Continuing the theme of my summer of suckiness (which began with my family being evacuated from our home due to Hezbollah’s war with Israel), my father was just diagnosed with multiple myeloma. Apparently, they caught it very early. However, according to the Wikipedia site on MM, the median survival time for people diagnosed with Stage I multiple myeloma is 62 months. I went with my dad to see the oncologist today, and the oncologist said that although the median time from diagnosis to death was 3 years, my dad would probably live longer because his is very early. My dad said, “So perhaps 5 or 6 years,” to which the oncologist replied, “Yes, but maybe much longer.” So not helpful. And I haven’t been able to find much more out on the internet. Obviously it is difficult to predict; but I am just wondering if people who survive for (say) 10 years after a diagnosis of Stage 1 multiple myeloma are statistical anomolies, and that I should expect my dad to die within the next 5 years. (He’s 71 by the way–not ancient, but no spring chicken either). Does anybody know anything about this stuff? What are the odds of his surviving more than 5 years, given that the cancer was caught early in the first stage? If only the occasional statistical outlier lives so long after a Stage 1 diagnosis, and the doctor is giving us false hope, I’d like to know.
Our knowledge of, and ability to predict, survival in people with multiple myeloma is changing.
In part, this uncertainty reflects the changing therapeutic options available (eg. standard chemotherapy, thalidomide and similar drugs, bone marrow transplants, proteosome inhibitors), but is also due to the develpopment of new, sophisticated, and powerful prognostic tests based on genetic markers (eg. abnormalities of chromsome 13 in the myeloma cells).
Historically, the most useful indicators suggesting a good prognosis and long survival included age < 70 and good “performance status” (with performance status basically being an integrated measurement of the ability to perform one’s daily activities). In myeloma, the Karnofsky score is most often used in this regard. By and large, younger age and higher performance status translate to a better ability to tolerate chemotherapy at therapeutically effective doses.
There are many other prognostic factors for myeloma. Things such as beta-2 microglobulin (an index of myeloma activity), anemia and low blood platelets (indicating bone marrow infiltration by the myeloma tumor cells), poor kidney function (having many reasons for occurring in myeloma), and the extent, if any, of myeloma deposits in the bones, taken alone or in combination, yield valuable and valid information.
And, back to your original question: in the presence of favourable prognostic features such as described above, and in the absence of unfavorable ones, survival in myeloma can certainly exceed ten years.
The median isn’t always the message. Having said that, malignant melanoma is, to use advanced oncological terms, a bitch. There is some promising work being done with cancer vaccines, and MM is a good fit for this approach, given the global nature of the disease. For the best options, 1)avoid quackery and 2)consider the options as understood by thsoe near a cancer center. Specialists really make or break a cnacer case, especially an advanced case.
cerberus: Are you talking about myeloma or melanoma?
Sophistry and Illusion: Data from a very famous study conducted between 1973-1998 (the Surveillance, Epidemiology, and End Results (SEER) program) indicated 5-,10-, and 20-year survivals for multiple myeloma of 31, 10, and 4 percent, respectively.
I’m sorry to present the ‘cold, hard’ facts, but the good news, I suppose, is that at age 71 the overall survival for anyone, even without cancer, is “only” about 14 years. I take this to mean that there’s a fair chance that someone newly diagnosed with myeloma at 71 may die with the disease, and not from it. This may be especially so since the myeloma survival statistics above, by and large, reflect results from a rather different, and less effective, therapeutic era.
D’Oh!
I was talking about Melanoma, though myeloma is also hard to localise, given the need to have blood everywhere. The vaccine route seems challenging, given the fact that the bone marrrow is the center of action here.
Anecdotally, my grandfather was diagnosed ~12 years ago with (I think Stage 3) multiple myeloma, at the age of 75. He was told he had a 15% chance of living 5 years. He died 10 years later, cancer-free, of something completely unrelated.
If his experience is anything to go by, a positive attitude toward treatment, combined with breathtaking pigheadedness, are the way to go.
More anecdotal stuff:
Former roommate’s mother diagnosed about age 62. She lived two years. (Actually dying from pneumonia during one of her “sick” spells.)
Tucker-Babe’s father diagnosed at age 63. Died almost exactly one year later.
Former co-worker diagnosed at age 50-55. He’s still alive and kicking eight years later. When he retired about 5 years ago, he would get chemo every six weeks, and then twice a year he would go offsite to get (other chemo?) treatments.
Thanks for all the input. So far, his markers are good–no anemia, kidney function fine (75%, which the doctor says is good for his age), calcium levels normal. She said she would have diagnosed MGUS, instead of multiple myeloma, except for two things: 25% plasma cells in the marrow and myelodysplasia (apparently, red blood cells are not being made properly). Also, his blood protein level is .5, whatever that means; but apparently that is low for a mm diagnosis. So he is definitely at a very early stage, which gives us some hope. I just ordered a book from Amazon.com on myeloma; hopefully this will give us some more information. But thanks again for the information you have provided; it’s good to be able to get straight talk from people who know what they are talking about!
Because I was much younger when my aunt was diagnosed with MM, I’m not sure of all the facts, such as stage, etc.
She died 5 years after she was diagnosed at the age of 49. That was in 1992. I’m sure treatment and diagnostic options have come a long way since then.
Hang in there!
It could be Paraprotein levels that this refers to.
Immunoglobulins (aka antibodies) are produced by the plasma cells and they normally produce lots of different ones to react to different antigens. In MM (and MGUS) one plasma cell is multipying excessively and producing too much of one very specific immunoglobulin (called the paraprotein). This can be detected using lab tests and is often used to monitor whether the MM is getting progressing and how fast or if it’s responding to chemotherapy.
I regularly do the test for paraproteins and if that .5 is in g/L (or even if it’s in g/dL) then it is very low indeed.
I cannot answer your question, but my Dad had it for many years before it was diagnosed when he was about 68. I was 1,000 miles away and only saw the folks during vacations so do not know stages or other details. He had constant head pain for years and that got real bad at age 70. He did not undergo chemotherapy, only medication (I know not what. It was 25 years ago.) He died of a heart attack at age 71, four months after the folks’ 50th wedding anniversary.
Slight hijack - my grandfather-in-law was just diagnosed, at the age of 82. I was going to ask for the Dope, but then found this thread. Thanks all!
Maybe a useful link: cancer.gov
No its not death sentence… I was diagnosed in February 2006 and also treated at UAMS. I was in stage III with 23 lesions and a fractured vertebra. I had chemo and two SCT’s and am now in complete remission and off all chemo. My doctor says I am cured and feels the MM will not return. I hope and pray he’s right. He is determined to find a cure and, God willing, he will.
In the abstract, cancers are very complex phenomena, each instance is unique, and all kinds of things can tip the balance between proliferation and remission.
So generally-speaking there are few cancers that doctors would call a “death sentence” in the early stages. In most cases, there is a probability of remission or long-term control, particularly with treatment.
Many cancer survival stories don’t depict things that way. They describe doctors as being sure that a cancer is terminal and then being astonished when it is not. I think this is partly to improve the story, and partly the way we parse odds of terrible events happening (understandably, anyone given poor odds of survival prepares themselves for the worst, but may forget that the prognosis was not absolute).
Update: Former co-worker still going. I last saw him about a 18 months ago, and he still looked pretty good.
KarlGauss, you appear to be Doctor on Call for absolutely everything in GQ, and have been for some time. You have helped me on numerous occassions.
If it is not too personal, or isn’t detrimental to your Web persona, do you have a particular medical specialty?
Since KG hasn’t chimed in yet, allow me to sing his praises (giving info already posted by him here on SDMB):
He’s an academic internist and endocrinologist for a great Canadian teaching university and hospital, and can be counted on to wax eloquently here at the Straight Dope on topics medical. He fought hard and bravely on the front lines in the War Against SARS some years ago, and persevered even as some of his comrades tragically succumbed. I hold him in great esteem for his knowledge and humor, and willingness to share both those things here and elsewhere.
Well given that the thread was a reanimated one from 8 years ago posted to by a new and now banned poster perhaps Sophistry and Illusion can return to let us know how things have been. Hopefully the same sort of story as Earl Snake-Hips Tucker"s co-worker.
Still probably a death sentence though.