in other body tissues. When a person develops more than one of these tumours, they have multiple myeloma.
2. Risk factors and causes
Unlike many other cancers, there are very few known risk factors associated with getting multiple myeloma. These factors are listed below.
Age: The majority of diagnoses are in people who are more than 45 years old (96 percent), and more than 63 percent of diagnoses are in people older than 65. Less than one percent of cases are in people younger than 35.2
Race: For reasons unknown, it is more than twice as common in African-Americans than in white Americans.
Gender: Men are at a slightly higher risk than women.
Family history: A person with a parent or sibling who has the disease is four times more likely to get the disease, too.
Obesity: Being overweight or obese increases the risk.
Having other plasma cell diseases: A person with solitary plasmacytoma (a single tumour), or someone diagnosed with monoclonal gammopathy of undetermined significance, which is a plasma cell disorder that does not normally cause problems, is more likely to later develop multiple myeloma.
Radiation: People exposed to are at a higher risk.
Workers exposed to ionizing radiation have been shown to have an increased risk of the disease as well, according to a study conducted at US Department of Energy facilities.
Workplace exposure: Some studies have shown that workers in occupations such as agriculture, leather, petroleum and cosmetology, and workers exposed to chemicals such as asbestos, benzene, and pesticides are at an increased risk.
Researchers do not have a clear understanding of what causes multiple myeloma, though they have made progress into better understanding how specific DNA changes can cause plasma cells to mutate. Studies show that abnormalities in genes called oncogenes, which promote cell division, develop early in the growth of plasma cell tumours. Studies also show that myeloma cells have abnormalities in their chromosomes; specifically, research has revealed that pieces of chromosome 13 are missing.
Research also shows that in approximately half of people diagnosed with multiple myeloma, a translocation has occurred. This is when “a part of one chromosome has switched with a part of another chromosome in the myeloma cell.” 4 Scientists have also discovered that people with plasma cell tumours have abnormalities in other bone marrow cells, which might cause too much plasma cell growth.
3. Symptoms
The early stages of multiple myeloma may not have any symptoms, and even when symptoms are present, they may be similar to those that occur with other conditions. Below are some of the common symptoms of the disease:
*Fatigue
*Bone pain and/or bone fractures
*Nausea/vomiting
*Increased thirst
*Increased/decreased urination
*Increased risk of infections
*Confusion
*Loss of appetite/weight loss
*Restlessness that is later followed by significant fatigue and weakness
*Problems with kidney function
4. Positive results from targeted therapies
There are many drugs available to treat multiple myeloma, with chemotherapy and autologous stem cell transplants (when stem cells are collected from the patient) the most common, but several of the most recent and exciting treatments to become available are two medications called daratumumab and ixazomib, and a form of treatment known as immunotherapy.
Darzalex (Daratumumab): In November 2015, the FDA granted “accelerated approval” for daratumumab injections in the treatment of multiple myeloma. The drug may only be used by individuals who have already undergone at least three other types of therapy.
Darzalex is part of a category of drugs called monoclonal antibodies. It works by binding to a protein called CD38, which is typically found on the surface of myeloma cells. Once it is attached to the cell, the drug attacks the cell while simultaneously signaling to the immune system to fight against the cells.
Almost one-third of clinical trial participants (with a median of five previous therapies) responded positively to the drug. Daratumumab can be purchased via our products page.
Ixazomib: Recently approved by the FDA, this completely oral treatment is used in combination with standard myeloma drugs to treat people who have already undergone at least one previous therapy. Clinical study results showed that the drug taken in combination with lenalidomide and dexamethasone increased “progression-free survival (PFS) in patients with relapsed/refractory multiple myeloma.” You find more information about Ixazomib on our products overview.5
Immunotherapy: Immunotherapy is when a person’s immune system is used to treat an infection or disease. In a recent study, scientists discovered that 70 percent of people with multiple myeloma who were treated with immunotherapy had a “significant clinical response” to the disease. 6 In the study, 14 of the 20 participants with an advanced form of multiple myeloma had a “near-complete or complete response three months after treatment; median progression-free survival was 91.1 months, while the overall survival lasted 32.1 months.” 7 Further, no significant side effects were reported. This is an important advance, given that current treatments such as chemotherapy and autologous stem cell transplants have low long-term responses and an average survival rate between three and five years. 8 *Update January 2018 – Empliciti (elotuzumab), is a type of immunotherapy that was approved in the US, Europe, and Australia, but has still not been approved in many other parts of the world and is therefore not directly available there. For more information head to our medicines overview page.
Despite advancements in the treatment of multiple myeloma, not all medicines are available in the same countries at the same time. This can be due to delays in initial approval by one regulatory body and approvals within a certain country — if the manufacturer has filed for approval in that country. There is no global, harmonised approval system and it’s up to manufacturers to decide where to go to market first (also known as applying for market authorisation). Regulatory bodies also differ in speed, which can cause delays.
Almost any country in the world allows individuals to import elsewhere approved medicines for personal use, which may give multiple myeloma patients access to new-to-market medicines. If you are seeking a medicine not yet available in your country, head to our home page to find out how our team can help.
5. Tom Brokaw is living with the disease and has written a book about it
NBC News anchor Tom Brokaw was diagnosed with multiple myeloma in August 2013 following a bout of severe back pain. Though he originally wanted to keep the diagnosis private, he eventually announced his fight against the disease. His memoir, A Lucky Life Interrupted, was published last year and details his journey following his diagnosis. In it, Brokaw discusses the challenges he faced from the disease: weight loss, the inability to sometimes walk without help, the side effects from his medications, and the moment when he learned that the disease was affecting 60 percent of his blood. After 16 months of treatment, his cancer went into remission.
6. How it’s diagnosed
Several different diagnostic tests must be used to confirm a multiple myeloma diagnosis because it is challenging to diagnose based on a single laboratory result. A physical evaluation will be done alongside a review of the individual’s history, symptoms, blood and urine tests, and a bone marrow biopsy. Other tests might include an MRI, CT scan, PET scan and X-rays.
In order to definitively diagnose multiple myeloma, a person must meet at least one major and one minor or three minor criteria. Those criteria are:
Major criteria:
*Plasmacytoma (based on a biopsy)
*The existence of 30 percent plasma cells in a bone marrow sample
*Increased levels of M protein in either blood or urine
Minor criteria:
*10 percent to 30 percent plasma cells in a bone marrow sample
*Osteolytic lesions
*A minor elevation in M protein levels in blood or urine
*Low levels of antibodies (that are not produced by cancer cells) in the blood.
7. Stages and classifications
The criteria as discussed above helps doctors determine not only whether a person has the disease, but also under which classification the disease falls.
Those classifications are:
*Monoclonal gammopathy of undetermined significance (MGUS)
*Asymptomatic myeloma, which is then divided into two subcategories:
*Smoldering myeloma
*Indolent myeloma
*Symptomatic myeloma
Once the classification is known, a doctor will then determine which stage of the disease exists, which will help establish the prognosis and treatment options.
The most common way to diagnose the stage of the disease is through the International Staging System (ISS), which is based on two different blood test results: the beta 2-microglobulin (β2-M) and the albumin. There are three stages of classification under the ISS:
Stage I: β2-M less than 3.5 mg/L and albumin greater than or equal to 3.5 gm/dL
Stage II: Either β2-M greater than 3.5 mg/L but not greater than 5.5 mg/dL and/or albumin less than 3.5 g/dL
Stage III: β2-M greater than 5.5 mg/L
The Durie-Salmon Staging System is an older system of diagnosis. This uses four measurements to determine which stage of the disease exists: 1) the amount of hemoglobin in the blood; 2) the amount of calcium in the blood; 3) the production rate of M protein; and 4) the number of bone lesions. The disease’s stage is then further subdivided based on kidney function.
The three stages of the disease as determined by the Durie-Salmon Staging System are: Stages I, II and III. Each of these stages is then subdivided into either Stage A or Stage B based on whether kidney function is affected. (Stage B means there is significant kidney damage.)
Stage I: Though a person with Stage I often shows no symptoms of the disease because there are fewer cancer cells present in the body, other signs will be present, such as: amount of red blood cells within or a little below the normal range, a normal amount of calcium in the blood, low levels of M protein in the urine or blood.
Stage II: More cancer cells are present in the body than in Stage I. An individual who does not fit into either Stage I or Stage III is said to have Stage II.
Stage III: There are many cancer cells present. Other characteristics of this stage include; hypercalcemia, high levels of M protein, anemia, and significant bone damage.
Note: In any stage, if kidney function is affected, the prognosis will be worse.
8. It’s treatable, not curable
The most common multiple myeloma treatment has typically been chemotherapy followed by stem cell transplants. Because the disease is not curable, this method of treatment aimed to create longer and longer stretches of time during which it did not progress. Now, however, significant advances in research have dramatically changed not only the prognosis but the treatment that is offered. In fact, treatments have advanced so much that there is an increasing discussion among the scientific community as to whether a stem cell transplant should be done after diagnosis or if it is better to wait until a relapse.
Scientists are currently experimenting with different combinations of medications to increase the survival rate. For example, efforts are being made to combine certain drugs that not only have diminished side effects but that also “lengthen stretches of progression-free survival (PFS). 9 Other drugs are being studied to see how they can work with the body’s immune system to fight the disease.
“It’s a massive convergence of our understanding of biology, the technology becoming available to understand myeloma cells and how they respond, the genetic subtypes of myeloma, the ability to engage both the patient community and researcher, to transfer data and information,” says Walter Capone, president and CEO of the Multiple Myeloma Research Foundation, in an article with Cure. 10
9. There’s an international support network
The International Myeloma Foundation—while not an official sponsor of the more than 150 multiple myeloma support groups around the world—conducts yearly conferences for support group leaders. Information on support groups according to an individual’s geographical location can be found on the IMF website.
10. The survival rate continues to increase
According to Cancer Research UK (which used data from 2010-2011), 78 percent of men diagnosed with the disease survive for at least one year and 50 percent survive for five years or longer. For women, that number is 75 percent for one year and 44 percent for at least five years or longer. 11
In the United States, researchers reported that a “newly diagnosed myeloma patient 15 years ago, for example, was about one-third as likely as someone without myeloma to live another five years.” 12 Those same researchers found that “By the end of the 2000s, in contrast, that same myeloma patient would be 45 percent as likely as someone without myeloma to live another five years.” 13 According to the American Cancer Society, the median survival rate for Stage I is 62 months; Stage II: 44 months; and Stage III, 29 months. 14
With advances in treatment, as well as ongoing clinical studies, those prognoses continue to increase. In fact, the prognosis today of someone diagnosed with the disease is nearly triple what it once was. 15
http://vhealthpluse.com/10-things-you-need-to-know-about-multiple-myeloma/?fbclid=IwAR0txI0qbJbtT4IcSGmxGErdx2Oj8_liAZbAIc8sW0Fl40jgdYv8MdpGGwE
Tuesday, January 8, 2019
Saying Goodbye to 2018- It Was a Rough Year! (And a Big Scare Already This Year)
The past two years have been pretty rough here. We were delighted to say goodbye to 2018!
Burning our Yule Log this year was very satisfying!
We had a real scare yesterday, but it was a false alarm. Dom's ribs have been KILLING him.
Our Oncologist ordered a chest x-ray last week to rule out Bronchitis or Pleurisy.
It didn't show anything, so he sent us for a Bone Scan yesterday. When we returned home, there was a message on our machine. "Come in to talk to Dr. C. tomorrow morning. The Bone Scan was ABNORMAL".
We called our "go-to" guy. He said that Dr. C. wanted to discuss the bone scan with us. There were multiple lesions on his ribcage.
That flew us into a tizzy. Dom decided that he wasn't going to get anymore Chemo. We thought that maybe these were Plasmacytomas that could get blasted with radiation like with his hip.
We drove into Slidell all gloom and doom this morning, thinking that this was going to be yet another horrid year.
SURPRISE! All is well with our world!
Our Oncologist told us that these were very small lesions, and Dom has always had various lesions. (This was NEWS to us- we were only aware of the large one on his left hip in May of 2017 ). He wasn't concerned, as his blood and urine were clean 2 months ago.
He didn't think that our Radiologist would want to do anything but was going to have the guy compare this bone scan with his most recent MRI just to be sure.
So... we are now back to normal! M-Spike and Light Chain tests on Valentines Day.
Dom also told him that he didn't want anymore Chemo or Zometa.
Doc's going to order a follow-up Bone Scan in 6 months to keep an eye on things.
Here's hoping that 2019 will be a VERY GOOD YEAR!
Burning our Yule Log this year was very satisfying!
We had a real scare yesterday, but it was a false alarm. Dom's ribs have been KILLING him.
Our Oncologist ordered a chest x-ray last week to rule out Bronchitis or Pleurisy.
It didn't show anything, so he sent us for a Bone Scan yesterday. When we returned home, there was a message on our machine. "Come in to talk to Dr. C. tomorrow morning. The Bone Scan was ABNORMAL".
We called our "go-to" guy. He said that Dr. C. wanted to discuss the bone scan with us. There were multiple lesions on his ribcage.
That flew us into a tizzy. Dom decided that he wasn't going to get anymore Chemo. We thought that maybe these were Plasmacytomas that could get blasted with radiation like with his hip.
We drove into Slidell all gloom and doom this morning, thinking that this was going to be yet another horrid year.
SURPRISE! All is well with our world!
Our Oncologist told us that these were very small lesions, and Dom has always had various lesions. (This was NEWS to us- we were only aware of the large one on his left hip in May of 2017 ). He wasn't concerned, as his blood and urine were clean 2 months ago.
He didn't think that our Radiologist would want to do anything but was going to have the guy compare this bone scan with his most recent MRI just to be sure.
So... we are now back to normal! M-Spike and Light Chain tests on Valentines Day.
Dom also told him that he didn't want anymore Chemo or Zometa.
Doc's going to order a follow-up Bone Scan in 6 months to keep an eye on things.
Here's hoping that 2019 will be a VERY GOOD YEAR!
Saturday, January 5, 2019
The Holidays Were Very Pleasant- Just the 2 of Us
Happy New Year, gang!
Our Christmas and New Year celebrations were very low-key and quiet. Extremely pleasant.
Christmas Eve found us eating a nice antipasto salad and French bread pizzas.
Christmas Dinner was out of this world. I roasted a 6# Duck and served it with potato pancakes, red cabbage with brown sugar/vinegar, and a wild rice/mushroom/cranberry pilaf. It was all yummy! (Very German)
New Years Eve was spent watching the Twilight Zone Marathon... a tradition for us.
Pigged out on Muffalettas!
Did our annual Pork and Sauerkraut on New Years Day. (Along with roasted pig tails, country ribs, mashed potatoes, baked apples, and Angel Hair Pasta in the pork drippings.) OINK OINK!
THIS WAS A REAL PLEASANT SURPRISE:
On the 23rd, I got a phone call from the American Legion saying that they had a "gift" for us and wanted to make certain that we'd be home.
I told him that we live behind a locked-gate 8/10 of a mile back in the woods and he could just leave the "gift" behind the gate. I thought that it was a scam and wasn't very pleasant. I hung up the phone.
2 hours later the same fellow called. "I hate to bother you again, Mrs. Manzo, but can you come down to your gate to get this?? I'd hate to leave a turkey and a ham out here. I'm afraid that the local critters will snatch it!"
(Not only did they give us the turkey and ham, but a storage container packed full with a pumpkin pie, fresh fruit and all sorts of dried and canned goods
He went on to say that Sharon at the local food pantry had given them Dom's name as a Vietnam Veteran!
I felt horrible. I apologized to the guy and he understood completely.
I volunteer at the local food pantry. The American Legion and the VFW had contacted the coordinator for names of veterans. Didn't she give them Dom's name with our address and phone number!!!!
HERE'S WHERE I VOLUNTEER
The Veterans organizations story in the local paper:
Christmas baskets for local veterans
Veterans in Pearl River County received a gift of food for the holidays due to the efforts of local organizations.
Members of the Sons of the American Legion, McSween-Johnston Post 73, Picayune, Miss., worked with the James L. Burge Veterans of Foreign Wars Post 3804, to distribute more than 100 food baskets for Christmas to local veterans and other Pearl River County residents, according to the release.
The annual Christmas Basket Food Drive included contributions from Sons of the American Legion, the Veterans of Foreign Wars, Froogle’s Cost Plus Foods in Bay St. Louis, Paul’s Pastry and the Church of Jesus Christ of Latter-Day Saints. The baskets included a 12-pound turkey, an 8-pound ham, several side dishes and a pumpkin pie from Paul’s Pastry.
“The annual drive exemplifies the spirit of the season, while allowing these veterans’ organizations to further their mission of service to our community, state, and nation,” the release states.
https://www.picayuneitem.com/2018/12/christmas-baskets-for-local-veterans/
Dominic and I wish you all a very HAPPY NEW YEAR and hope that your holidays were GREAT!
Our Christmas and New Year celebrations were very low-key and quiet. Extremely pleasant.
Christmas Eve found us eating a nice antipasto salad and French bread pizzas.
Christmas Dinner was out of this world. I roasted a 6# Duck and served it with potato pancakes, red cabbage with brown sugar/vinegar, and a wild rice/mushroom/cranberry pilaf. It was all yummy! (Very German)
New Years Eve was spent watching the Twilight Zone Marathon... a tradition for us.
Pigged out on Muffalettas!
Did our annual Pork and Sauerkraut on New Years Day. (Along with roasted pig tails, country ribs, mashed potatoes, baked apples, and Angel Hair Pasta in the pork drippings.) OINK OINK!
THIS WAS A REAL PLEASANT SURPRISE:
On the 23rd, I got a phone call from the American Legion saying that they had a "gift" for us and wanted to make certain that we'd be home.
I told him that we live behind a locked-gate 8/10 of a mile back in the woods and he could just leave the "gift" behind the gate. I thought that it was a scam and wasn't very pleasant. I hung up the phone.
2 hours later the same fellow called. "I hate to bother you again, Mrs. Manzo, but can you come down to your gate to get this?? I'd hate to leave a turkey and a ham out here. I'm afraid that the local critters will snatch it!"
(Not only did they give us the turkey and ham, but a storage container packed full with a pumpkin pie, fresh fruit and all sorts of dried and canned goods
He went on to say that Sharon at the local food pantry had given them Dom's name as a Vietnam Veteran!
I felt horrible. I apologized to the guy and he understood completely.
I volunteer at the local food pantry. The American Legion and the VFW had contacted the coordinator for names of veterans. Didn't she give them Dom's name with our address and phone number!!!!
HERE'S WHERE I VOLUNTEER
The Veterans organizations story in the local paper:
Christmas baskets for local veterans
Veterans in Pearl River County received a gift of food for the holidays due to the efforts of local organizations.
Members of the Sons of the American Legion, McSween-Johnston Post 73, Picayune, Miss., worked with the James L. Burge Veterans of Foreign Wars Post 3804, to distribute more than 100 food baskets for Christmas to local veterans and other Pearl River County residents, according to the release.
The annual Christmas Basket Food Drive included contributions from Sons of the American Legion, the Veterans of Foreign Wars, Froogle’s Cost Plus Foods in Bay St. Louis, Paul’s Pastry and the Church of Jesus Christ of Latter-Day Saints. The baskets included a 12-pound turkey, an 8-pound ham, several side dishes and a pumpkin pie from Paul’s Pastry.
“The annual drive exemplifies the spirit of the season, while allowing these veterans’ organizations to further their mission of service to our community, state, and nation,” the release states.
https://www.picayuneitem.com/2018/12/christmas-baskets-for-local-veterans/
Dominic and I wish you all a very HAPPY NEW YEAR and hope that your holidays were GREAT!
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