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Posts Tagged ‘multiple myeloma’

TerryHollenbeckMD

As many of you know, two years ago I was diagnosed with multiple myeloma, a cancer of the plasma cells in the bone marrow. It was put into remission after 2 1/2 months of chemotherapy. It took awhile to get back to my old self again but for the past year, other than the neuropathy of my feet, I feel great. I returned to work half time last October and was happy to be “back in the saddle” again, doing the work that I love to do.

The stem cell transplant I was to have had after my first round of chemotherapy two years ago was postponed because it was thought that it could make the neuropathy worse. So I’ve been on a low dose maintenance drug and my oncologist has been following monthly blood tests to monitor the myeloma activity. After about six months the numbers were slowly creeping up but no one was too alarmed. Then it was decided to do a PET scan (a CAT scan using a radioactive dye) which I had done in late August. Surprisingly and unfortunately, it showed a lot of myeloma activity affecting many parts of my bones. In other words my myeloma has relapsed. However, unlike the first time I was diagnosed, I really feel very well and as everyone tells me, “You look great!” I’ll take that as a good sign.

Because the steroids from my first round of chemo have caused a deterioration of my hip joint, I was to have had a hip replacement last month, but that has now been postponed so that I could begin chemo right away. I have just finished my third week of chemo, still feel very well, still have my hair and my most recent blood test shows very favorable improvement already. That is music to my ears.

I’ve begun an extended leave of absence from work to deal with the new round of chemo and to keep me from exposure to sick patients. I’ll miss seeing many of you but I find myself once again as the patient and now I’ve got to take care of myself.

I will continue writing my articles and, in fact, I will have more time to do so. I’ve been encouraged by many to put my articles in a book format which I hope to do this coming year.

Thanks to all of you who have had me in your thoughts and prayers.

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Terry

I am in remission of my multiple myeloma cancer. The three months of chemotherapy last fall and winter did a great job in knocking out most of those cancerous plasma cells which were taking over my body. The stem-cell transplant I was originally to have following chemotherapy has been canceled. I will have my blood tested regularly to monitor my remission. My thanks to Dr. Michael Wu and his wonderful caring staff at the Palo Alto Medical Foundation oncology department who did a superb job treating my disease.

I discovered that one doesn’t necessarily have to leave Santa Cruz for state-of-the-art cancer care that I found right here through my group at PAMF. I sure wasn’t used to being — nor particularly enjoyed — being on the patient side of the doctor/patient relationship. It was a humbling experience and has taught me more about patients and patience along my journey.

Unfortunately, I am suffering from a fairly severe neuropathy of my feet from the chemo drugs, and this is currently adversely affecting my ability to walk normally. I do, however, feel it’s a small price to pay for my successful cancer treatment. I’m told the neuropathy should improve with time. I’ll try to be patient, (not one of my virtues however).

Another little complication I had in the past month, most likely unrelated to my cancer or treatment, is a condition of my heart called constrictive pericarditis. This occurs when the sac of tissue surrounding the heart (the percardium) becomes inflamed and tightens in on the heart, causing the heart to pump less efficiently.

This threw me into mild heart failure with significant shortness of breath, swelling of lower extremities and general fatigue. Dr. Neil Sawheny, one of my cardiologist partners at PAMF, is treating me for this unexpected complication and I seem to be responding well and improving day by day.

In general , my overall well-being is improving significantly. I feel as though my life as I once knew it is being slowly restored. Once my neuropathy shows signs of improvement, I hope to return to work at least half-time.

I’ll give myself a break to work a bit less since I’ve now been practicing medicine for the past 40 years, 27 years in urgent care Scotts Valley. I love my staff, my patients, many of whom I’ve come to know quite well. Most of all, I love the satisfaction I receive in helping make people feel better and in maintaining their good health.

My thanks to all of you who have mailed get-well cards or sent email messages for my recovery. I am a strong believer in the power of prayer and I know your prayers for me have been heard.

My personal lesson from my cancer experience is this: If you have any health symptoms that seem unusual to you or are lasting longer than you think they should, see your doctor for a work up. If everything checks out OK and your symptoms soon improve, then be thankful.

If something serious like cancer is found, the sooner it’s treated the better the outcome. This a proven fact. Also, for those many of you who are healthy, give thanks every morning that you can begin a new day.

My best wishes to you for long healthy lives.

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C

My stem cell transplant has been put off for a while until I see some improvement of severe peripheral neuropathy in my feet and legs caused by the chemotherapy I received. So I am at home biding my time and able to continue writing for the foreseeable future. I’d like to begin today a three-part series on cancer.

Cancer definition and a description

When my oncologist told me that I had multiple myeloma, a type of blood cancer, all I could hear was the dreaded word “cancer.” I felt as if I had just received a death sentence. Even as a seasoned physician I found this difficult to accept. Throughout my career it was always other people who got cancer, not me. When I shared this news with my wife we both had a good cry. It wasn’t until I was told that of all the known cancers—multiple myeloma has one of the most successful treatments for remission—was I then able to get a grip on reality and wanted to get started with treatment.

Since my diagnosis, it seems that everyone I talk to has either had cancer, or has a family member or friend with cancer. It struck me that cancer is a lot more prevalent in our society than I had realized.

What exactly is cancer? Cancer is a group of diseases characterized by uncontrolled growth of abnormal cells that have the ability to spread to and destroy normal body tissue. Cancer cells may stay in one location only or they can spread to all parts of the body by traveling through the blood stream or the lymph system. Once cancer cells arrive at their final destination, they begin to grow and destroy normal tissue. When cancer spreads in this manner it is referred to as metastasis.

Cancer can be caused by internal factors such as genetic mutations, immune system conditions and metabolic disorders, and also by external factors, such as radiation or chemical exposures, tobacco or alcohol use, and even by infectious organisms.

As I have found out, anyone can develop cancer. The risk of cancer increases with age, with the majority of cancers occurring in those above 55 years of age. Sadly, it can also affect the very young. The risk for getting cancer over the course of a lifetime is one in two for men and for women it is one in three. In other words, one-half of all men and one-third of all women can expect to develop some form of cancer during their lifetimes. Only about five percent of all cancers are due to heredity (an internal factor) and the remainder are due to damage to genes occurring during one’s lifetime (the external factors as mentioned above).

About 15 million Americans are living with cancer. It is expected that over a million and a half new cases of cancer will occur this year. Almost 600,000 people will die this year from cancer which works out to more than 1,500 people a day. Cancer is the second leading cause of death in the U.S. exceeded only by heart disease. The cost of cancer is high, with some $100 billion being spent on direct medical care and treatment and about $125 billion of lost productivity due to premature death.

Common symptoms of cancer are:

– A change in weight, especially unintended weight loss.

– Significant fatigue or unexplained increasing pain.

– Changes of skin color, or texture or changes to an existing skin mole, or a sore that doesn’t heal.

– Persistent cough, difficulty swallowing, or hoarseness.

– Changes in bowel or bladder habits.

Risk factors for cancer include:

– Age. Since cancer can take long to develop it most commonly occurs later in life.

– Habits. Smoking, excessive alcohol consumption, exposure to the sun or tanning facilities, and unsafe sex.

– Environmental. Exposure to certain chemicals and second-hand smoke.

– Family history. Cancer development passed on through genes.

– Excess weight and lack of exercise.

There is some good news amongst all this information about cancer and that is that the survival rate for most cancers is improving. This encouraging improvement is due to earlier diagnosis of many cancers, as well as improvement of treatments.

In my next article I will discuss some of the most common types of cancers.

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multiple, myeloma, cancer

I would like to begin this week’s article with a deeply sincere appreciation for the outpouring of emails, cards, well wishes and words of encouragement from my readers, patients, friends, family and even strangers. This support will go a long way in getting me through my recent diagnosis of multiple myeloma. I’ve survived my first two weeks of chemotherapy and feel fine, except for the persistent back pain.

Although described as being somewhat uncommon, I’m aware of a number of people who have had multiple myeloma and many more who are acquainted with or related to someone with the disease. The good news is that most of them are doing well. I like to hear that.

So what is multiple myeloma?  It is a cancer that causes an over production of plasma cells — a type of white blood cell found in the bone marrow. Plasma cells function to produce antibodies which are necessary for our immune system to fight infections. In multiple myeloma, the growth of the cancerous cells causes them to produce an over-accumulation of a certain protein called immunoglobulin that travels throughout the body and can cause damage to various organs.

The other problem, as in my case, is that the plasma cells can enter normal healthy bone causing osteoporosis as well as causing local areas of bone weakness leading to bone fractures, such as I have in my spine. I also have the typical anemia because the plasma cells crowd out the red blood cells in the marrow.

The cause of multiple myeloma remains a mystery, however there are some associated risk factors such as:

– Being over age 65.

– Being a male.

– Being African-American.

– Having a family member with multiple myeloma.

Early stages of multiple myeloma may cause no symptoms. However, as the disease progresses, plasma cells accumulate in the bones and other tissues causing these symptoms:

– Unexplainable persistent pain in any location of the body especially the back.

– Extreme weakness and fatigue.

– Unintended weight loss.

– Recurring infections.

After seeing your doctor for any of these symptoms, you will have some blood tests done and if there is some indication that you may have multiple myeloma you will be referred to a doctor specializing in blood and cancer diseases. Further testing can prove or disprove whether or not one has multiple myeloma.

Therapeutic options include the one I just began, which is undergoing up to four months of chemotherapy followed by a stem cell transplant which I will explain in more detail as I get further along with my treatment.

What I have learned from my experience is that it is important to recognize early symptoms and see your doctor about your concerns. As with any cancer, the sooner it is detected and treated the better the chance of survival. If you or a loved one have any of the above-mentioned risk factors and unexplainable symptoms, see your doctor.

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