Hope For Multiple Myeloma
- Retired news anchor Tom Brokaw has just celebrated his 85th birthday—amid his ongoing battle with multiple myeloma, a rare type of blood cancer he was diagnosed with in 2013. It’s wonderful to see Brokaw continuing to live with the disease more than 10 years after his diagnosis, and especially after his doctors didn’t think he’d live past 83.
- In 2013, Brokaw was diagnosed with multiple myeloma, and he recalled the experience being a tough one to endure. The disease caused him to step back from NBC, where he made his career, before his full retirement in 2021.
- Brokaw found hope with the chemotherapy drug Revlimid (generic name lenalidomide), which has been shown to improve survival for patients living with multiple myeloma.
- 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 treatments have improved the lives of patients battling the disease.
- It’s important to note that although this type of disease is manageable thanks to treatment advances, multiple myeloma patients face a higher chance of relapse (the cancer coming back), and maintenance treatment is often an important part of one’s cancer journey because it can extend periods of remission.
- What’s also encouraging is that there continues to be new treatment options and therapies, which can include immunotherapies such as CAR-T cells and a growing number of drug combinations. There are a significant number of clinical trials being conducted for multiple myeloma and SurvivorNet has resources about how to access these options.
Brokaw, who was born on February 6, 1940, has been powering through the disease with the help of a groundbreaking, effective treatment—a chemotherapy drug called Revlimid (generic name lenalidomide), however, he was reportedly spotted in a wheelchair enjoying some time with his wife and health aides in Manhattan’s Central Park last year.
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“He and his wife looked so happy. It was sweet — sad, but sweet.”
What makes Brokaw’s recent birthday celebration even more special is that he previously recalled his doctors not thinking he would live past 83.
During a 2023 interview with CBS News Sunday Morning, Brokaw said, “I’ve had a bad experience [with multiple myeloma]. I kept thinking bad things wouldn’t happen to me.
“But as I grew older, I began to develop this condition. And what you try to do is control it as much as you can.”
As for how he had to step away from his work and retire, he said, “I’ve had to change my life in some way. I really had to give up my daily activity with NBC. You know, I had to walk away from them, as they were walking away from me. I just wasn’t the same person.
“And so, for the first time in my life, I was kind of out there, you know, in a place I had never been in my life.”
Legendary journalist and anchor @tombrokaw talks about his dad “Red,” his new book “Never Give Up: A Prairie Family’s Story,” and his decade-long battle with incurable blood cancer in an emotional interview with his longtime friend anchor Jane Pauley, THIS SUNDAY. pic.twitter.com/mMi9c4DdHT
— CBS Sunday Morning 🌞 (@CBSSunday) June 23, 2023
How Brokaw Managed to Cope With His Diagnosis
Brokaw was diagnosed with multiple myeloma in August 2013. The rare blood cancer hinders the body’s ability to fight infections. It causes weakness, dizziness, bone pain, and confusion, among other symptoms. For Brokaw, these mounting symptoms fueled his retirement.
“I didn’t go into a meltdown of some kind. I was very cool about it. I was kind of in two parts: I was operating as a journalist human being, and the other part was kind of on the outside looking in saying, ‘This is a big deal, you’ve got to stay cool.’” Brokaw previously explained in a column.
Brokaw noted that he didn’t want this diagnosis and its treatment to hold him back from the life he wanted to keep living.
WATCH: Veteran journalist Tom Brokaw shares his thoughts on the medical community and the patient experience.
SurvivorNet sat down with Brokaw in his Florida home a while back, and he shared some details about his treatment, which included chemotherapy.
Brokaw received Revlimid (generic name lenalidomide), a breakthrough oral medication that has helped treat patients living with multiple myeloma. In combination with other therapies, standard doses of lenalidomide kill off myeloma cells.
Low doses of Revlimid are then used as maintenance therapy to help keep the immune system on alert and target the myeloma in case it reemerges within the body.
“The Revlimid thing for me has been no side effects whatsoever,” Brokaw previously told SurvivorNet.
WATCH: Journalist Tom Brokaw shares his multiple myeloma treatment.
“I think that I’m doing as well as I am in part because of Revlimid. I’ve been very fortunate, of course, in not having a reaction to a lot of the very powerful drugs that I am taking…Revlimid on a daily basis,” Brokaw continued.
The new treatment has shown great promise, giving multiple myeloma patients and their families hope.
“If you look at the most recent meta-analysis of clinical benefit from lenalidomide, you’re seeing survival gains of two and 1/2 to three years as a median by virtue of its use. And that’s not progression-free survival; that’s overall survival,” Dr. Paul Richardson, director of clinical research at the Jerome Lipper Multiple Myeloma Center, previously told SurvivorNet.
“What we’re realizing is that lenalidomide (Revlimid) is really conferring tremendous clinical benefit by virtue of its continuous use, and it’s impacting on survival and progression-free survival in a remarkably substantial fashion,” Dr. Richardson added.
Brokaw’s experience with Revlimid as maintenance therapy is a testament to the importance of ongoing treatment and management of multiple myeloma. While the disease may not be curable, maintenance therapy can help patients maintain a good quality of life and control the disease for extended periods.
Understanding Multiple Myeloma
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 the healthy blood cells your body needs to fight infections. They can also spread to other parts of your body and cause problems with organs like your kidneys.
Expert Resources for Multiple Myeloma
- Are the Treatments the Same for a Second or Third Relapse of Multiple Myeloma?
- CAR T-Cell Therapy and BiTE: Two New Approaches to Multiple Myeloma Treatment
- Clinical Trials for Multiple Myeloma: Why They Matter
- Deciding Which Approach to Take During the Maintenance Phase of Multiple Myeloma Treatment
- Diagnosis: Do I Have Multiple Myeloma?
- Does Multiple Myeloma Risk Affect Your Treatment?
- Exciting New Immunotherapy Treatments for Multiple Myeloma
- Bone Marrow Biopsies: ‘A Vital Part of Diagnosing and Staging Multiple Myeloma’
- “An Important Step”: FDA Approves New Combination Treatment For Newly Diagnosed Multiple Myeloma Patients
Sometimes, doctors find multiple myeloma while doing a blood test to look for another condition or when trying to find out what’s causing a patient’s unexplained 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.
Hematologist and SurvivorNet advisor, Dr. Nina Shah, helps you understand this rare cancer
Multiple myeloma symptoms can range from tiredness, nausea and constipation. Other symptoms may include:
- Weakness, dizziness, and shortness of breath, which are signs of a low red blood cell count, are called anemia.
- Bone pain, which could be a sign of a fracture.
- Urinating too much or too little, muscle cramps, nausea, and vomiting are symptoms of kidney failure.
- Confusion is caused by too much calcium in the blood.
- Frequent infections because you have too few white blood cells to fight them.
It’s important to know that these symptoms could be attributed to other conditions. If you experience any of these symptoms or are concerned about any changes to your body, you should address them promptly with your doctor.
Hematologist-oncologist Dr. Adam Cohen lays out your options during the maintenance phase of treatment
Getting a Diagnosis
Sometimes doctors find multiple myeloma while doing a blood test to look for another condition, or when trying to find out what’s causing a patient’s unexplained symptoms.
According to SurvivorNet’s experts, blood tests are also the way your doctor might learn that you have smoldering multiple myeloma or MGUS, because these conditions don’t usually cause symptoms. Smoldering multiple myeloma and MGUS aren’t cancer, but they can sometimes turn into cancer.
The odds that either condition will become cancer are very small, but to be safe, your doctor will probably check you more closely with blood and urine tests, and sometimes a bone marrow biopsy–removing and testing a small sample of the spongy material inside your bones. These tests can help monitor you for changes that signal you’ve switched over to multiple myeloma, and that you need to start treatment for this cancer. You may also need a bone marrow biopsy to help your doctor make the initial diagnosis.
Doctors use blood and urine tests and imaging tests such as X-ray or MRI to help diagnose multiple myeloma and to guide treatment options. Ultimately, a bone marrow biopsy will confirm the diagnosis.
Monitoring your bone strength and health over time will help your doctors understand how, or if, your disease is progressing.
Treatment Options For Multiple Myeloma
Not everyone with multiple myeloma needs treatment right away. If you have smoldering multiple myeloma, your doctor might simply monitor you regularly, to see if your disease progresses.
If you develop symptoms or your doctor thinks you need treatment, there are many options. Which of these treatments you receive, and how they are sequenced, depend on several factors, and on whether your treatment team thinks you are a good candidate for a bone marrow transplant.
Bone Marrow (Stem Cell) Transplant
This is also known as a stem cell transplant. It is a procedure to replace diseased bone marrow with healthy bone marrow without myeloma cells. Based on multiple factors, your doctor may decide that a stem cell transplant is best for you. The transplant process can be involved and requires multiple steps. Be sure to discuss this with your treating team to understand what is involved and what options are available.
If you’re not a good candidate for chemotherapy, your treatment options include targeted therapies, biologics, and steroids.
Targeted Therapy
Targeted therapy is now available for patients with multiple myeloma, and targets abnormalities in myeloma cells that allow the cancer to survive. Examples of targeted agents your doctor may use include bortezomib (Velcade), carfilzomib (Kyprolis), and ixazomib (Sarclisa). These drugs are either given in a pill or through an IV, and cause myeloma cells to die by preventing the breakdown of certain proteins in myeloma cells. You doctor may also use other targeted agents in the class of medications known as monoclonal antibodies.
Biologic Therapy
Biologic therapy is another class of medication your treatment team may use to treat your myeloma. These medications use your bodys immune system to help fight and kill myeloma cells. This class of medication is most often given in pill form and include medications such as thalidomide (Thalidomid), lenalidomide (Revlimid), and pomalidomide (Pomalyst).
Chemotherapy
Sometimes your treatment team may recommend chemotherapy to treat your myeloma. Chemotherapy uses strong medicine to target cancer cells throughout your body. If your doctor recommends a bone marrow transplant high doses of chemotherapy are used for this purpose.
Steroids
Occasionally, doctors may use corticosteroids such as dexamethasone or prednisone as part of your treatment. Steroids are different from chemotherapy, targeted therapy, and biologic therapy. They work to reduce inflammation throughout your body. Steroids are given as a pill, and are also active against myeloma cells.
Radiation
Radiation uses high-dose X-rays to stop cancer cells from dividing. It is sometimes used to target myeloma in specific areas that may be causing you issues or pain. It is also used if there are tumors or deposits of myeloma cells that need to be treated, such as a plasmacytoma — a tumor made of abnormal plasma cells — of the bone.
Sometimes the cancer can return, or relapse after treatment. If this happens, your doctor can put you on one of the treatments you’ve already tried again, try a new treatment, or recommend that you enroll in a clinical trial.
Any of these treatments can cause side effects, which may include nerve pain and fatigue. Your doctor can adjust your medication if you do have side effects. In general, you should start to feel better once your treatment starts to work.
Extending Your Lifespan With Multiple Myeloma
Then you’ll ultimately reach the maintenance phase of treatment. Now that your doctor has gotten your cancer under control, from here the goal is to keep your disease stable and to maintain your quality of life. Which type of maintenance therapy you get, and what prognosis you can expect, will depend on whether your doctor determines that your multiple myeloma is standard risk or high risk.
One of SurvivorNet’s experts describes the maintenance process for this disease as similar to lawn care. Once you care for your lawn and it’s no longer overgrown (that’s the initial treatment), it will need some tending but with that attention (such as low doses of maintenance drugs), it can remain healthy.
Why the many phases of multiple myeloma are like caring for your lawn, says hematologic cancer specialist, Dr. Sid Ganguly
Sometimes this disease will return, even when you’re on maintenance therapies. You’ll still have treatments available if this happens.
Though it can be daunting to choose treatments for relapsed multiple myeloma, the medical experts at SurvivorNet are here to help you make sense of them. Remember that you do have options, and that the goal which becomes more achievable with each new treatment that’s introduced is to preserve your quality of life and extend your lifespan.
Questions for Your Doctor
If you are facing a multiple myeloma diagnosis, here are some questions to help you begin the conversation with your doctor:
- What stage is my multiple myeloma?
- What are my treatment options?
- Am I a good candidate for Revlimid?
- What are the possible side effects of your recommended treatment?
- Who will be part of my healthcare team, and what does each member do?
- Can you refer me to a social worker or psychologist who can help me cope with my diagnosis?
Contributing: SurvivorNet Staff
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