Thalidomide Isn't Working Any More

That seems to be the bottom line; my myeloma is no longer responding to thalidomide 50 mg daily. As the table shows, three of the four important markers were up on March 28, not down. None of them are down substantially since December, despite the use of thalidomide during that time.



Beta-2 Microglobulin is one of two markers used in the new International Myeloma Staging System to determine the stage (severity) of a person's cancer. It is a protein that can be high because of kidney disease, perhaps caused by the cancer. But most likely in a myeloma patient it will be high because it is shed by the cancer cells themselves. I'm concerned because it has risen steadily, if slowly, since December. However, it may also be shed in greater quantities right now because the thalidomide is still killing some cancer cells, causing beta-2 microglobulin to be released by each dying cell. We will see when the thalidomide treatment ends. Let's hope it goes back down to normal.

For now, the plan is to continue thalidomide for one more three-week period, then have more tests and see the doctor. Assuming that those results don't show a dramatic improvement, we will then be able to conclude that thalidomide at 50 mg, as a single agent, is no longer a useful treatment for me.

Then what? The doctor has suggested Revlimid, a new analog of thalidomide which is more powerful and less apt to cause side effects. It's unimaginably expensive ($6000 per month I hear); thank Heaven we have good insurance.

I have also read about curcumin, and discussed it with people who have taken it, with good results. Curcumin is an extract of the spice turmeric, and does not seem to cause side effects even in large amounts. Its anti-cancer effect appears to be modest, not dramatic, but that may be appropriate for me since my myeloma is still in an early stage (technically still MGUS). It is actually being studied in clinical trials for treatment of multiple myeloma and other diseases. Here is an informative blog by one person convinced of its value: Margaret's Corner.

In early May I will probably go to see the doctor armed with information about curcumin and see if I can talk him into ordering the tests while I take curcumin.