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New Study Provides Clues to What Causes Myeloma

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Six months ago, cancer was added to the list of illnesses covered by the $3.4 billion World Trade Center fund. Now, as reported on December 19th in the New York Times, the New York City Health Department has completed a study that compares cancer rates among 9/11 responders with overall cancer rates for New York State. Myeloma is at the top of the list of cancers occurring at a statistically higher rate in 9/11 responders. Myeloma is occurring at a 3-fold increased rate: the rate being +185% versus the average for New York State. Thyroid cancer was at +102% and prostate cancer at +43%. All others were not statistically increased in this study.

The findings are controversial in part because it is very early to be assessing the ultimate risks--and therefore much too soon to be drawing conclusions for most cancers, the occurrence of which will increase over time. However, the early increase in myeloma cases is quite remarkable and suggests a particular susceptibility to the exposures at 9/11 sites.

The specific chemical identified by the Zadroga Act reviewers (6 months ago) was 1-3 butadiene, a chemical linked to rubbers and other  fumes present at the 9/11 sites.  The chemical 1-3 butadiene is metabolized in the body via an epoxy mechanism. A study which I published in 2009 (Leukemia article on DNA SNP) showed that myeloma patients are more likely to have a defect in this epoxy metabolism, and, therefore, are potentially more susceptible to the toxic effects.

So it seems that a story is coming together linking exposure, susceptibility, and early onset of myeloma in the 9/11 setting. More studies and follow-ups are needed, but these findings are plausible and satisfy elements of what are called the "Bradford Hill Criteria," used to link toxic exposures and the development of cancer such as myeloma. There is already "proof of principle" that several toxic chemicals can cause myeloma, including pesticides, solvents, and chemicals such as 1-3 butadiene.

With this knowledge, there is now an opportunity for early screening to diagnose any case as soon as possible and look toward even curative intervention.  Every cloud has a silver lining--in this case, the ability to understand the process and intervene early.

36 Comments

I was diagnosed with MM in 2011. I had worked as an executive for a commercial roofing contractor for six years, ending in mid-2008. While I worked in an office, everyone there was exposed to asphalt fumes from time to time that emanated from a hot asphalt storage tank in the warehouse yard nearby.

I used to call it "the smell of money." Now I am wondering if it was "the smell of cancer."

In January of 2006 I began to have have classic symptoms of hypercalcemia from MM. Unfortunately, I basically ignored them except for seeing a chiropractor for the very severe muscle spasms I would get that came and went and moved around with about a 2 week duration in each place. Useless and one even broke a rib, exrays showed nothing. Did not refer me for blood tests. I popped plenty of tylanol and motrin and went to work and even took sailing scuba and golf vacations right up to 9 months later when the spasms were so bad I could not get myself dressed. My neighbor took me to a recommended doctor who immediately brought in Dr. LUTHRA A hemotologist who knew right away what it could be and got me into UCONN and through many tests all day. I was in severe pain at the time. Naturally admitted to hospital. Dr.'s and their onterages came through regulary every day. A few days later they gave me my diagnosis. It was then I found out my Dad had MM in 1984 and died within months of his corrected diagnosis (Dr. At Jackson Memorial in Miami Missed large tumor on spine while focused on lungs which after taking most of one out discovered benign lesions) Dad died of nuemonia after receiving radiation. I always thought it was bone cancer from asbestos exposure as a marine engineer. I was put on thalidimide and dexamethasone for 6 months which brought my very high lamda light chain numbers down far enough for a autologous stem cell transplant (through Yale with Dr. Cooper). I got 38 months of normal counts from this but it was a good year of recharging energies, etc. Immune system has never been the same. When my numbers started creeping up again both Dr. BONA from UCONn and Dr. COOPER agreed that it was time for a revlimid protocol that I tried for 1 year without the dex. But very slowly my numbers increased enough to add the dex. I have been on this cocktail for about 1 year and my numbers are trending down very slowly. The side effects mostly from the dex withrawal every week for 1-2 days are bad. I must be near my bathroom and sleep many hours. I began effexor to help with my very nasty moods. Big help. I go for pamidronate intravenus every month to keep my bones from breaking down any further. I have lost 3 inches of height from spinal compressions and lesions. I am very lucky that my aches and pains are very manageable. Fatigue is big problem and digestive roller coaster. MOM when needed big help. Exercise especially yoga helps so much. I have gained 20 pounds since onset of illness at 47. Immediate Menapause from thalidimide, steroids, and gelato with much lack of motivation/discipline can be blamed. This is the first time I have shared my story but what I really wanted to tell you all is when I was looking for the best Drs. and place for stem cell transplant I met with Dr. RICHARDSON at Dana Farber in Boston. He had researcher from Italy who came in to talk to me about his findings which noone mentioned here. He told me MM is not hereditary. But our ancestral genetics play a large roll. Black men from west Africa have the first highest incidence, somewhere next are people of Mediterranean decent. ITALIAN, GREEK, JEWISH, ETC. WIHICH IS WHERE MY DAD and I fit in. I believe the stresses of chemicals and pollutants, acute trauma or emotional long term stress likely trigger our MM gene. I hope they find A CURE Quickly! For all of us.

I was diagnosed with MM in August 2011, after 58 very healthy years of life. Every physician I visited for my annual exams gave prescriptions and referrals to bone specialists to alleviate the intense pain in my body. I finally went to the hospital and was given an MRI which revealed the lesions on my hipbones, backbone and breastbone. I have been evaluated for a stem cell transplant, but chose to postpone it because I did not want to miss the birth of my grandson, family graduations, my 60th birthday party and my wedding after being a widow since 1998. I have been blessed with an awesome doctor whose treatment plan for me took me from 46% to 1% in four months. I worked for a chemical distributor for 11 years and in an asbestos infested company for 6 years, and lived in a community with an oil refinery for 23 years. It is very possible that all three contributed to my MM status. I pray that I will continue to respond to my therapy until a CURE is found. My prayers to all of my MM sisters and brothers.

My father was diagnosed with Multiple Myeloma in 2003 and passed shortly after in 2008, and my family believed that it was from him being present at the test sites in nevada from the radiation. It was hard to know concidering he was there in the mid 50's to early 60's and my mother is getting older as the time goes by so it is now just myself doing more research. This past week i've continued looking and came across something called radiation exposure and as i did more reading i came across google search, cancer benefits and very interesting detail on location my father was at while in the service which made me believe more so it could be caused from this radiation he worked with so i continued looking further on this and learned that although not what i was looking for exactly but found my father qualifys for benefit earnings and even though hes passed his earnings would go to my mother. very impressed with there knowledge on these veterans i felt as if i should share with all of you. check it out and see if you or your loved ones qualify it has helped my mother so dearly shes so close to fighting her breast cancer because now she can afford the chemo. Everyone's in my Prayers as these times are hard. God Bless

Has anyone ever considered smoking to be one of causes of multiple myeloma due to solvents, chemicals used in the production of cigarettes? I have known many who have died in our small town who were smokers or reformed smokers.

I was diagnosed at 61, one year into retirement after 42 years working at power generating plants. I had Benzene exposure there before it was banned and 10 years of radiation exposure working at Nuclear plants. Now at 68 and after three stem cell transplants I live on well with low numbers, never zero! Life it still good!

I just read all the comments on exposure to the various chemicals. Not everyone exposed to them gets MM I wonder if the MM researchers should be looking at what genes some of us have or don't have that makes us targets for MM. I know lots of people whose lives have paralleled mine in growing up, working, and exposure to chemicals and they do not have MM. Maybe we need to look at why some are more likely than others to these things.

My mother was diagnosed with MM in 2005 at the age of 71 after given the run around from a terrible PCP. She clearly had all the symptoms of the disease including anemia, fractures of the spine,along with ribcage pain and elevated creatinine levels. I being in the medical field had an idea this did indeed sound like MM so i challenged the physician to run a protein electrophoresis. Even though he became offended that i would suggest he do something he did not think was necessary he did to shut me up. My suspicions were correct and that weekend she went downhill while we awaited a consult with a hematologist. I rushed her to the ER and there she was admitted in acute renal failure. She did recover from that after dialysis and after 10 days in house sh was discharged to an uphill battle with this terrible disease. She did suffer terribly from all the chemo and radiation treatments to only add insult to injury and end up with dementia. She passed away from renal failure secondary to MM January of 2012. My mother never worked and was all of her life a house wife. All i can think of that might have caused her disease is her gardening pesticides for the many years she tended to her garden.
If there are any care takers out there that are a bit skeptical about your loved ones care or diagnosis please step in and insist for second opinions. The only thing that gave my mother those extra 5 years of life is the fact that i was able to figure out what it might be and INSISTED she be tested for it. At that point i had nothing to lose by being wrong if it would have been negative. In this case that irresponsible physician was the one that should have been ashamed of himself for being so arrogant and want to deny testing her for the disease.

As a young adult of age 19, I was in training to be a x-ray technician. In those days there was not much protection from xrays for the technicians or students.
We went into the rooms with nothing but a lead apron or nothing at all. This was in the year of 1956.
I was diagnosied with MM in 1959. I really believe the exposure to the xrays was the cause, but something besides xrays in my body was involved in prompting the MM.
Because of wonderful Drs.and the help of God,it is 2013 and I am writing this comment

Carol Massich

Both my mother and I were diagnosed with MM, but 11 years apart. She passed in 1996 at age 71. I am 53 and 5 years out from diagnosis.
After much reflection, my best guess as to the cause of our both having MM is the theory that we were both exposed to the same pesticide. My parents used Chlordane, a pesticide banned in 1983, liberally, in a home they built when I was 7 years old. My father used it inside the house, which I believe was an incorrect way to apply it. Further, I have read that the chemical continues to stay in the air of the home for as long as 30 years after application (and this is assuming correct application outside the house itself).
I believe sharing these stories and theories helps.

I was diagnosed with Stage III-b MM in March of 1993. I underwent a clinical trial in "intensification of stem cell transplantation" in 1996 and have had no sign of MM in monitoring tests since that time. On March 9, 2013, I will observe the 20th anniversary of my diagnosis. I think people should know that survival statistics are numbers based on the dead, not on the living. As long as you are alive, there is hope and opportunity to live well with MM.

I worked near the World Trade Center and, took a subway train that sopped prior to the World Trade Center. After 9/11, We were assured the air quality was safe. A fire smouldered for 4 months at the World Trade Center.. One can only imagine the toxins released into the environment. Years after the attack, I sought medical treatment for respiratory problems and nosebleeds. In March 2012, I was diagnosed with a plasmacytoma in my sternum and, later told I had Multiple Myeloma. I have no family history of Myeloma.

My diagnosis at age 49 was surprisingly as I was very healthy with no other health problems. This was in 2004. My sister was diagnosed early in 2010. After that we tried to figure this out and suspected some exposure. Our dad was a painter and had a commercial business. The benzene exposure as kids is the only thing we could come up with. It is a very toxic world.

i am in a current clincal trial using genetically engineered t-cells. ihave been at this for about 1 year.
i am at present timeshowing good signs that the t-cell are replicating themselves and ihave not taken any chemo except maphalen for my 2nd transplant which was in jan/12 the last restageing could not detect any blood markers that we were trying to destroy. my oc was very optomistic at this point,he even left me bypass bone marrow at this restaging. i know i still have mm but knowing i have scored a victory over this little part may lead to bigger and better things. i have had prostrate, mm, and skin cancers. i had my mother,sister, and two brothers all who had cancer so i guess it is in my genes, that is why i am excited about this tageted gene therapy. hopefully this nano engineering of t-cells will open up new avenues of study, and give patients another route to take to fight this scurge of mm,

marty

My father was diagnosed with mm in 2001.He should've been diagnosed earlier b/c his blood tests were a 'red flag' that something was wrong. Finally, a cardiologist saw this 'red flag'.He worked his whole life in a dry cleaning store and huge laundry company but was retire for the past 30 years. I was wondering if mm can lay dormant for years and then start to reveal itself much later. It was always in the back of my mind that the chemicals he was exposed to everyday, were a contributing factor in his contracting mm. He passed away in Oct. 2011. He was 89.

10 years with MM! That gives me hope. My grandfather age 81 was just diagnosed with MM. Everything I read was such short term life expectancy. He's had no problems until recently very tired and anemia. I've focused so much on his age that I started to believe that I didn't have much time left. He was a merchant marine transporting oil. and he worked in the boiler room. I'm sure his years in the merchant marines is what caused this. I just pray to see him ride his horse one more time. Thank you for your blog. I wished others would put ages and symptons.
blessings

I sprayed a house with Malathion at age 26 and certainly got a large dose myself. I was also exposed to Benzine, another suspected cause of Myeloma, for a couple of summers as a teenager working in my Dad's machine shop. (It was frequently blown off parts with compressed air into the room. I even put my hand in it sometimes to retrieve parts.) I was diagnosed with MM at age 53. Ignorance is not always bliss.

I am surprised that I made it 69 before my MM became apparent. I am a chemical engineer. Worked in the refinery industry, petrochemical industry and Dow Chemical Company for 30 years. Spent one summer drumming benzene and loading chlorinated benzenes into tank cars. In their defense, companies had no idea that these ingredients were harmful in small quantities. I am sure that more protective measures are available today

I was diagnozed with multiple myeloma in June 2000. At that time the experts opined that MM could be caused by exposure to radiation, to pesticides or even to stress. I had all three.

If there is a lesson to be learned, it is that we should do our utmost to reduce exposure to all forms of toxins for the benefit of those who do not have MM, if that is possible. I hope people are listening; I hope they are willing to act.

My husband had mgus and was being watched by his doctor for the last year. In July 2012 he began to have weakness in his knees. A plasmacytoma had wrapped around his spinal cord. After surgury,radiation and chemo he is preparing for a stem cell transplant.
He worked as a civil engineer and after the earthquake in Kobe, Japan in 1995 he was sent to repair one of his company's buildings. He lived in the area for 9 months. Roads and buildings were destroyed. I wonder if this experience may have contributed to his mm.

This study just confirms what I knew to be true in my heart when I was diagnosed with myeloma five years ago.

I was diagnosed with multiple myeloma 1/21/11. Went into the hospital on 1/14/11 with severe back and stomach pain. Previous office visits only for the doctors to say I was depressed. Finally an MRI found a tumor on my spine, I had 10 radiation treatments, was released from hospital 2/18/11 with a walker and wheelchair. A tumor was also on my sternum but no radiation because too close to my heart so put on a steroid dex. I also had a stem cell transplant 8/8/11. Now on Revlimid, bone aspirations are good, when diagnosed I was 40% to 50% myeloma. I had to learn to walk twice and still have issues .. neuropathy from my chest to my feet. I live in the country, I have been healthy all my life, hardly missed a day of school and work. I try to eat right, don't smoke, or drink? One chemical, if this counts, is I have died my hair for many years, I just turned 60? And where I worked, my first 3 years in 1979 to 1982, I worked on an assembly line where I soldered components on boards that go into electronic equipment. At that time, smoking was allowed on the line also. Just don't get it??

My husband Richie Hass grew up in Plainfield, New Jersey, a very polluted area of North Jersey. When he finally moved to another part of the country, he ended up here in Los Angeles in 1977, where we were still having second-stage smog alerts and dealing with industrial pollutants of all sorts.

I have a strong conviction that Richie's MM was directly linked to his growing up in a very polluted area of the country. He was only 55 when he died. MM used to be an "old person's cancer" and now it hits people in the prime of their lives. We have fouled our own nest, and we are facing the consequences of those actions.

My husband died in 2005 from MM and I always thought it was connected to working in the construction business; mainly freeway work where he inhaled fumes from asphalt and also worked in a forest burn area when he was very young and remarked "their faces were so black only the white of their teeth showed." Also, one winter he worked on a building site in the snow area where they had heaters to keep warm and the chemicals leached out of the new lumber. It made his breath and skin smell of it. He was 67 years old. I appreciate the information through research and your e-mails to inform us. Thank you.

This is the first information I have seen in the past five years since my husband was diagnosed with MM that addresses the possible causes of this disease.
I have been very concerned with the apparent lack of interest into discovering reasons for MM.

No research seems to be directed at finding the causes of myeloma and other cancers. This is because it is generally known that they are linked to products from industry. No one wants to implicate or regulate industry. There is no money to be made in attacking industry, only lawsuits from industry to protect itself.

I have been trying to determine the comparative incidence for multiple myeloma for "area" residents and all residents of NYC, since 9/11, with absolutely no support or success from anyone, including the IMF, the MMF, the VCF, the WTC Health Program, and the NYH and MT. Sinai Hospital in NYC.
Just to see this comment is a miracle, but, I do not understand Dr. Durie's use of the word "early".
I live in the "area", and became ill with myeloma in the winter of 2008.
The ledges of my south-facing bedroom windows were coated with dust with dust the next morning after,but,thankfully, my windows had been closed,and I kept them closed for months.
Sincerely,
Harold A. Hamer, M.D.
27 North Moore Street, 8E
New York, NY 10013

My husband was diagnosed in 2010 and passed away 3 months ago of myeloma. It is good to see that research and findings are becomoing more prevalent. As no one knows what caused his and we had no hope. So I hope that this will give those that are diagnosed early enough the hope we didn't have. My heart goes out to all that have been diagnosed and to the families that watch this horrible disease take their loved ones.

The Dept. of Defence recognizes pesticides and petroleum exposure as probable cause in a fairly long list which includes several blood cancers (including MM), lymphoma, lung cancer and Parkinson's just to name a few.

Humans didn't evolve to breathe, ingest and live with toxic chemicals. It seems we are living in a kind of toxic stew. My husband was in Vietnam during the war and flew over the top for recon with the "Ranch Hands" or planes that sprayed Agent Orange on the countryside there. His multiple myeloma is presumed to be caused by that herbicide/pesticide.

Although I live in Queens NY I always thought my mm was related to 9/11. I was diagnosed with mm at age 42 on December 2011 after enjoying perfect health all my life. My house was very far from the World Trade center, but two days after 9/11 the walls in my bedroom and in the entire house were covered with a thick gray dust that I cleaned myself, could this have caused my mm a few months later??

I was working overseas in Afghanistan as a Government Contractor. My position was a Fuel Manager (JP 8 Jet Fuel0. Also expose to the Burning Pits. Could this be the cause of my Myeloma. I worked there from June 2009 thru June 2012. I have Mytple Myelomaand is currently receiving treatment.

In trying to figure out why my husband of 47 years and perfectly healthy got myeloma a year ago at age 66.

He worked in our finished garage as an engineer with exposure to pesticides in there for lawn and bug spraying for over 10 years up to 8 hours a day.

Could this been the cause? I now have remmoved all pesticides from garage. I believe toxic chemicals have an effect as talking to other myeloma patients from support groups as they have also been in someway exposed too.

Yes, my father died at age 53 he did contract work for DOW Chemical there is definitely an environmental exposure component

My husband, now deceased, and I sought out Dr. Durie for a second opinion for care at Veterans Hospital. Edward Rodman Hollister had multiple myeloma. After reading this article, I am fairly sure that Butadiene is what caused his illness. Rod was a chemist and worked with that chemical at Rexam Graphics. They made special coatings for papers. I believe Rod saw Dr. Durie some time between 2003-2005. Thought this information might be helpful.

Nice to see that Doctors such as Dr. Durie are looking into these possible causes of MM.

I agree. Any help to screen and diagnose MM sooner is a win win for society as a whole.

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