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August 2013 Archives : Myeloma Voices

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Recent findings have suggested that consuming at least some alcohol may reduce the risk of myeloma. A new comprehensive analysis (pooled analysis of several studies) of 1,567 patients with myeloma compared to 7,296 controls--individuals without myeloma--was published this month.  The myeloma patients were from the U.S. and Europe. Several different levels of alcohol consumption were considered, ranging from "ever drinks" to "never drinks" to drinks per week and years of drinking. 

The bottom line was that study participants who "ever drank" had a lower risk of myeloma versus those who "never drank." In scientific parlance there was "no dose response relationship," meaning there was no relationship to the amount or the number of years of drinking. This also has been true in prior individual studies.

What is going on here? What are the possible explanations? Well, firstly it has been shown broadly that light to moderate alcohol intake can reduce factors triggering inflammation. Such factors include several cytokines (TNF-alpha, IL-1beta, IL-10 and TGF-beta), hormone-like growth factors involved with the development of myeloma.  These cytokines can regulate the function of cells present in the microenvironment around myeloma cells. So this can be important.

In addition, as far as specific beverages, there is support for the benefits of red wine, which contains polyphenols. Polyphenols reduce key cellular factors such as NFK-beta and MCP-1.  Resveratrol, a natural grape product, has natural cancer chemopreventive properties. 

If you happen to prefer beer, there is evidence that chemicals called "prenylflavonoids" and hop bitter acids have chemopreventive activities. 


And so there you have it: light to moderate alcohol intake can be a good thing! If that happens to be as red wine, that could be even better--especially wines with higher polyphenol levels such as Malbec varieties derived from grapes grown at higher altitudes with more weeks of sun and maturation.

But beer could also be good. And I suspect that an occasional single malt scotch could also be excellent. So enjoy in moderation over the Labor Day weekend!

Dr. Durie sincerely appreciates and reads all comments left here. However, he cannot answer specific medical questions and encourages readers to contact the trained IMF Hotline staff instead. Questions are answered with input from Dr. Durie and/or other scientific advisors and IMWG members as appropriate. To contact the IMF Hotline, call  800-452-CURE, toll-free in the US and Canada, or send an email to hotline@myeloma.org. Hotline hours are 9 am to 4 pm PST. Friday summer hours are 9 am to 3 pm PDT. Thank  you.
DurieBlog_plain.jpgThe Black Swan Research Initiative team has been busy since our spring launch. Team members are laying the groundwork for clinical trials and perfecting the extra-sensitive testing regimes that will allow us to measure minimal residual disease, identify pathways to cures, and improve treatments along the way. 

We already know where we want to end up--curing this destructive disease--but as we move ahead our key focus is discovering the best route or routes, as the case may be, to get us there. As the Hungarian physician and Nobel Prize winner Albert Szent-Gyorgyi put it: "Research is to see what everybody else has seen, and to think what nobody else has thought." 

As most myeloma patients are aware, researchers around the world are currently looking into causes and cures for myeloma. One aspect BSRI focuses on is, "Which protocols currently in use are perhaps already curing some myeloma patients?" The new diagnostic tools under development will tell us which therapies have worked best. This allows us to focus on specific types of therapies for each patient.

Since we know that there will be multiple strategies to achieve success, there are many aspects to consider. An important early question is: "when can we consider myeloma cured?" We are approaching this question by closely evaluating patients who have been in excellent complete remissions for 4 or more years already--some as long as 27 years!

Another aspect is how best to integrate a constant stream of new research results. Just this week we learned about a study identifying aging genes in myeloma, published in Nature Genetics.  It's an important study because one of the chromosomes the researchers identify is chromosome 17. We already know that the loss of the p53 gene on chromosome 17 during cell division is a prognostic factor for poor risk myeloma.

Okay, so where do we go with that? Well, further researching the impact of newly identified genes takes time--probably years. In the meantime, the BSRI team will be testing therapies which work well in patients with chromosome 17 problems.  The driving engine behind the BSRI is to look for unknown answers to the riddle of myeloma by implementing multiple projects at the same time. For example, coming up with a clear, precise definition for high risk or "ultra high risk" smoldering myeloma is a top objective of BSRI.  The research team in Heidelberg, Germany are key collaborators and have already used MRI imaging to evaluate the likelihood of progression in MGUS patients.  For smoldering myeloma as well, imaging can be used to identify patients at highest risk for early progression and thus eligible for potential early decisive treatment. Starting curative therapies early in the disease maximizes the chances of success.

"But how will the BSRI affect my myeloma?" patients ask. At this stage in our research, we do not know which types or stages of myeloma will benefit most or first. And, we cannot rule out what would be an especially wonderful possibility that there can be a "one-shot cure" that will work well for all patients!!

With the BSRI, multiple strategies give the needle in the haystack a chance to pop out. It's an exhilarating process! And one that I'm pleased to report is moving along faster than we'd originally anticipated. In the months ahead, watch this space for announcements of exciting BSRI partnerships and team members. 

Dr. Durie sincerely appreciates and reads all comments left here. However, he cannot answer specific medical questions and encourages readers to contact the trained IMF Hotline staff instead. Questions are answered with input from Dr. Durie and/or other scientific advisors and IMWG members as appropriate. To contact the IMF Hotline, call  800-452-CURE, toll-free in the US and Canada, or send an email to hotline@myeloma.org. Hotline hours are 9 am to 4 pm PST. Friday summer hours are 9 am to 3 pm PDT. Thank  you.
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A recent article by David Berreby in Aeon magazine dubs this "the obesity era" in America. As we are all aware, a high percentage of US citizens are overweight. This is an especially important topic for myeloma patients because several studies have linked excess body weight or high BMI (body mass index greater than 25 kg/m2 body surface area) to an increased risk of myeloma.  

Interestingly, not only are people getting fatter, but so are animals in the wild, laboratory animals, and even pets. A study by David Allison and colleagues (from the University of Alabama and other research centers) notes a particular weight increase among research colonies of primates, including the very cute marmoset monkeys!  So why is that?  The laboratory conditions are tightly controlled, especially with regard to calorie intake.  The answer is not the calories which are unchanged, but "global hidden factors."  Hidden factors are things that can alter or trick the body's fat metabolism toward weight gain.  

Top of the list of possible factors are chemicals, leading to the new concept that "all calories are not equal."  I have discussed suspect obesogenic chemicals before, including compounds such as BPA (bisphenol-A) present in many household plastics--"in everything from children's sippy cups to the aluminum in fizzy drink cans," Berreby writes. Marmosets can pick up chemicals from their food and drink containers as well as their environment.  Persistent environmental organic pollutants are  being linked to obesity, diabetes, plus multiple myeloma as well as other hematologic cancers, such as lymphoma.  

Other ideas about possible hidden factors include a lipid-triggering virus called Adenovirus-36 (linked to higher body mass); a hormone called leptin, linked to stress and sleep; plus a whole range of other chemicals, such as artificial sweeteners.  Researchers at Cedars Sinai right here in Los Angeles have noted increased numbers of gut microorganisms called methanobrevibacter smithii (!) pointing to yet another type of factor in our complex modern environment.

So how can we connect the dots here?  Clearly, we need to learn more.  The recurring theme, however, is to protect yourself against chemicals as best as possible, and stay tuned to see how research proceeds to further clarify "hidden factors" contributing to both obesity and cancer.

Dr. Durie sincerely appreciates and reads all comments left here. However, he cannot answer specific medical questions and encourages readers to contact the trained IMF Hotline staff instead. Questions are answered with input from Dr. Durie and/or other scientific advisors and IMWG members as appropriate. To contact the IMF Hotline, call  800-452-CURE, toll-free in the US and Canada, or send an email to hotline@myeloma.org. Hotline hours are 9 am to 4 pm PST. Friday summer hours are 9 am to 3 pm PDT. Thank  you.

DurieBlog_Food.jpgI have received quite a bit of feedback about my previous blog, mostly with comments or added information. Many readers were happy to learn about the book A History of Food in 100 Recipes by William Sitwell, a copy of which was given away at the IMF's recent Support Group Leaders' Summit in Dallas. An especially helpful comment came from a reader named Jeannie, who cited a British study that indicates an especially low incidence of myeloma among vegetarians.  But, it has also been noted, and I believe very importantly, that red meat can also be needed by myeloma patients from time to time--especially during recovery from a stem cell transplant, when new red blood cell formation requires plenty of iron.  Some myeloma patients also note that adding some red meat back into the diet can help improve neuropathy symptoms.  So these are some good things!
Unfortunately, it seems there are always plenty of  bad things to comment about in the world of food. Vitaminwater, a Coca-Cola product, has recently been in the news.  As it turns out, there is less than 0.5% actual fruit juice in the dragon fruit, kiwi strawberry, and acai blueberry pomegranate varieties. But what there is plenty of in Vitaminwater is sugar. Each 20-ounce bottle has about eight teaspoons of sugar (120 calories). So the recent attention has concerned marketing: is it really healthy?  It appears to be just another source of unwanted calories plus unnamed chemicals.

Talking about unwanted chemicals, one to watch out for is arsenic. In a blog post for Discover magazine, Pulitzer Prize-winning science journalist Deborah Blum cites a study released last week "showing the first direct link between rice consumption and arsenic-induced genetic damage." It turns out rice contains unwanted arsenic, especially rice imported from China. This has been brought to the attention of the FDA and a ruling is awaited, which will probably be similar to the maximum allowable limit in water, for example.  Be cautious.

And finally, there is a debatable update.  Unfortunately, one has to be careful about pomegranate seeds.  I mentioned my liking for fresh pomegranate juice plus sparkling water, which is fine.  But it turns out that two types of frozen berry blends can contain hepatitis A in pomegranate seeds imported from Turkey.  These have already been withdrawn from the market by the Center for Disease Control and Prevention. So again, the safe and healthy answer is local, fresh, and organic, if possible. 

The bottom line is that what you eat and drink can be hazardous to your health. Try to make healthy choices and enjoy!

Dr. Durie sincerely appreciates and reads all comments left here. However, he cannot answer specific medical questions and encourages readers to contact the trained IMF Hotline staff instead. Questions are answered with input from Dr. Durie and/or other scientific advisors and IMWG members as appropriate. To contact the IMF Hotline, call  800-452-CURE, toll-free in the US and Canada, or send an email to hotline@myeloma.org. Hotline hours are 9 am to 4 pm PST. Friday summer hours are 9 am to 3 pm PDT. Thank you.