Living with Cancer
- Patti Scialfa, 71, wife of Bruce Springsteen, has been living with multiple myeloma, a type of blood cancer, for roughly six years. Multiple myeloma is a rare type of blood cancer that hinders the body’s ability to fight infections. It can cause weakness, dizziness, bone pain, and confusion, among other symptoms.
- Advancements in multiple myeloma maintenance treatments have improved the lives of patients battling the disease.
The standard treatment approach for multiple myeloma goes from the induction phase, the stem-cell transplant phase, and then the maintenance phase. Since multiple myeloma patients face a higher chance of relapse (the cancer coming back), maintenance treatment is important because it can extend periods of remission. - The chemotherapy drug Revlimid (generic name lenalidomide) is a type of maintenance treatment that has been shown to improve survival for patients living with multiple myeloma, including journalist Tom Brokaw. Other treatments also exist for relapsed patients.
The key is, after her 2018 diagnosis with the rare type of blood cancer, she has kept going.
Read More“She is lovely Patti….I know about your disease and I am hoping you are in remission for years to come…you are one week older than me and I have always looked up to you…your beautiful voice etc…I have seen Bruce in concert so many times and many times with you with the E Street band..”
And Patti’s music career is still going strong, having recently cranked out multiple songs in studio on The Howard Stern Show.
A ‘Romantic’ Performing Duo
“Howard Stern/ exciting day….Crazy fun was had by all!!!! Howard has us laughing all day…” she wrote in October.
“He is not afraid to ask some crazy questions,” Patti joked of the radio icon, who has been widely known as a “shock jock,” especially throughout the earlier majority of his near 50-year career.
Although Stern, for the most part, commented on their evident chemistry together while live on the air.
“Nothing more romantic than that,” Stern marveled after a moving performance by the duo with “Brilliant Disguise.”
And they even followed with one of Bruce’s biggest hits, 1984’s “Glory Days,” per Stern’s request.
Glory days indeed for the couple, who married in 1991 — had three children together, Evan, 34, Jessica, 32, and Samuel, 30 — and are still going strong.
“You sounded great! Loved this. And you look like a million bucks!” fellow singer Rita Wilson, wife of Tom Hanks, praised her pal, while Jill Vedder, wife of Pearl Jam singer Eddie Vedder, wrote, “Patti!! Gorgeous !!! Sending love from Seattle.”
During the appearance, Bruce, referencing his legendary nickname, made a point to say that he is only “boss” while on stage “for three hours,” then he “happily” surrenders the title, sweetly alluding to his other half calling the shots.
Patti’s ‘New Normal’
Though Patti is clearly still well enough to sing, she has reduced her overall role on tour to focus more on her health, but still has been a part of some major shows recently, like September’s Sea.Hear.Now. Festival in Asbury Park, New Jersey (where Bruce’s career initially kicked off back in the 1970s at The Stone Pony), and a special show at the L.A. Forum last April, where Bruce and Patti sang “Fire” and “Tougher Than the Rest.”
“Touring has become a challenge for me,” Patti shared when she first disclosed her diagnosis in the documentary Road Diary: Bruce Springsteen and the E Street Band, which premiered at the Toronto International Film Festival (TIFF) last September, reported by PEOPLE.
“In 2018, well, Bruce and I were doing a play on Broadway. I was diagnosed with early stage multiple myeloma. This affects my immune system, so I have to be careful what I choose to do and where I choose to go.”
“Every once in a while, I come to a show or two and I can sing a few songs on stage, and that’s been a treat. That’s the new normal for me right now, and I’m OK with that.”
Understanding Patti’s Diagnosis
Multiple myeloma is a rare and incurable type of blood cancer. When you have this cancer, white blood cells called plasma cells (the cells that make antibodies to fight infections) in your bone marrow grow out of proportion to healthy cells. Those abnormal cells leave less room for your body’s healthy blood cells to fight infections. They can also spread to other parts of your body and cause problems with organs like your kidneys.
“In general, having blood cancer means that your bone marrow is not functioning correctly,” Dr. Nina Shah, a hematologist at the University of California San Francisco, explained to SurvivorNet.
Known risk factors for multiple myeloma include your age, family history of cancer, and if you have monoclonal gammopathy of undetermined significance (MGUS). MGUS is a condition that occurs when you have too much monoclonal protein in your blood and bone marrow.
Most people diagnosed are in their 60s. However, people younger than 60 can still get this type of cancer also; if you have a close relative with multiple myeloma, that can increase your risk.
WATCH: Recognizing multiple myeloma symptoms.
Multiple myeloma can cause symptoms such as weakness, dizziness, bone pain, and confusion, among other symptoms.
Doctors use blood and urine tests and imaging tests such as X-rays or MRIs to help diagnose multiple myeloma and to guide treatment options. Ultimately, a bone marrow biopsy will confirm the diagnosis.
Treatment Options for Multiple Myeloma
Treatment for multiple myeloma depends on your risk level. Some patients are considered standard risk, while others are high-risk. Your risk depends on irregularities in the chromosomes of their cancer cells:
- Standard Risk – Extra copies of some chromosomes typically characterize this.
- High Risk – A missing part of chromosome number 17 typically characterizes this
These gene differences control the aggressiveness of the cancer cells. According to Dr. Kenneth Anderson, director of the Multiple Myeloma Center at Dana Farber Cancer Institute, standard risk has “a better prognosis.” In contrast, high-risk myeloma “confers a much poorer outcome.”
The standard treatment approach for multiple myeloma goes from the induction phase, the stem-cell transplant phase, and then the maintenance phase.
- Induction Phase: This phase is the same regardless of risk. It consists of triplet drug therapy, which includes an immunomodulatory drug (Revlimid or Pomalyst), a proteasome inhibitor (Kyprolis, Velcade, or Ninlaro), and a steroid (dexamethasone or prednisone).
- Stem-Cell Transplant Phase: This phase is the same regardless of risk. It consists of chemotherapy coupled with a stem-cell transplant.
- Maintenance Phase: This phase will differ based on the risk profile.
- Maintenance treatment is essential because it keeps the cancer at bay. Since multiple myeloma patients face the risk of relapse even if the cancer is put into remission, maintenance treatment helps keep the cancer in remission for more extended periods.
To help patients better understand this type of cancer, SurvivorNet has shared retired journalist Tom Brokaw’s treatment journey in the video below, which includes the previously mentioned maintenance treatment, Revlimid (generic name lenalidomide). This treatment is an oral medication that has helped treat patients living with multiple myeloma. Combined with other therapies, standard doses of lenalidomide kill off myeloma cells.
WATCH: Tom Brokaw explains his cancer journey and breakthrough treatment.
This drug activates immune cells that kill bacteria, viruses, and cancers. It also reduces vital blood flow to cancerous tumors, helping kill them. However, some patients don’t tolerate lenalidomide well because of some of its potential side effects, including nausea, vomiting, swelling of the limbs and skin, and liver problems.
When Multiple Myeloma Relapses, You Still Have Options
When your multiple myeloma comes back within about a year, your disease is generally classified as “high risk.”
When multiple myeloma returns after treatment, “It usually means there were residual cells, even in very small numbers. They were either resistant to the treatment from the start, or they acquired resistance as the treatment was growing,” Dr. Anderson explains to SurvivorNet.
In other words, not every myeloma cell in your body is precisely the same. Some start with a set of mutations that can give them resistance to treatments and make them more likely to relapse, whereas others develop mutations as a result of treatment.
The Signs of a Multiple Myeloma Relapse
- Increased levels of monoclonal antibodies: myeloma cells are cancerous plasma cells in the bone marrow that overgrow and produce abnormal proteins. These abnormal proteins are released in the blood and can be detected by physicians. When the levels of these increase substantially, that can be a sign multiple myeloma has relapsed.
- Increase in plasma cells in the bone marrow: Oncologists can use magnetic imaging, like MRI or PET scans, to see if there is a greater than normal level of plasma cells in the bone marrow, which is typical of overly dividing myeloma cells.
- Bone fractures and lesions: Myeloma cells activate the cells that break down bones and deactivate the cells that build up bones, which can result in fractures or small holes in bones. Oncologists can use X-rays or CT scans to detect bone damage indicative of relapse.
When or if multiple myeloma returns, remember that many treatment options exist. Oncologists may turn to therapies approved only for clinical trials, namely CAR T-cell therapy.
“We’re using the CAR T-cells now literally in patients who have no other options,” explains Dr. Anderson. CAR T-cells are immune cells harvested from a patient’s body, genetically modified to target specific cells (like multiple myeloma), and then reinfused into a patient.
Second-generation drugs, which are more recent adjustments and improvements to existing therapies, are an option to treat resistant forms of the disease.
For relapsed patients, the second-generation treatments include:
- Kyprolis (carfilzomib) – is a proteasome inhibitor.
- Pomalyst (pomalidomide) – 2nd generation immunomodulatory.
- Dexamethasone – a mainstay of myeloma treatment in both relapsed and initially diagnosed patients.
- Daratumumab, an immunotherapy, is also added to the mix. More specifically, Dara is a monoclonal antibody that ‘tags’ cancer cells for quick and efficient recognition by the immune system.
For more options following multiple myeloma relapse, clinical trials may offer a solution.
Back in March, the U.S. Food and Drug Administration (FDA) advisory panel expressed support for previously-approved CAR T-cell therapies Carvykti and Abemca to treat adults diagnosed with relapsed or refractory multiple myeloma sooner in their treatment journey. During clinical trials, the treatments saw a “59%” reduction in multiple myeloma disease progression in clinical trials for patients who received one prior line of treatment. During these same clinical trials, some patients experienced “early deaths”; however, experts reviewing the drugs felt the benefits outweighed the risks.
The FDA approved both drugs shortly after, on April 4, 2024, specifically “for the treatment of adult patients with relapsed or refractory multiple myeloma after two or more prior lines of therapy.”
Positive Tips for Living with Cancer
Living with cancer can certainly manifest a mix of emotions and obstacles. Perhaps one of the biggest obstacles you’ll have to deal with is cancer treatment.
While everyone has their own journey with cancer treatment, there are some golden rules to follow that are effective in managing this new life.
Dr. Geoffrey Oxnard, a thoracic oncologist at Boston Medical Center, has three tips/reminders for getting through cancer treatment:
- Don’t give in to the “I’m sick” mentality. Just because you have cancer doesn’t mean that you have to stop doing the things that you enjoy. Stay active.
- Don’t lose weight. Cancer can eat away at your physical reserves, so it’s important that you top them up with the calories and nutrients you need to fight the disease.
- Don’t be a tough guy. When you have cancer, things like diarrhea or tingling nerves can be a sign that the dose or frequency of your treatment needs to be adjusted. Speak up and let the members of your care team know so that they can help.
Ultimately, dealing with your cancer treatment means staying positive, having full communication with those who can help and support you, and remembering that your life went on before treatment, and will go on just the same after treatment. There’s no reason why it shouldn’t go on during. And yes, you have the strength!
Contributing by SurvivorNet staff.
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