An Overview of Multiple Myeloma - symptoms, treatments and alternative therapies

An Overview of Multiple Myeloma - symptoms, treatments and alternative therapies

Multiple Myeloma is a cancer of the white blood cells which help you fight infection and is also called plasma cell myeloma. Frequent infections, bone pain and even cracking of bones can occur and so some people call it bone cancer; this overview looks at symptoms, causes and treatment options.

This multiple myeloma overview and associated articles will give you help you increase your personal odds of beating the disease. It covers the causes, symptoms, the diagnosis, and all the latest options on integrative cancer treatments - from cancer drugs and chemotherapy to surgery, radiotherapy and complementary cancer therapies; including all the very latest alternative cancer treatments and emerging cancer treatments too. 

This article has been compiled  from worldwide research and expert sources; CANCERactive is also part of drug appraisal group for the National Institute for Health and Clinical Excellence (NICE) in the UK.

Read the whole article below or just select the part(s) that you are interested in from the list below and click onto that page. 

What is Multiple Myeloma?

MM1Multiple Myeloma (MM) is a cancer of the plasma cells located in the bone marrow. These plasma cells fight infection and the first signs of Multiple Myeloma are often frequent colds and 'flu, chest infections, ear or throat infections and even pneumonia. Experts may call it Plasma Cell Myeloma. Healthy plasma cells are normally found in the bone marrow and their primary job is to fight disease and infection. When too many cancer cells are produced, they literally crowd out the other healthy cells in the bone marrow, for example red cells, other white cells and platelets. Thus low red blood cells, anaemia and poor immune response is common with this disease. This overcrowding can also put pressure on the bones.  

Plasma cells normally produce infection-fighting antibodies called immunoglobulins. When the plasma cells grow rapidly, so does the level of Immunoglobulins. A measure of Multiple Myeloma is the volume of these antibodies, also called Paraproteins.

Myeloma cells produce a protein antibody which doesn’t work and cannot fight infection. It may often weaken and even destroy the other white cells. 

For these reasons, oncologists want to use very high dose chemotherapy to kill these white cells in the bone marrow and throughout the blood stream.

MM is a rare cancer with 20,000 cases a year in the USA and approximately 5,600 cases in the UK; only 15 years ago it was felt to be incurable. Men over 65 years of age are felt to be at the greatest risk. Nowadays, modern drugs and particularly Stem cell and bone marrow transplants have helped control the disease in the body, allowing people to live with the disease in much the same way as, say, diabetes, and increasing survival times significantly.

Types of Multiple Myeloma: MM is one of a number of related blood disorders called monoclonal gammopathies; Monoclonal means that a single family (a clone) of identical plasma cells is causing the disease, while Gammopathy denotes that the production of immunoglobulins is abnormally high.

Systemic light-chain amyloidosis (AL) is a rare and often fatal variant. Another variant is a plasmacytoma, where there is a discrete build up of monoclonal plasma cells in the bone marrow. 

Finally, there is MGUS: monoclonal gammopathy of undetermined significance. This is where a Monoclonal protein (or M protein) produced by abnormal plasma cells builds up in your blood. Many websites describe it of no significance, but it can lead to a variety of blood cancers. It can (but not always) link to evidence of myeloma cells. The condition does not need immediate treatment but can sometimes be referred to as 'Smouldering myeloma’ or asymptotic myeloma, in which case you will be monitored for progression (the build up of M protein, or paraprotein, and decline of haemoglobin)

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Symptoms of Multiple Myeloma

In the early stages there may be no symptoms, but eventually the symptoms like bruising, bleeding, infections, bone pain and fatigue come from the main problems:

  •  * Immune depletion: increased levels of infection especially urinary and respiratory
  •  * Bone weakness: pain in the back or ribs; and even unexplained fractures or lumps on bones. Pain in movement and arthritis-like symptoms
  •  * Increased blood-protein levels: Bruising, nosebleeds, dizziness, headaches and even vision loss as protein levels build in the blood.
  •  * Lowered red cells: Fatigue, anaemia and weight loss. 
  •  * Loss of kidney performance, increase in uric acid (even symptoms of gout), liquid in lower limbs with resulting heaviness and tiredness.

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Diagnosis of Multiple Myeloma

Routine blood tests can quickly diagnose the disease often before any symptoms have appeared. Doctors look for increased levels of Paraproteins, levels of normal red and white cells and kidney function, while both blood and urine samples can show increased protein levels

Imaging tests can not only diagnose MM but help determine the extent of disease throughout the body, its locations and how active it is. X-rays, magnetic resonance imaging (MRI), and positron emission tomography (PET) may be used for this.

Bone marrow aspiration and needle biopsy may also be used to show the percentage of plasma cells in the bone marrow.

In some cases oncologists may also perform chromosome tests on bone marrow.

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Causes of Multiple Myeloma

MM3A number of causes have been indicated although, officially, nothing is proven and there may be several ways of developing the disease called Multiple Myeloma. The Truth is that MM seems to be caused by environmental toxins, chemical or biological.

This may result in chromosome damage, but this is rarely the case, more often being epigenetic in nature. However, where there is chromosomal damage, outcomes are poorer.

Links to toxins have been indicated in several worldwide studies:

1. Previous chemotherapy an/or radiotherapy, and X-rays. Several US Hospitals and Cancer Centers confirm these as risk factors. 

2. Pesticides, fertilisers and chemical toxins in the environment:  There is a growing concern that pesticides and fertilisers can cause disorders of the blood. Papers have been produced by the EU and by IARC to this effect. Epidemology studies show a higher incidence of Multiple Myeloma amongst farmers, chemical workers, sheet metal workers and others exposed to environmental toxins.

3. Ingested toxins such as Aspartame: A research study, repeated because the first was criticised, carried in Cancer Watch showed that the consumption of a single can of diet soda a day significantly increased risks of multiple myeloma, leukaemia and lymphoma. In the Boston Nurses Health Follow-up, 2012, a single can of diet drink a day was associated with +102% increase in multiple myeloma - more than doubling the risk - particularly in men..

4. Toxins produced by pathogens, parasites and yeasts: Parasites (including viruses, bacteria and yeasts) weaken the body, steal important nutrients and often produce debilitating toxins. Some have been linked to blood disorders and cancer. Some multiple myeloma cases have been driven or worsened by excessive yeast presence in the gut and blood stream. 

Go to: Heal your Gut; Heal your Body

5. Genetic risk: Some people seem to have genetic factors that make them more susceptible to such chemical toxins and even the use of everyday household chemicals and toiletry products has been questioned in the EU parliament and the California legislature.

If you find all the information on the Internet confusing, and/or want help in building a simple plan to increase your personal odds of survival, why not look into having a chat with Chris Woollams?

Go to: Personal Prescriptions with Chris Woollams

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Alternative treatments for Multiple Myeloma

Multiple Myeloma is not considered curable, but is treatable. A number of top cancer hospitals use bone marrow transplants - the Karolinska Institute offering it to patients, not once but twice if it has recurred, with a ’maximum’ life extension across the two transplants of 20 years.

Treatments can be several and depend upon individual patient conditions. New drugs are coming on stream all the time. 

There is no doubt that some people look for non-invasive alternative treatments fearing the rigours of drugs and bone marrow transplant treatment. One option (chosen, famously, by Oxford English Don, and recorded in his book Living Proof), was the Gerson Therapy.

In 2017, a small scale clinical trial on a CAR-T immunotherapy put 94 per cent of patients into some degree of clinical remission with 2 months. There is more below on this.

For information on cancer drugs and chemotherapy click here.

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1. Multiple Myeloma Integrative Treatment considerations:

While patients should most definitely avoid compromising their oncologist’s recommended treatment programmes, there is an argument for taking some extra, precautionary steps around them. For example:

1. By cutting out exposure to environmental chemicals and pesticides

  •  Eating organic foods from a known source
  •  Choosing a manufacturer of toxin-free household and personal care products
  •  Avoiding in-home pesticides, herbicides and even animal parasite treatments (like some flea collars)
  • Avoiding local pollution to your living environment e.g. living near a factory chimney, a cement factory, a garage forecourt, a mast, a chemical or steel plant, surround by fields using pesticide sprays etc. Benzene and working with oil are other risk factors.
  • Avoiding contact with heavy metals such as cadmium or mercury (for example, in many vaccines or in sheep dips, if you are a farmer)

2. By working to remove these above possible contaminants from your body

  • Organic green vegetable juices containing broccoli, wheatgrass, sea kelp (for a little iodine) and chlorella powder have been shown in research on diabetes to reduce blood fats, and in research with children to detoxify the cells and blood stream.
  • Selenium (200 micrograms) has been shown to displace certain heavy metals
  • The consumption of foods high in lignans, and green foods like chlorella have been shown to bind to certain heavy metals and chemical toxins, and with adequate levels of beneficial bacteria in the intestine, clinical trials have shown these can be eliminated.
  • Other clinical trials have shown that foods containing Indole-3-carbinol  (e.g. from broccoli) can displace chemicals and even dangerous dioxins

3. By reducing your odds of having ’parasites’ in your body:

  • The term 'parasites' can include actual parasites, pathogens, viruses and yeasts which can produce toxins in the body and these can be just as problematic as environmental toxins. 
  • Parasites and pathogens may be killed off with the use of herbal ingredients  - like sweet wormwood (artemisinin), and Black Walnut, cloves and garlic.
  • Yeasts may be killed off by combining natural yeast killers, with an anti-yeast diet ...Yeast Killers: cinnamon, garlic, oregano, caprylic acid, wormwood Anti-yeast diet: Avoid all sugar, alcohol, dairy, yeast products like marmite and mushrooms. Avoid eating fruit after a meal, and eating 'soft vegetables’ like courgettes, marrows and squash because yeasts ferment these.
  • Pau d'arco also kills yeasts and can be effective against viruses.

4. By keeping blood fats down, reducing the risk of a fatty liver and reducing BMI.

         See blow - fat helps 'anchor' multiple myeloma in the bone marrow, and people with MM often have fatty livers

  • Consume fresh ginger - it controls both cholesterol and triglyceride levels in the body according to a double-blind, randomised placebo controlled study.
  • Look at the research of Professor Roy Taylor on using non-starchy vegetable juice diets to control blood fats and a fatty liver and reverse type-2 diabetes
  • Consider using a statin such as atorvastatin, or taking lycopene, which beats statins in research for lowering cholesterol..

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2. Multiple Myeloma and curcumin

Professor Aggerwal of MD Anderson suggested people with cancer might use 3.2 gm of curcumin in cancer treatment. It seems especially useful in the treatment of multiple myeloma. Research covered in Cancer Watch from UC San Diego has shown that curcumin can block an enzyme DYRK2 which regulated proteasome activity, important in Myeloma development.

Curcumin which is found in the root Turmeric  (curcuma longa), should be taken with black pepper and a little fish oil, olive oil, flaxseed oil or fat to aid absorption and effectiveness.

Resveratrol or quercitin taken about 15-30 minutes before seem to help.

A good number of studies since 2003 have shown turmeric or curcumin can help in multiple myeloma.

In a 2017 paper in the British Medical Journal entitled ’Long Term stabilisation of Myeloma with curcumin’, a patient approaching her third relapse and no further orthodox treatment, switched to the use of Hyperbaric Oxygen Therapy and 8 gm of curcumin daily. 5 years on, she is stable despite taking no orthodox medical treatment. Curcumin has strong anti-proliferation benefits with cancer and research specifically with myeloma cells. It is used in Ayurvedic medicine. It is an antioxidant and anti-inflammatory herb. It kills microbes in the gut.

Go to: Hyperbaric Oxygen and curcumin with biopiperine stabilises Myeloma patient

Go to: Hyperbaric Oxygen and cancer

For people with Slumbering Myeloma, there is a Website called Margaret’s Corner. Margaret took (and still takes) 8 gm of curcumin, and this stopped the progression of her disease into Multiple Myeloma. Margaret reports that previously she had had bad headaches due to the viscosity of the blood in MM. Curcumin reduces the viscosity - it thins the blood, as might do aspirin and fish/krill oil supplements.


3. Multiple Myeloma and blood fat

There is research showing that increases in LDL (bad cholesterol) and triglyceride fat levels can lead to more metastases and lowered survival in cancer patients generally. In 2016, American University, Washington, research showed that as BMI increased, so did Multiple Myeloma progression. "We know multiple myeloma cells will anchor into bone marrow, " said researcher DeCicco-Skinner. "Fat cells support the growth and spread of the cancer". As the BMI increases, the fat cell numbers increase, and this supports growth and anchoring of multiple myeloma. Cancer cells need blood supplies to grow. As the BMI rises, so does the number of blood vessels. It is not uncommon for people with cancer to have fatty livers, and this in turn can increase fat levels in the blood stream. Drugs do not help in one sense as they increase the fat in the liver.

4. Multiple Myeloma and Green Tea

EGCG, a bioactive ingredient of green tea has been shown in at least four studies to selectively kill multiple myeloma cells by targeting over-expressed 67LR. It also induces apoptosis by up-regulating guanosine monophosphate in cancer cells. Sulphide donors in research significantly help this process. Therefore MSM might be a useful purchase for patients. The research stated that it was not enough to just drink green tea.
 

5. The GERSON Therapy and Multiple Myeloma

CANCERactive readers may know the story of the Oxford Don, Michael Gearin-Tosh, who back in the mid 1990s felt that the drugs on offer then and their predicted survival benefits were not worth the bother, and after much research, opted for the Gerson Therapy an alternative, diet-based therapy involving the consumption of organic foods (as juices or whole), no meat, fish, animal fat, and no processed or packaged foods. The therapy also involves the use of coffee enemas to dilate the bile ducts and encourage the excretion of toxins. Having been given 18 months to live without orthodox treatment, Michael lived for more than ten years before dying of an unrelated illness. On this Website we review his book (Living Proof, a medical mutinyclick here  and have several articles on the Gerson Therapy.

It is not hard to see why the Gerson Therapy might have a positive effect on patients with this cancer as it is a naturally cleansing therapy. Importantly, it does not have to be seen as an alternative to orthodox therapies. 

However, there are no clinical trials to support this therapy. 

6. Other self-help possibilities with multiple myeloma

i) Vitamin D - People with cancer should always ensure that their serum vitamin D levels are satisfactory. People with low vitamin D (and 80% of people on diagnosis have levels below 20 ng/ml) develop more cancer, and those with cancer and low vitamin D levels have shorter survival times. Patients should be in the range of 75 ng/ml - 100 ng/ml. Boston Medical School recommend patients take 5,000 IUs a day - which is equivalent to 4 hours in the sun. Sunshine is best!

ii) Cancer Stem Cells - Research has shown that multiple myeloma recurs because not all the cancer stem cells were killed and/or that patients create an environment in their body through poor diet encouraging the return. Johns Hopkins Kimmel Research centre has identified a special type of cancer stem cell involved in MM. Although there are currently no drugs that can kill off cancer stem cells, Johns Hokins are looking at developing vaccines.

Some natural compounds are known to have effects against cancer stem cells - notably, Holy Basil, lycopene, turmeric, resveratrol and Black Cumin Seed.

Three repurposed, off-label drugs you might look into are Niclosamide, Doxycycline and Accutane, each of which  has been shown to have anti-cancer stem cell benefits.

iii) Feverfew, Dandelion, Honokiol and Agaricus blazei each has research supporting some benefits against Multiple Myeloma.

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Orthodox Therapies for multiple myeloma 

Currently no treatment approach is considered to be a cure for MM. Current orthodox therapies do slow the progression of the disease prolonging survival, and alleviating the symptoms. New drugs and improvements are coming on stream all the time. 

Observation - In the early stages of the disease with few symptoms, doctors may decide to wait and watch. If paraprotein levels rise, or anaemia occurs then they will want to take action.

Overall - Typical chemotherapy drugs used for multiple myeloma include:

   * Melphalan, cyclophosphamide, vinicristine, etoposide, doxorubicin and its liposomal form doxil are the drugs most commonly used, sometimes in combinations. All provide limited control, have side-effects and are covered on our Website.

   * Thalidomide this drug became infamous as a medicine used in the late 1950s as a sleeping pill and to combat the nausea some women experience in pregnancy. It was found to cause birth defects by cutting blood supplies and was banned. However, these properties (cutting new blood supplies) seemed appropriate in the fight against cancer and in the 1990s researchers decided that thalidomide could be used to treat myeloma.

Newer versions of thalidomide, e.g. Lenalidomide (Revlimid), are more potent with fewer side effects than thalidomide. The drugs seem to both inhibit plasma cell growth in the bone marrow and directly promote the death of cancer cells. In the USA doctors use the combination of lenalidomide with low-dose dexamethasone for many newly diagnosed patients, or for people who have relapsed.

   * Bortezomib (Velcade) is the first in a completely new class of drugs called Proteasome Inhibitors (PIs). Proteasomes are found within all cells and their role is to break down proteins. This makes them essential in a host of normal cellular processes like gene expression and message carrying. Research has shown that inhibiting proteasome activity in cancer cells seems to block cell proliferation and increase apoptosis or cell death. Currently bortezomib is approved in the USA for patients with resistant or relapsed myeloma. Hospitals such as Sloan-Kettering in New York have high hopes for PI drugs and are investigating one called carfilzomib.

   * Daratumumab (Darzalex) binds to CD38 which multiple Myeloma cells over-express. It was given FDA approval in 2016 for use with Lenalidomide or Bortezomib; and Dexamethasone, for use with patients who have had one prior drug treatment.

   * Interferon: Sometimes interferon may be used after chemotherapy as a treatment to maintain the status of remission. Click here to read articles on Interferon

Chemotherapy is then often used in combination with steroids, like dexamethasone, prednisolone and methylprednisolone. Unfortunately, these drugs significantly increase your blood sugar levels. 

   * Dexamethasone - This is a potent steroid and may be used alone or in combination with other medicines like doxorubicin in the early stages of the disease. It is claimed it also has a chemotherapy benefit against MM. It does, however, increase blood sugar levels.

   * Bisphosphonates - Other drugs called bisphosphonates may be used specifically for your bones. e.g. pamidronate (Aredia) or zoledronic acid (Zometa), are prescribed to help to alleviate bone pain and to slow bone loss. They can also repair bone tissue and reduce the excess calcium that often occurs in MM. Patients could consider taking a calcium supplement, or better still using organic green vegetable juices on a daily basis, along with Magnesium (125 mg) and little phosphorus and 5,000 IUs per day of vitamin D3.

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Bone Marrow or Stem Cell Transplants with multiple myeloma

Oncologists want to use high dose chemo to eradicate all the cancer cells wherever they may be. Stem cell or bone marrow transplants allow them to do this.

More than half of the patients in clinical trials have achieved complete or near-complete responses. Thus oncologists view transplants as the only route offering a potential cure.

MM2Stem Cell therapy - High-dose chemotherapy followed by stem cell transplantation is becoming a standard therapy for patients with myeloma and has been shown to greatly prolong survival. It is however an extreme treatment. High levels of powerful drugs are used to kill all the cancer cells, then the stem cell transplant takes place, and the fear of infection necessitates anti-viral drugs, ant-yeast drugs, a PPI like omeprazole to counter inflammation caused by the drug cocktail, steroids like Dexamethasone and more. 

There are two forms of the treatment.

   i). Autologous Treatment. Stem cells from the patient - stem cells are the body’s general precursor cells. In autologous transplants they are obtained from the patient’s own bloodstream or bone marrow and frozen. The patient can then receive a high dose of chemotherapy that destroys all the white cells including the cancer cells in the patient’s bone marrow.

The patient can then have infusions of the frozen stem cells back into his/her body and bones and rebuild his immune and blood systems.

   ii). Allogeneic Treatment - where the stem cells are obtain from a host who has very similar stem cells to the patient - for example, a close blood relative. This is a riskier approach, but results can be excellent.

This procedure involves spending at least three weeks in hospital and recovery takes several months. One side-effect is the medical team’s fear factor. Because they have killed every white cell they are scared that the patient might develop an infection. It is not uncommon for the patient to be on, anti-viral, anti-yeast, anti-anything drugs - up to six of them. Patients are advised not to eat probiotic foods or even organic vegetables for fear of picking up a bad bacterium. They are even told not to take a probiotic or eat organic foods. Clearly much of this is nonsense and varies by country, and by hospital. One thing is clear, this can work well and give the patient another decade. A genuine worry is that the excessive chemo destroys all gut bacteria and that these never return in a healthy balance state. Because of the damage, yeast infections are a real worry that needs to be monitored.

Researchers at Sloan-Kettering, New York are currently investigating tools such as microarray analysis (a test that reveals which genes are mutated) that will help doctors to profile an individual patients cancer and determine the therapy to which a patient is most likely to respond.

Immunotherapy and Multiple Myeloma

In a phase 1 Clinical Trial in China, the patient’s own T-cells (a type of white cell), were gathered and a chimeric antigen receptor T cell drug (CAR-T) individualised to each patient. Only 35 patients were involved but after 2 months 100% had seen some response, 33 having a complete or very good response. One year on, 14 have still complete remission and another 5 have partial remission. Results were reported in 2017 at the American Society of Clinical Oncology Symposium in Chicago. 

Early days yet.

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Further reading:

There is an excellent interview answering many of the questions you will have on the MD Anderson Cancer Centre web site (http://www.patientpower.info/transcripts/mda111307.pdf). The interview can be downloaded as a video or as a transcript.

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Complementary Multiple Myeloma cancer therapies; Alternative Multiple Myeloma cancer therapies?

For people with a family history it is very important to go for an annual check even a regular endoscopy. The UK Government has been promising to bring these in on the NHS as a serious prevention weapon for several years now.

If you already have cancer you will want to ensure that inflammation and polyps are kept in check. We hope you found the diet information above useful.

CANCERactive is Europe’s Number 1 Integrative Cancer Charity. This website alone has more than 4,000 pages of information on it, either as articles or as news stories. More than 10,000 people visit our websites every day. We know from the feed-back we receive just how much we are valued by people trying to beat cancer. 
We believe you can increase your personal odds of cancer survival by taking simple health-enhancing steps and adding both complementary cancer therapies and alternative cancer therapies into your mix of treatments. 

For example, Hyperbaric Oxygen, curcumin, calorie restriction, melatonin, probiotics and whole body hyperthermia have all been shown in research to make chemotherapy work better. It kills more cells! The research is covered on this website. Surely it makes a lot of sense to use them in your personal cancer treatment programme?

We have a complete review of Immunotherapy telling you the accurate figures and what to watch out for. We tell you what is working and when two new drugs have been used, rather than one. It’s a new, emerging and alternative cancer therapy, but not fully there yet!

Go to: A complete review of Immunotherapy  

Then we have an article on how to improve the success of your radiotherapy (and reduce the potential side-effects) – all by adding complementary therapies. Our Guidelines on Diet and Exercise can be found through this link:

Go to: CANCERactive Guidelines on Diet and exercise 

Our recommended anti-cancer diet is the colourful Mediterranean Diet (with its focus on the French paradox):  

Go to: The Rainbow Diet

Like Hippocrates, we believe all cancer begins in the gut and that gut problems, yeast, viral and parasite infections are common constituents of cancer.

Go to: All cancer begins in the gut

But if you just want to look at the most comprehensive list of Complementary Therapies you can find it here:

Go to: CANCERactive Complementary and Integrative cancer therapies

And if you want alternative cancer therapies start here:

Go to: CANCERactive Alternative cancer therapies 

Finally, if you want all this put together for you in one simple plan, why not look into having a Personal Prescription?

Go to: Personal Prescriptions with Chris Woollams

We don’t take one penny from any Pharmaceutical company, cancer clinic or supplements' company. We have no vested interest. We just want to see you beat cancer. 

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 *Cancer (and its related illnesses) are very serious and very individual diseases.  Readers must always consult directly with experts and specialists in the appropriate medical field before taking, or refraining from taking, any specific action.
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