Myeloma nutritional expert, Danny Parker, has been following curcumin research for years. He emailed me last evening, excited about a new micro study he found:
Pat,
This study was just published on February 18th in the Journal of Hematological Malignancies, tracking two patients with smoldering myeloma. Margaret Graziano surfaced it on her blog recently (http://margaret.healthblogs.org/), so thanks to her we have more information on this potentially important development.
http://www.sciedu.ca/journal/
EDITOR’S NOTE: Click-on the Full Text PDF link to access the entire report. Use the link below or the one located on the lower left side of the abstract page in red.
Summary findings are encouraging:
“Both patients showed continued improvement in a number of markers of disease activity including serum free light chains, paraprotein and % plasma cells in the bone marrow. These results suggest that patients with smoldering myeloma may benefit from daily ingestion of curcumin and long term use does not result in toxicity.”
I would suggest that this result not only portends well for smoldering myeloma, but also, in particular, for patients with minimal residual disease.
If you are excited, we’re excited, Danny! Here are links to several of Danny’s columns about this mysterious compound–the only known supplement to have proven anti-myeloma properties. And using it enhances how well Velcade and Revlimid works, too!
The Spice: Curcumin and Myeloma (Part One)
The Spice: Curcumin and Myeloma (Part Two)
Supplements that enhance Velcade’s performance
Nutritional plan to help maximize performance of my RVD therapy
More about nutritional plan to help maximize performance of my RVD therapy
Diet and Multiple Myeloma: Danny Parker’s dietary recommendations
Thanks for the update, Danny! The ongoing challenge is to somehow get enough curcumin into our bloodstreams and keep in there. Topic for a future column?
Feel good and keep smiling! Pat
March 5th, 2013 at 3:47 pm
An article published last year in “Critical Reviews In Oncology Hematololgy” raises questions regarding the use of curcumin for monoclonal gammopathies….questioning whether curcumin may induce immunosuppression, increase susceptibility of infection, stimulate clonogenic growth of tumor cells, and possibly induce a more malignant phenotype.
The article, which was reviewed by S. Vincent Rajkumar, M.D. and Ramaswamy Narayanan, Ph.D., concludes that patients with monoclonal gammopathies should be excluded from curcumin trials until there is empiric evidence that will allow the establishment of patient selection criteria as to which subset of patients might benefit from curcumin usage, and those who would be at risk.
Read the article here: http://tinyurl.com/bzyp3s5
Worth the read!
Steve
March 5th, 2013 at 6:14 pm
I’m glad you brought that up, Steve! I saw it and lost track of the link when Danny asked me about it. Good news here is it seems clear that, unlike many supplements, at least curcumin does something! I have concerns and questions about how well its absorbed and whether or not a few grams is enough to make a difference. Lets continue to monitor and gather all the info we can. I will do a post about this so we’re on 4record and it shows-up if someone types “curcumin” into grey query bar. That’s such a useful tool, but betting few use it. I would run content dedicated to it but I’m out of access from my homepage. If I get that technical stumbling block figured out I will start grouping important topics like this together for easier access. Thanks again! Made my day you would pass this along…
March 5th, 2013 at 6:15 pm
Steve,
What I find interesting is that the side-effects you mentioned are identical to those that potentially occur with long term Revlimid use. (Immunosupressoin, infections, selection of more malignant clones, etc…) Their latest data does suggest, though, that concerns about effects on immune function may not be warranted, and that long term curcumin use may be beneficial. (Notice the judicial use of the word “may”.)
It seems to me that the main point of the study is that there may actually be something to curcumin use, the exact nature of which (as the authors point out) should be determined by large-scale trials. For those of us with the disease, it becomes a personal decision to try this approach based upon the evidence at hand, or wait until we have trial data sometime in the (probably not so near) future.
Regards,
Russ
March 5th, 2013 at 6:17 pm
Steve, maybe I should have saved my effusive praise until I tried the link – it doesn’t work. Can you try again?
March 5th, 2013 at 6:17 pm
Pat,
I agree with your point about absorption – That seems to be the question with a number of potential supplements.
And by the way, I use the query bar from time to time myself, so there!
Regards,
Russ
March 5th, 2013 at 6:31 pm
We are on the same page, Russ!
March 5th, 2013 at 7:49 pm
Here’s a link that worked for me
http://www.croh-online.com/article/S1040-8428(12)00102-3/fulltext
but it looks like you might have to cut and paste it into your browser.
March 5th, 2013 at 9:06 pm
I would like to offer my testimonial of curcumin use for 1.5 years (8gm/day, the good kind), after I was diagnosed as SMM. During that time my M-spike and free light chains kept steadily creeping up, in the end of that 1.5 years I had progressed to full-blown MM with bone lesions. Obviously I am not a believer anymore. There are always SMMers (20-25% of SMMers), like the two persons in the study, that never progress whether they take curcumin or not.
March 5th, 2013 at 10:08 pm
Sorry about the broken link, Pat. It looks like Holt has provided us with a working link…thanks Holt!
Russ, my take on this article is that the authors seem to imply that “blind optimism” regarding curcumin can be harmful not only to those in whom curcumin is ineffective, but to those in whom it actually may be effective. They further suggest that curcumin is not as benign as many would believe in that there are as many reasons to be concerned about curcumin as there are, they freely admit, reasons to be optimistic. (see Table 2.)
And yes, some of the possible downsides to curcumin may be similar to many of the side effects of the FDA approved drugs most of us have taken, the differenc being however that for SOME patients with monoclonal gammopathies there may be ONLY a downside with curcumin, particularly with those who are only MGUS/SMM; hence the authors warning regarding patient selection criteria vis a vis MM patient involvemnt in curcumin trials.
Of course, I recognize there are the “true believers” who feel anectdotal observations are sufficient to support their use of curcumin… and goodness knows that when confronted with a diagnosis such as MM there is the temptation/need to find a much larger array of “belief systems” in order to help buoy ourselves in such rough waters…I understand that and have no problem with others who adopt/enhance such beliefs. However, I’m just not one of them. And in the context of supplement use I need more than anectdotal opbservations to support use of any substance…and…I “BELIEVE” that others should as well. Oh, the irony!
Finally, in support of the authors in this article one might find the following letter to the editor interesting in The International Journal of Cancer.
http://onlinelibrary.wiley.com/doi/10.1002/ijc.24967/pdf
Best,
Steve
March 5th, 2013 at 10:41 pm
Steve,
I agree with the idea that “blind optimism” is not good for anyone – We should all be giving due diligence to our treatment decisions, whether it involves chemo or additional supplements. Truth be told, our docs don’t really know why numerous meds work the way they do, or how much we should be given in what combination, etc. (Hence the need for trials.) Currently, there is no consensus recommendation for Velcade maintenance, but I felt there was enough data out there showing efficacy that I pushed for this as my treatment. (I personally did not feel that waiting until the proper trial data was completed made sense for me.) I apply the same decision making process to any supplements I may decide to incorporate, again making decisions based upon the best available data at the time.
Just my thoughts and opinion, but it seems to be working for me.
Regards,
Russ
March 5th, 2013 at 11:15 pm
You’re right there, Russ…as with any terminal illness the treatment choices are, by definition, only educated guesses. Glad to hear your decision process seems to be working for you!
Best,
Steve
March 5th, 2013 at 11:29 pm
Not sure where this will show-up in the chain of comments, but I would like to respond to Smah. Just because using curcumin didn’t work for you doesn’t mean it won’t work for someone else. Conversely, just because it works for someone else doesn’t mean it will work for you! Myeloma presents itself in different ways in different people. It responds differently to different therapy combinations. I’m sorry it didn’t help you, but you make a good point. There is what–a one our of five chance a smoldering patient will still be smoldering after ten years without doing anything (or is it a one out of ten chance?) Either way, it is difficult to quantify exactly what works in which patient. That’s why clinical studies are carefully constructed to optimize the “apples vs apples” effect. But even then, most studies only give OS or PFS percentages. Medians like, “48% of the patients lived five years.” Using the same meds in the same way! My take on curcumin was “what do we have to lose?” Well, apparently a lot if you believe this latest study review. Just when we thought it was safe to go back in the curcumin stained water…
March 6th, 2013 at 1:14 am
From scanning the paper that Holt posted, it seems that cur cumin could suppress the immune system, in particular dendritic cells (DCs). I will just stay with the amount of turmeric that we frequently use in cooking, since Dilip and I eat a lot of Indian food. Then I would get some benefit from it, but hopefully not interfere with my DC’s.
March 6th, 2013 at 1:15 am
The study that I brought up is one I saw by chance on Margaret’s Blog. I think the study is interesting, but it suffers the fate of small samples– a case study of two patients, albeit with good results.
Unfortunately, the conflicting information that Steve brings up in the detailed survey paper of Vermorken et al. is equally important for our attention. Table 2 is particularly interesting. Thus, taking curcumin is obviously not without risk; indeed there may be patients where taking it may be worse than not.
In reality, ALL drugs and supplements carry risks. This is why large double-blind clinical trials with patients will remain the key statistical method by which we can sort out which therapies are most likely to be beneficial.
I would argue, however, that more evidence exists relative to the helpful nature of curcumin– particularly in suppressing inflammation– than to the contrary. The issue with the supplement’s potential for immunosuppression, however, is potentially important. Still, on balance, the available evidence is soft.
Should one believe in such a supplement blindly? Obviously not and more clinically related information would be helpful. Unfortunately, larger scale studies that are meaningful for the myeloma community have been limited so far.
Let’s hope for better.
March 6th, 2013 at 8:59 am
Hi Danny,
Well said!
March 6th, 2013 at 10:02 pm
Pat, and others,
My decision to comment on Danny’s curcumin post, had a one simple reason: IN ANY OF THESE BLOGS, MYELOMA BEACON, ETC, DO YOU EVER HEAR OF PEOPLE FOR WHOM CURCUMIN DID NOT WORK ? Why aren’t the other people coming out of the woodwork, after all 75% of the SMMers progress and many of them probably resorted to curcumin or other potions. It seems that use of curcumin has received a cult status thanks to Margaret, and reporting of a negative response is heretical.
The paper in question, originally found publicity in Margaret’s blog, is an example of poor statistics and poor science; there is no statistical significance for their result that these two persons improved/stayed stable due to curcumin.
March 7th, 2013 at 1:53 am
A bit harsh, don’t you think? Not that you aren’t correct on most points. There are other curcumin studies with positive results. To me, the anti-inflammatory aspect makes it worth a shot to me. We all look hard for info that supports our positions–human nature. Taking a shot at Margaret may be justified. But why not do that “face to face” on her site. Won’t she allow comments contrary to her position(s)? My impression is she is intelligent and includes lots of detail and supporting documentation. One thing you are absolutely correct about. It is always hard to prove a negative. So if curcumin doesn’t work, I’m sure its assumed the myeloma was too strong. And if someone smoldering stays asymptomatic, then curcumin gets the credit!