So-so Doctor Visit

Yesterday my oncologist/hematologist gave me the results from last week’s tests.

IgG, M-spike, and Beta-2 Microglobulin were all up from a month ago, though none very much. Lambda light chains were down a little. Actual values are displayed graphically in the charts and numerically in the test result table. In short, it appears that the cancer is still advancing slowly despite the thalidomide treatment. Time for something new.

The doctor suggested Revlimid. I proposed, instead, a two-month respite to let the effects of the thalidomide settle out, followed by an "alternative medicine" curcumin regimen. That will probably mean eight grams of curcumin daily, with bioperine and an oil to enhance bioavailability. We will continue that regimen until a result is evident, and then start Revlimid and dexamethasone if the curcumin has not stabilized the cancer. He readily agreed; I'm proud of him!

Meantime, we will do tests every month to see what’s happening, and I will meet with the doctor again in two months.

An interesting side note: The doctor asked about my running. When I told him that I won my age group in the recent Austin Marathon, he said that he was surprised that I was feeling so well and running so well, considering the test results. He further remarked that some of the CBC and chem test results showed evidence of very good nutrition. Kudos to Eagle Momma.

Related links:

• My Myeloma A discussion of my myeloma, not very technical.
• Charts Graphic displays of several key test results over time.
• Test Result Table Best with a wide browser window. Very “technical.”
• Treatment History Not technical.

These links are also on the side panel and will remain there.

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.