Category: Multiple Myeloma

Goh (H443) was 58-years old when he was diagnosed with multiple myeloma – a rather rare cancer in Malaysia. His problem started in October 2006 when he complained of indigestion and acid reflux. He went to see a gastroenterologist. Examination showed he had polyps and fatty liver. It was noted that he was anemic (low blood) with low platelet count. A biopsy was done and indicated multiple myeloma.

Goh was referred to a haematologist in a private hospital in Kuala Lumpur. A repeat bone marrow biopsy was performed and confirmed that he had a plasma cell neoplasia, which quite extensively infiltrate the bone marrow.  The marrow cytogenetic analysis showed a complex karyotype which is seen in multiple myeloma.

Goh immediately underwent chemotherapy with Cyclophosphamide, Dexamethasone, Zometa and Thalidomide.  Each of this monthly chemo cycle cost about RM 4,000.  Goh received a total of 22 cycles.

About three years later, in May 2009, Trephine biopsy showed: “Multip0le myeloma with some residual disease.” Goh was asked to undergo another 33 cycles of chemotherapy. A new drug, Velcade – bortezomib  –  was used this time.  This was the so-called targeted therapy and was given intravenously (injection into the vein) twice weekly. Each cycle of this chemo cost about RM 7,000. Goh was told that even if he underwent this treatment  he would get another relapse in two years time. In other words, this treatment would not cure him. In total Goh said he had already spent about RM200,0000 for his treatment.

Goh received 6 cycles of Velcade and suffered severe side effects. He had difficulty breathing and had to be hospitalized. He decided to give up further treatment and came to seek our help on 29 October 2010. In fact we were rather reluctant to prescribe him any herbs for reason that we did not have any experience in healing multiple myeloma unlike other common cancers.  However, Goh insisted that he would like to try our herbs.

• He presented with severe numbness of the hands and legs. The problem occurred in the evening and at night. He was alright in the morning.
• He was unable to withstand cold.
• He was always tired.
• He had difficulty sleeping and fall asleep around 2 to 3 a.m.

Five months on the herbs and later on the e-Therapy, Goh reported that:

• He could sleep well.
• His appetite had improved.
• His high blood pressure had become normal. Before taking the herbs it was 150+/90+. After taking the herbs it became 120/80.

His blood test results showed a slight improvement after taking the herbs. More important is that his health did not deteriorate (Table below).

Literature Review on Velcade

The US-FDA approved this drug for the treatment of multiple myeloma in May 2003. It is also approved for mantle cell lymphoma.

Proof of Effectiveness

• The effectiveness of Velcade is based on response rates.
• There were no controlled trials demonstrating a clinical benefit, such as an improvement in survival.

Approval of Velcade was based on a study of 202 patients. Patients were administered with Velcade injection twice weekly for 2 weeks, followed by a 10-day rest period (21-day treatment cycle) for a maximum of 8 treatment cycles.

Results showed:

• 2.7%  achieved a complete response (i.e., 100% disappearance of the original monoclonal protein from blood and urine on at least 2 determinations at least 6 weeks apart by immunofixation, and <5% plasma cells in the 133 bone marrow on at least two determinations for a minimum of six weeks, stable bone disease and calcium).
• 25% achieved a partial response (50% reduction in serum myeloma protein and 90% reduction of urine myeloma protein on at least 2 occasions for a minimum of at least 6 weeks, stable bone disease and calcium).
• 17.6% demonstrated a clinical remission (75% reduction in serum myeloma protein and/or 90% reduction of urine myeloma protein on at least 2 occasions for a minimum of at least 6 weeks, stable bone disease and calcium).
• Overall response rate = 27.7%.

Source:  http://www.medilexicon.com/drugs/velcade.php

Side Effects

The following are some side effects of Velcade .

• Fatigue, generalized weakness
• Peripheral neuropathy: characterized by numbness and tingling of the hands and feet.
• Nausea and vomiting
• Diarrhea
• Poor appetite
• Constipation
• Low platelet count which can lead to increased risk for bleeding
• Low red blood cell count or anemia
• Headache
• Difficulty sleeping
• Joint pains
• Swelling of the face, hands, feet or legs
• Low white blood cell count which can lead to increased risk for infection
• Shortness of breath
• Dizziness
• Rash
• Upper respiratory tract infection
• Cough
• Bone pain
• Anxiety
• Muscle cramps
• Heartburn
• Abdominal pain
• Low blood pressure
• Itching
• Blurring of vision
• Blood test abnormalities: such as low sodium, low magnesium, low calcium and low potassium.

Comments

Mayo Clinic in the United States, is one the world’s premier multiple myeloma treatment centers, with more than 60 years of experience treating this blood disorder. Mayo claimed that although no cure exists. Treatments can prolong survival and greatly improve patients’ quality of life.

Take note that even an outstanding hospital in the world says there is no cure for multiple myeloma. Then, as most oncologists would say, their treatment can prolong life and improve quality of life – do you believe that?

Treatments for Multiple Myeloma

Patients may be asked to undergo the following:

1.       Stem-cell transplantation or autologous stem-cell therapy. This involves transfusion of the patient’s own immature blood cells to replace diseased or damaged marrow. This procedure cannot cure myeloma but it can prolong survival.

2.       For those who are not candidates for transplant, then chemotherapy is offered using  any of the following regimens:

• Melphalan, prednisone, thalidomide (MPT)
• Bortezomib (Velcade), melphalan, prednisone (VMP)
• Lenalidomide plus low-dose dexamethasone.

In this case, Goh received Dexamethasone, Zometa and Thalidomide. Goh received a total of 22 cycles over a period of two years. The treatment did not cure him. About a year after the completion of the treatment he suffered a relapse.

Goh was asked to undergo another 33 cycles of chemotherapy using Velcade. After 6 cycles with Velcade he had to be hospitalized for breathing difficulty. It was then that Goh realized the futile effort of chemotherapy. He decided to stop further medical treatment.

Before patients under any chemotherapy /or radiotherapy, it would be prudent for them to ask some basic questions, such as:

• How effective is the recommended regimen or procedure? What can it do for you? A review of literature indicates that Velcade does not cure multiple myeloma. Its effectiveness is shown as nothing more than a  “response”. It is really disappointing. It has never shown to even prolong life, let alone cure.
• What are the side effects? Weigh out the harm versus the benefit. You can be sure that treatment with Velcade comes with a host of side effects. In fact, Goh is now experiencing these problems.
• How much does the treatment package cost? In this case, Goh  would have to spend another RM250,000 for the treatment what would not cure him. This is in addition to the RM100,000 already spent on the first round of chemotherapy.

Having understood your odds – ask this question: Is it worth the gamble? Goh came to seek our help as a last resort. He knew about CA Care long before but he would rather go for medical treatment. Now, he knew that he had taken the wrong path. Five months on the herbs, his health has not deteriorated!  In fact he got better and his quality of life has improved. His sleep was better, appetite improved and he had more energy.  Even his high blood pressure had normalized!