Cancer

Multiple Myeloma, a Blood Plasma Cancer, and the Arkansas Treatment

Within the last 20 years, the Arkansas Treatment has been developed for patients suffering from Multiple Myeloma. An acquaintance of the author’s, who was treated with this chemotherapy regimen several years before his own diagnosis, had to travel to Arkansas to receive the treatment. After being diagnosed in June, 2008 with multiple myeloma, the author was able to receive this chemotherapy regimen locally near his home in the Upstate of South Carolina.

This treatment uses several different drugs during chemotherapy, followed by an autologous stem cell transplant. The full treatment actually calls for a tandem stem cell transplant (two in succession.) Whereas years ago, the only treatment for multiple myeloma was the drug that directly targets the cancerous cells (and then also targets lots of good cells as well), the several drugs used in this treatment all target the abilities of the cancerous cells to reproduce and encourage the body’s normal disease fighting cells to eliminate them.

This treatment uses thalidomide as the main, cancer-fighting, oral drug, plus a cocktail of chemotherapy drugs which include bortezomib, cyclophosphamide, etoposide, cisplatin, doxorubicin, and dexamethasone. A variety of other drugs such as antibiotics, to help the body’s impaired immune system, anti-nausea drugs, and pain killers (steroids) are administered concurrently.

With the older treatments directly targeting the cancerous cells, the life expectancies of multiple myeloma patients were on the order of two to four years following diagnosis. Since those drugs adversely affected many good body cells as well as the cancerous cells, the patients’ bodies took a major hit every time the drug was administered. A high dose of that same drug (or similar ones) is part of the stem cell transplant procedure. Following the administration of the high dose drug, the author’s white blood cell count was near zero. Fortunately, the stem cell transplant immediately followed the administration of the high dose, so his body was able to recover from the high dose by creating new stem cells and new good blood cells.

Newer treatments such as the Arkansas Treatment use drugs that target the cancerous cells indirectly. They attempt to turn OFF the ON switch that tells the cancerous cells to reproduce ad infinitum. They attempt to block blood supplies which allow the cancerous cells to flourish. They attempt to block signals sent from the cancerous cells to normal body disease-fighting cells that says, in effect, “I am a normal cell — leave me alone.” They attempt to encourage the body’s disease-fighting cells to go after those cancerous cells and do their jobs — that is, to eliminate them as unwanted cells in the body. Obviously, this is a layman’s explanation of the tasks requested of the drugs in this treatment regimen, but you get the idea.

Since these drugs are not directly expected to kill the cancerous cells, they are much less harmful to the good cells of the body. This does not mean they are harmless to normal body cells. They still are quite potent chemicals that should not be used lightly. But they appear to each work well to perform the jobs requested of them. Life expectancies of patients receiving the Arkansas treatment are listed as ten plus years, and climbing.

Major side effects occur with this treatment regimen, but they appear to be worth the inconveniences. In the author’s case, the two major side effects are deterioration of the heart muscle, and peripheral neuropathy. The author’s heart efficiency deteriorated sufficiently over the course of treatment that he was prevented from receiving the second stem cell transplant. Having read lots of information on the internet prior to and during treatments, he somehow missed the possibility that the chemo drugs could adversely affect the heart muscle. The efficiency of his left ventricle went from normal values above 50% all the way down to 26%. At this low level, he was treated for congestive heart failure. The cardiologist said, however, that in many cases, the heart can recover from chemo-induced levels like this. This, in fact, has happened in the author’s case. His heart’s efficiency has risen once again to near-normal levels.

After the heart’s efficiency problems were diagnosed, the author searched for and found several articles that did indeed warn that some of the chemo drugs used in this regimen can adversely affect the heart muscle. One of the drugs, in particular, was listed as prone to causing heart problems. When he asked one of the chemo nurses which of the medications could adversely affect the heart, she answered, “Oh, they probably all do.”

The peripheral neuropathy is a major nuisance, but it does not appear to be a life-threatening problem. The author’s fingers and toes all tingle and feel somewhat numb most of the time. The cancer drugs, and even the cancer maintenance drugs, appeared to cause these problems. After the main cancer medications were stopped, the tingling and numbness receded a little, but not completely. There were days following the chemo treatments when the author’s hands hurt — especially when holding or touching cold items. Today, they are tingly but that sensation can be ignored most of the time.

The author’s body is currently “as clean of the cancerous cells as possible,” according to his oncologist. This doctor also commented during that visit that many don’t appreciate the gravity of that statement. “Years ago, half of the people who contracted multiple myeloma died within 3 years of diagnosis.” Those numbers are greatly extended now due to chemo regimens like the Arkansas Treatment.

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