The Latest Myeloma News from the American Society of Hematology Meeting

Andrew Schorr:

Thank you. Okay, Jim Berenson, any patient, and I'm sure you get this question a hundred times a day, wonders about what else they can do themselves, and we got this e-mail from Heather from Indianapolis. She says she's a nursing student, and she has a friend who was just diagnosed with multiple myeloma just a couple of weeks ago, and she wants to support her, and she is wondering is there any evidence of help from supplements or other forms of nutrition that could slow the progression of the disease?

Dr. Berenson:

Obviously there are a number of things that are being tried. I can't tell you we have good clinical trials. I would say in terms of side effects, I certainly would highly advocate alpha lipoic acid in terms of neuropathy. I think that's been very useful for my patients. On of the Millennium MSLs turned me on to that about a year and a half ago, and even one of my patients in this morning who has myeloma, the husband has diabetic neuropathy and has started benefitting from that use, so in terms of helping with side effects, I think that's been useful. Other little tidbits that will be useful to you guys out there; cramps, believe it or not, dill pickles are extremely useful to overcome cramps, and in fact football players on the sidelines take pickle juice, so try that. You'll like it, and it will help. In terms of directly attacking the myeloma: Well, as you know there have been attempts to use curcumin, and there are people working on that. There are others, and I certainly can't say I have had patients who have had direct benefit from that, but I've seen some pretty amazing responses with some pretty, if you will, alternative things. For example, I have patients who have done work themselves with homeopaths with mushroom extracts that have actually led to responses. I wish I knew what it was in those extracts, but I can't tell you these have been studied in really any large clinical trials.

Andrew Schorr:

Right. I mean, I'm impressed. Let's just say so everybody gets it, not everything is equal. So, for instance, in the different trials we've discussed, some had 40 patients, some had 1600 patients, and in this area of supportive efforts in nutrition, unfortunately we often don't have the big trials. So, that's a discussion that Heather will have with her friend. Is there anything you'd want to call out though, Jim, that you would warn people against where you think it works against the myeloma effective treatment?

Dr. Berenson:

Actually, that's a very good point Andrew. The recent use of vitamin C, which we've shown very active with both melphalan/Cytoxan as well as arsenic actually works against Velcade. Actually, is was Sagar's group who directly showed that vitamin C inactivates Velcade, so we warn our patients who are receiving Velcade avoid vitamin C on the mornings you're receiving Velcade; however, that being said, if there's been several hours away from the Velcade administration, you can take the vitamin C. It's an immediate interaction, and one of the lead scientists at Millennium also believes it's an immediate effect. In addition, our own laboratories recently demonstrated that what I just advocated, the alpha lipoic acid, we also tell patients to avoid it on Velcade days because clearly it inhibits the ability of Velcade to kill myeloma in our laboratory, but again it's when they're in the test tube together, so we believe that if there's a separation there that we will not observe that effect, and we certainly haven't seen any negative impact.

Andrew Schorr:

Folks, this is the active discussion you need to have with your doctor for yourself or Heather for her friend as well.

We're going to go just a little bit over. If we don't get to your question when our doctors have to go, we're going to have a colleague of Dr. Lonial's from the Winship Comprehensive Cancer Center at Emory with us next week, and I'm gonna just grill him with questions that you send in, and then we'll be posting that next Friday, and that's going to be Dr. Tom Heffner who has a lot of experience in transplant as well as all these drug therapies used by themselves.

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Page last updated on November 22, 2013