I feel strongly that this debate about the purpose and effectiveness of different multiple myeloma therapies is more than an academic exercise. The more any myeloma patient can learn about his or her therapy options, the better chance they will select the therapy option which is most effective for them. Here is part two of Nick van Dyk’s response to my post, written earlier this week, questioning the stats and claims made on the University of Arkansas Multiple Myeloma Research Center Website:
Second, the nature of the treatment, and how broadly it applies. Barlogie will generally use a tandem transplant with any patient, regardless of age, state of diagnosis, whether the disease is new or recurrent, etc. In some cases, he expects this will lead to a cure. In other cases, he expects it will lead to sustained remission, though how long that can be sustained is a question of the type of the disease. Having been through two transplants, I can say that they aren’t nearly as scary as the non-transplant people make them out to be. However, they aren’t trivial. There is about a 2-3% treatment related mortality across all age groups. Obviously younger patients in otherwise better health have a much lower rate, and older patients have a higher rate. Having said this, I observed a 91-year old man go through a double transplant and come out the other side looking great, and I observed a 50-something woman receive a transplant and die from shock during its administration. The bottom line it is a serious procedure that shouldn’t be undertaken unless the risk of NOT doing it is even worse. This depends, in part, on what stage of life one is in when one receives the diagnosis. Let’s say that Myeloma can be suppressed (I don’t like to use the word control, because that implies a level of living with the disease for many years, and as the medical director of the MMRF put it to me, “we are not there yet.” But let’s say Myeloma can be suppressed through Velcade and other drugs for 7 years. If one is in ones 80s at diagnosis, one might not expect to live much longer any way. Clearly this person would approach the issue of more aggressive treatment differently than one who is 50.
Thanks, Nick! We will wrap this up tomorrow. Feel good and keep smiling! Pat