Dr Shaw

Dr Shaw.

Interesting Article

A Place Where Cancer Is the Norm

Scott Dalton for The New York Times

Virginia Montes is a patient at M. D. Anderson Cancer Center, where 90,000 patients will be seen this year. 

By GINA KOLATA

HOUSTON — M. D. Anderson Cancer Center has a mission statement, and everyone who works there, from the president to the cleaning crews, can state it like a catechism: to “eliminate cancer in Texas, the nation and the world.”

“It feels sometimes like the entire world has cancer,” said Cindy Davis, a nurse in Anderson's breast cancer clinic who has breast cancer herself. More Photos »

For the nearly 90,000 patients who will go to the center in Houston this year, that mission cannot be fulfilled soon enough. They and their families arrive at the world’s largest freestanding cancer hospital from around the world, often leaving behind jobs and stashing children with relatives for months. Some rent apartments or stay in mobile home parks near the hospital.
They enter through a soaring lobby, with cheery aquariums and exuberant volunteer greeters eager to help in any way. They come looking for hope..(Continue NY Times )

MD Anderson

We have been very lucky to be so close to MD Anderson. For the fifth year in a row, and the eighth time in the past 10 years, The University of Texas MD Anderson Cancer Center earned the No. 1 spot in U.S. News & World Report’s annual rankings of the best hospitals for cancer care. Since the survey began in 1990, MD Anderson has been ranked every year as one of the top two hospitals in the nation for cancer care. This Knowledge is so comforting that Dad could not be in a better place, with the disease that he does. This is there website on Multiple Myeloma to help you if you want detailed information or maps or even where to volunteer or get involved if you feel so inclined. We Are so Grateful to be where we are and as I am sure you all know this gives dad one more reason to think..(I've been corrected)..KNOW that Texas is the best place in the world. Lets kick cancers butt, ya'll!


MD Anderson Cancer Center Details

Eating To Starve Cancer

Eating to starve cancer? Wouldn’t that be great? And look at all the other anti-angiogenic substances in the pantry. Some might help. Along with the blog, I include Dr. Li’s often requested slide from the presentation on anti-angiogenic foods.  You’ll note a lot of foods we’ve have already been emphasizing:

• Blueberries
• Turmeric
• Raspberries
• Grapes
• Apples
• Kale and Bok Choy
• Cooked Tomatoes
• Red Wine

Dr. Li is the medical director of the Angiogenesis Foundation:

http://www.angio.org/

According to Li, most cancers start as tiny clusters of malignant cells that remain dormant until they recruit new vessels to deliver oxygen and nutrients. Yet, after angiogenesis builds up steam, a cancer can expand like a wildfire—dividing 16,000 times in just two weeks.

Li also has a lot of other practical hints: dunking your tea bag to release more of the cancer- fighting nutrients, cooking tomatoes in olive oil to potentiate their advantages and chewing your greens well to release the nutrients. Li strongly endorses fermented soybean products such as miso (seven times the concentration of helpful compounds) and broccoli sprouts. He suggests trying to add one anti-angiogenic food to each meal.

I did find Dr. Li’s final talking point in the TED presentation particularly intriguing.

Here, he speaks of the importance of early intervention with diet before cancer takes hold. However, I wonder if this also might apply to myeloma patients in remission, nearly complete response or with smoldering myeloma.

Could anti-cancer foods (and limiting pro-angiogenic foods such as sugars and carbohydrates) make a bigger difference when the disease is not well established, or has been hammered down by a drug assault?

I think that would be in line with Dr. Li’s thinking. While, we don’t know his opinion, in a conversation in Atlantic Magazine, last March, Li was asked what was the big takeaway point he wanted everyone to hear relative to his work:

“Understanding that food is the chemotherapy we take three times per day is a game changer. We are learning that Mother Nature has imbued many foods–fruits, vegetables, herbs, seafoods, tea, coffee, even chocolate–with natural substances that can cut off the blood vessels that feed cancer and other diseases. Eating to starve cancer will pull the rug from under the cancer epidemic, and in a way that puts control in the hands of consumers, not doctors.”

Anti Cancer Diet

The Anti-Cancer Diet

Cancer Prevention Nutrition Tips and Cancer-Fighting Foods

Cancer prevention diet tip #1: Focus on plant-based foods

Why plant-based foods are cancer-fighting powerhouses

It comes down to this: Plants have less fat, more fiber, and more cancer-fighting nutrients. These three elements work together to support your immune system and help your body fight off cancer.

The best diet for preventing or fighting cancer is a predominantly plant-based diet that includes a variety of vegetables, fruits, and whole grains. A plant-based diet means eating mostly foods that come from plants: vegetables, fruits, nuts, grains, and beans. 
The less processed these foods are—the less they’ve been cooked, peeled, mixed with other ingredients, stripped of their nutrients, or otherwise altered from the way they came out of the ground—the better.
There are many ways to add plant-based foods to your diet. A nice visual reminder is to aim for a plate of food that is filled at least two-thirds with whole grains, vegetables, beans, or fruit. Dairy products, fish, and meat should take up no more than a third of the plate. Keep in mind that you don’t need to go completely vegetarian. Instead, focus on adding “whole” foods, which are foods close to their original form. Just as important, try to minimize or reduce the amount of processed foods you eat. Eat an apple instead of drinking a glass of apple juice, for example. Or enjoy a bowl of oatmeal with raisins instead of an oatmeal raisin cookie.

Simple tips for getting more plant-based foods in your diet

• Breakfast: Add fruit and a few seeds or nuts to your whole grain breakfast cereal (oatmeal!).
• Lunch: Eat a big salad filled with your favorite beans and peas or other combo of veggies. Always order lettuce and tomato (plus any other veggies you can!) on your sandwiches. Order whole grain bread for your sandwiches. Have a side of veggies like cut up carrots, sauerkraut or a piece of fruit.
• Snacks: Fresh fruit and vegetables. Grab an apple or banana on your way out the door. Raw veggies such as carrots, celery, cucumbers, jicama, peppers, etc. are great with a low-fat dip such as hummus. Keep trail mix made with nuts, seeds and a little dried fruit on hand.
• Dinner: Add fresh or frozen veggies to your favorite pasta sauce or rice dish. Top a baked potato with broccoli and yogurt, sautéed veggies, or with salsa. Replace creamy pasta sauces, with sautéed vegetables or tomato sauce made with healthy olive oil.
• Dessert: Choose fruit instead of a richer dessert. Or a single square of dark chocolate.

Buy organic or local produce, if possible

Some pesticides found in commercially-grown produce are also suspected carcinogens. Organic foods are free of these pesticides, and locally grown produce is less likely to have been treated with chemicals to prevent spoilage.

Cancer prevention diet tip #2: Bulk up on fiber

Another benefit of eating plant-based foods is that it will also increase your fiber intake. Fiber, also called roughage or bulk, is the part of plants (grains, fruits, and vegetables) that your body can’t digest. Fiber plays a key role in keeping your digestive system clean and healthy. It helps keep food moving through your digestive tract, and it also moves cancer-causing compounds out before they can create harm.
Fiber is found in fruits, vegetables, and whole grains. In general, the more natural and unprocessed the food, the higher it is in fiber. There is no fiber in meat, dairy, sugar, or “white” foods like white bread, white rice, and pastries.

Simple ways to add more fiber to your diet:

• Use brown rice instead of white rice
• Substitute whole-grain bread for white bread
• Choose a bran muffin over a croissant or pastry
• Snack on popcorn instead of potato chips
• Eat fresh fruit such as a pear, a banana, or an apple (with the skin)
• Have a baked potato, including the skin, instead of mashed potatoes
• Enjoy fresh carrots, celery, or bell peppers with a hummus or salsa, instead of chips and a sour cream dip
• Use beans instead of ground meat in chili, casseroles, tacos, and even burgers (bean burgers taste great!)

High-fiber, cancer-fighting foods
Whole grains	whole-wheat pasta, raisin bran, barley, oatmeal, oat bran muffins, popcorn, brown rice, whole-grain or whole-wheat bread
Fruit	raspberries, apples, pears, strawberries, bananas, blackberries, blueberries, mango, apricots, citrus fruits, dried fruit, prunes, raisins
Legumes	lentils, black beans, split peas, lima beans, baked beans, kidney beans, pinto, chick peas, navy beans, black-eyed peas
Vegetables	broccoli, spinach, dark green leafy vegetables, peas, artichokes, corn, carrots, tomatoes, Brussels sprouts, potatoes

Cancer prevention diet tip #3: Cut down on meat

Research shows that vegetarians are about fifty percent less likely to develop cancer than those who eat meat. So what’s the link between meat and cancer risk? First, meat lacks fiber and other nutrients that have been shown to have cancer-protective properties. What it does have in abundance, however, is fat—often very high levels of saturated fat. High-fat diets have been linked to higher rates of cancer. And saturated fat is particularly dangerous. Finally, depending on how it is prepared, meat can develop carcinogenic compounds.

Making better meat and protein choices

You don’t need to cut out meat completely and become a vegetarian. But most people consume far more meat than is healthy. You can cut down your cancer risk substantially by reducing the amount of animal-based products you eat and by choosing healthier meats.

• Keep meat to a minimum. Try to keep the total amount of meat in your diet to no more than fifteen percent of your total calories. Ten percent is even better.
• Eat red meat only occasionally. Red meat is high in saturated fat, so eat it sparingly.
• Reduce the portion size of meat in each meal. The portion should be able to fit in the palm of your hand.
• Use meat as a flavoring or a side, not the entrée. You can use a little bit of meat to add flavor or texture to your food, rather than using it as the main element.
• Add beans and other plant-based protein sources to your meals.
• Choose leaner meats, such as fish, chicken, or turkey. If possible, buy organic.
• Avoid processed meats such as hotdogs, sausage, deli meats, and salami.

Cancer prevention diet tip #4: Choose your fats wisely

A major benefit of cutting down on the amount of meat you eat is that you will automatically cut out a lot of unhealthy fat. Eating a diet high in fat increases your risk for many types of cancer. But cutting out fat entirely isn’t the answer, either. In fact, some types of fat may actually protect against cancer. The trick is to choose your fats wisely and eat them in moderation.

• Fats that increase cancer risk – The two most damaging fats are saturated fats and trans fats. Saturated fats are found mainly in animal products such as red meat, whole milk dairy products, and eggs. Trans fats, also called partially hydrogenated oils, are created by adding hydrogen to liquid vegetable oils to make them more solid and less likely to spoil—which is very good for food manufacturers, and very bad for you.
• Fats that decrease cancer risk – The best fats are unsaturated fats, which come from plant sources and are liquid at room temperature. Primary sources include olive oil, canola oil, nuts, and avocados. Also focus on omega-3 fatty acids, which fight inflammation and support brain and heart health. Good sources include salmon, tuna, and flaxseeds.

Tips for choosing cancer-fighting fats and avoiding the bad

• Reduce your consumption of red meat, whole milk, butter, and eggs, as these are the primary source of saturated fats.
• Cook with olive oil instead of regular vegetable oil. Canola oil is another good choice, especially for baking.
• Check the ingredient list on food labels and avoid anything with hydrogenated or partially hydrogenated oils, which are usually found in stick margarines, shortenings, salad dressings, and other packaged foods.
• Trim the fat off of meat when you do eat it, and avoid eating the skin of the chicken.
• Choose nonfat dairy products and eggs that have been fortified with omega-3 fatty acids.
• Add nuts and seeds to cereal, salads, soups, or other dishes. Good choices include walnuts, almonds, pumpkin seeds, hazelnuts, pecans, and sesame seeds.
• Use flaxseed oil in smoothies, salad dressings, or mixed in snacks such as applesauce. But do not cook with flaxseed oil, as it loses its protective properties when heated.
• Limit fast food, fried foods, and packaged foods, which tend to be high in trans fats. This includes foods like potato chips, cookies, crackers, French fries, and doughnuts.
• Eat fish once or twice a week. Good choices include wild Alaskan salmon, sardines, herring, and black cod. But be conscious of mercury, a contaminant found in many types of fish. 

Making smart seafood choices

For a list of the best and worst seafood choices, see the Pocket Seafood Selector, from the Environmental Defense Food.

Cancer prevention diet tip #5: Choose cancer-fighting foods

Your immune system keeps you healthy by fighting off unwanted invaders in your system, including cancer cells. There are many things you can eat to maximize the strength of your immune system, as well as many cancer-fighting foods. But keep in mind that there is no single miracle food or ingredient that will protect you against cancer. Eating a colorful variety gives you the best protection.

• Boost your antioxidants. Antioxidants are powerful vitamins that protect against cancer and help the cells in your body function optimally. Fruits and vegetables are the best sources of antioxidants such as beta-carotene, vitamin C, vitamin E, and selenium.
• Eat a wide range of brightly colored fruits and vegetables. Colorful fruits and vegetables are rich in phytochemicals, a potent disease–fighting and immune–boosting nutrient. The greater the variety of colors that you include, the more you will benefit, since different colors are rich in different phytochemicals.
• Flavor with immune-boosting spices and foods. Garlic, ginger, and curry powder not only add flavor, but they add a cancer-fighting punch of valuable nutrients. Other good choices include turmeric, basil, rosemary, and coriander. Use them in soups, salads, casseroles, or any other dish.
• Drink plenty of water. Water is essentially to all bodily processes. It stimulates the immune system, removes waste and toxins, and transports nutrients to all of your organs. 

Cancer prevention diet tip #6: Prepare your food in healthy ways

Choosing healthy food is not the only important factor. It also matters how you prepare and store your food. The way you cook your food can either help or hurt your anti-cancer efforts.

Preserving the cancer-fighting benefits of vegetables

Here are a few tips that will help you get the most benefits from eating all those great cancer-fighting vegetables:

• Eat at least some raw fruits and vegetables. These have the highest amounts of vitamins and minerals, although cooking some vegetables can make the vitamins more available for our body to use.
• When cooking vegetables, steam until just tender using a small amount of water. This preserves more of the vitamins. Overcooking vegetables leaches the vitamins and minerals out. For an extra vitamin boost, use the vegetable cooking water in a soup or another dish.
• Wash or peel all fruits and vegetables. Use a vegetable brush for washing. Washing does not eliminate all pesticide residue, but will reduce it.

Cooking and carcinogens

Carcinogens are cancer-causing substances found in food. Carcinogens can form during the cooking or preserving process—mostly in relation to meat—and as foods start to spoil. Examples of foods that have carcinogens are cured, dried, and preserved meats (e.g. bacon, sausage, beef jerkey); burned or charred meets; smoked foods; and foods that have become moldy. Here are some ways reduce your exposure to carcinogens:

• The 5 Worst Foods to Grill

  • Chicken breast, skinless, boneless, grilled, well done
  • Steak, grilled, well done
  • Pork, barbecued
  • Salmon, grilled with skin
  • Hamburger, grilled, well done

  Source: Physicians Committee for Responsible Medicine
  
  Do not cook oils on high heat. Low-heat cooking or baking (less than 240 degrees) prevents oils or fats from turning carcinogenic. Instead of deep-frying, pan-frying, and sautéing, opt for healthier methods such as baking, boiling, steaming, or broiling.
• Go easy on the barbecue. Burning or charring meats creates carcinogenic substances. If you do choose to barbecue, don’t overcook the meat and be sure to cook at the proper temperature (not too hot!).
• Store oils in a cool dark place in airtight containers, as they quickly become rancid when exposed to heat, light, and air.
• Choose fresh meats instead of cured, dried, preserved, or smoked meats.
• Avoid foods that look or smell moldy, as they likely contain aflatoxin, a strong carcinogen. Aflatoxin is most commonly found on moldy peanuts. Nuts will stay fresh longer if kept in the refrigerator or freezer.
• Be careful what you put in the microwave. Use waxed paper rather than plastic wrap to cover your food in the microwave. And always use microwave-safe containers.

How to Help..

I did not write this, I just saw it at thought it might be helpful. We absolutely realize that it can feel frustrating and helpless to feel like there is no way you can help when your heart is grieving with someone, after a diagnosis. So I hope this will help to give ideas in some ways to help, though your prayers and support are more important and supportive.  I went through a wrote a few bits in red.

Specific ways to support a loved one with cancer

• Emotional help
• Practical help
• Things that won't help
• What to say
• Gift ideas

The diagnosis of cancer can be distressing for the patient, their family and friends. As a friend you can provide wonderful support, both emotional and practical.

To provide the best help possible, it is important that you take the time to acknowledge how your friend’s diagnosis makes you feel. It may be useful if you take the time to do some reading about the type of cancer and treatment.

It is important not to over-commit yourself. It is better to be able to fulfill realistic commitments than to take on things that you cannot carry through.

When thinking about how you can help it is important to consider the following:

• Does the person want my help?
• What sort of help have they requested?
• What do I have time for?
• Is the help I am offering appropriate to my relationship with the person?
• Who else is available to help?
• How will the rest of the family react to my involvement?
• Are there any language, cultural, gender or religious differences that might aid or interfere with my help?

Resist the temptation to ‘take over’. Being diagnosed with cancer can cause some people to feel as if they are losing control. It is important to assist the person to maintain a sense of control.

Much of our sense of self comes from the roles we fulfill – parent, spouse, sibling, worker or friend. Illness can interfere with these valuable roles and sometimes the best help you can give is to call on people’s skills and experiences and to reassure them they are still valued.

Emotional help

• Talking is the best method of communication we have. Simply acknowledging and talking about distress can help to relieve it. Talk openly and honestly. Let the person indicate when and where they want to talk and what they want to talk about. Follow your friend’s lead.
• Listening may be more important than speaking. You do not need to have all the answers; just listening to questions can help. Be a sensitive, compassionate and empathetic listener.
• Don’t be afraid of silence or feel uncomfortable if there's a lull in the conversation. Quiet is better than empty words, and sometimes it’s better to say nothing at all than to say something potentially insensitive. Sharing silence can be very comforting. Your presence shows you care.
• Although people need to talk about what they are going through, equally they want to hear about the outside world and be distracted and entertained for a while. (WE DO WE DO!!)
• Respect that there will be times when he/she doesn’t want to talk and needs time to himself/herself.
• Maintain contact throughout the cancer experience through letters, cards or emails.
• If you have had cancer, respect that the person’s experience will be different to yours.
• Celebrate the milestones in the person’s experience, for example the halfway mark of their chemotherapy, the end of their treatment, their remission.
• Sometimes what you think is best for the person may differ from what they think. Try to ‘be with’ the person emotionally through their various feelings even if your feelings are different.
• Understand that needs change. Some people might be less willing to accept concrete help than others. If you have offered and have been refused, don't take offence. You might try asking again a few weeks later, or you might try directly asking your friend what, exactly, it is you could do to help most.
• Be humorous and fun when appropriate and when needed but also allow for sadness - do not ignore uncomfortable topics or feelings.
• Make time for a weekly check-in phone call. Let your friend know when you will be calling, and let your friend know that it is okay to not answer the phone.
• Over the phone, be sensitive to the needs of your friend. Always ask if your timing is appropriate, and if it isn't, then just convey your good wishes and offer your friend the option to call you back when convenient. Be sensitive to the possibility that your friend may need short breaks from phone contact at difficult times. Try sending postcards, letters, e-cards or emails.
• Tell your friend it is okay to turn down a call or a visit, and that you understand.
• When you make a commitment to help, follow through. For example, if you offer to bring a meal over on Sunday, don't forget.
• Continue to talk to your friend as the person they were before the cancer diagnosis. Ask about interests, hobbies, and other topics not related to cancer—people going through treatment sometimes need a break from talking about cancer.
• Offer support to your friend’s support-person/caregiver. The tendency is to focus attention on the individual dealing first-hand with cancer but the needs of the partner or main support-giver can often get lost in the haze. See if there is anything you can do to make this person's life a little easier.
• If you aren't sure how to help, ask.

Practical help

• Be specific about your availability and what you can do. As sincere as you are when you say something like "Please call if there is anything I can do," it is very awkward for someone in need to take you up on this kind offer. Try to make your offer more specific. Something like, "I want to bring over dinner tonight." This is more direct and is something that is easier to say "thank you" for than to ask for.
• Draw up a roster among your friends to do things such as shopping, house cleaning, ironing, collecting children or preparing a meal.
• Offer to drive them to and from appointments and if they want, stay with them when they see the doctor or have treatment. (With the long term scope of this, Drivers to MD ANDERSON WOULD BE INCREDIBLE DOWN THE ROAD!)
• If they live alone or have little support, they may appreciate help sorting through medical bills, Medicare claims and household expenses.
• Check if the person has a contact person for family and friend’s enquiries to be directed towards.
• Make plans for the future—this gives your friend something to look forward to.

Things that won’t help

• Avoid giving medical advice. Suggest that medical concerns are discussed with the doctor or nurse.
• Don’t give advice on how they can change their lifestyle or diet. They may already be struggling with their normal routine without having to change it and it may make them feel as if they have caused their cancer in some way.
• Avoid making assumptions about what the person can and can’t do.
• Refrain from telling the person about the latest cure or treatment you’ve heard about.
• Avoid over-staying your visit. Be sensitive to their needs.
• Don't comment on your friend's appearance. (Dad's ALWAYS been bald so, that is allowed hahah)
• Try not to offer platitudes. As much as we all want to believe "Everything is going to be all right!", hearing people say that can make someone living with cancer feel like the gravity of their plight is being trivialised or under-appreciated. Although that statement is very optimistic and well-intended, it can convey a lack of understanding about the severity of the situation. Try statements like "We think about you every day," "You are in our prayers," "I wish I was there to give you a great big hug," "If only there were something I could actually do to make this easier for you," etc.
• Don't offer advice or talk about the people you've known who have died from cancer.

What to say

What do you say when you learn that someone you care about has cancer? What do you do? Is there any "right" way or "wrong" way to respond to the news?
Most cancer survivors have stories to tell of comments and gestures made by friends and family members, some of which were hurtful and some of which were helpful. Based on those survivors' stories as well as my own experience, I offer the following "do's" and "don'ts".

First the don'ts:

1. The worst thing you can say or do is to say or do nothing at all. Almost every survivor can tell of at least one person who, upon hearing the news, disappeared and was never heard from again. Maybe the fact that your friend or loved one has cancer is the worst news you've ever heard and you can't stand the thought of him being this sick. You don't know what to say or do, and it's too painful to see him without hair, and the house smells like a hospital, and, well, it's all so just so scary. I don't mean to be harsh here, but this really isn't about you. Stick around, please. Your loving presence alone can be the healing salve for a wounded, frightened spirit.
2. I know you mean well when you say, "God won't give you more than you can handle," but I wish you would listen to the implications in that comment and refrain from using it. It implies that God gave us cancer which inference often leads newly diagnosed patients to wonder if God is punishing them for something they did or failed to do, and that's the last thing we need to be worrying about right now.
   
   To clean up a popular phrase, stuff happens. People get cancer (1 in 3, in fact). People get lots of other awful diseases, too. Babies are born with defects. Long-distance runners have heart attacks. Brave men and women go to war and get killed. Supermen fall from horses, and maniacs fly airplanes into buildings. And, yes, many people do get more than they can handle as evidenced by suicide rates. Not to step on anyone's religion here, but I refuse to believe God is the one causing all this mayhem, destruction and chaos.
   
   Instead of telling us that God gave us cancer, tell us that God will be with us every step of the way (even if we’re not religious, this is better than the former comment).
    
3. Don't predict the future. Acknowledge the seriousness of the diagnosis without being morbid (Oh, my God! My aunt had the very same thing and she died 8 months later!"), and without being unrealistic ("You'll probably outlive me. I could get hit by a bus tomorrow!"). We don't know what's going to happen to us, and neither do you. Tell us happy stories of other long-term cancer survivors (but refrain from saying someone had "the very same thing"; no two cancer diagnoses are ever the same).
   
   Never, ever tell us stories with unhappy endings.

Now for the do's:

1. Things to say: "I'm here for you." "You can cry with me." "I love you." "I won't leave you." "Whatever you're feeling is okay."
   
   Just be there. Follow our lead. We'll let you know if we want to "talk about it," and if we do, please let us. Don't change the subject. When you don't allow us to talk about our disease, it makes us feel alone and isolated.
    
2. Things to do: Take my kids out for pizza and a movie or, better yet, for the weekend. Offer to pick up prescriptions, take the dog to the groomer and run other errands. Clip cartoons and funny pictures and send them in a card. Bring thoughtful gifts (a book or magazine, a tabletop fountain, a meditation tape or CD); avoid things with strong smells (bath sets, flowers, food, etc.) until you know how I'm reacting to my treatments.

Source: The Cancer Crusade e-newsletter
And finally, here are some simple guidelines to use when talking with your friend.

Avoid saying:

• I know just how you feel.
• You need to talk.
• I know just what you should do.
• I feel helpless.
• I don't know how you manage.
• You're lucky, yours is the good cancer - this is often said of Hodgkin's disease because it is curable but there is nothing at all lucky about having any cancer.

Do say:

• I'm sorry this has happened to you.
• If you ever feel like talking, I am here to listen.
• What are you thinking of doing, and how can I help?
• Please let me know what I can do to help.
• You are an inspiration.

Gift ideas
If you are wanting to give your friend a gift, the following list might give you some ideas:

• gift certificates for massage, spa services, bookstore, restaurants, movies, museum/art gallery passes
• a soothing CD
• a funny movie or book (He Loves the Show ARCHER)
• relaxation and meditation books, or a voucher for educational classes
• light reading such as magazines (He Likes fishing magazines)
• homemade soup
• A Good laugh

Anything that provides laughter or comfort is healing and is always welcomed. Sing or play a song for your friend, take them for a walk, or give them a massage or foot-rub. Don’t underestimate the value of physical touch; sometimes the best gift of all is a hug.

Multiple Myeloma Interactive Tutorial

This is a wonderful website and interactive tool to better understand Multiple Myeloma. 

Interactive Tutorial

Surviving Multiple Myeloma

Multiple Myeloma Treatment Options

Treatment

Watchful Waiting
Induction Therapy
Stem Cell Transplant
People with multiple myeloma have many treatment options. The options are watchful waiting, induction therapy, and stem cell transplant. Sometimes a combination of methods is used.
Radiation therapy is used sometimes to treat painful bone disease. It may be used alone or along with other therapies. See the Supportive Care section to learn about ways to relieve pain.
The choice of treatment depends mainly on how advanced the disease is and whether you have symptoms. If you have multiple myeloma without symptoms (smoldering myeloma), you may not need cancer treatment right away. The doctor monitors your health closely (watchful waiting) so that treatment can start when you begin to have symptoms.
If you have symptoms, you will likely get induction therapy. Sometimes a stem cell transplant is part of the treatment plan.
When treatment for myeloma is needed, it can often control the disease and its symptoms. People may receive therapy to help keep the cancer in remission, but myeloma can seldom be cured. Because standard treatment may not control myeloma, you may want to talk to your doctor about taking part in a clinical trial. Clinical trials are research studies of new treatment methods. See the Taking Part in Cancer Research section.

Watchful Waiting

People with smoldering myeloma or Stage I myeloma may be able to put off having cancer treatment. By delaying treatment, you can avoid the side effects of treatment until you have symptoms. If you and your doctor agree that watchful waiting is a good idea, you will have regular checkups (such as every 3 months). You will receive treatment if symptoms occur.
Although watchful waiting avoids or delays the side effects of cancer treatment, this choice has risks. In some cases, it may reduce the chance to control myeloma before it gets worse.
You may decide against watchful waiting if you don't want to live with untreated myeloma. If you choose watchful waiting but grow concerned later, you should discuss your feelings with your doctor. Another approach is an option in most cases.

You may want to ask your doctor these questions before choosing watchful waiting:

• If I choose watchful waiting, can I change my mind later on?
• Will the cancer be harder to treat later?
• How often will I have checkups?
• Between checkups, what problems should I tell you about?

Induction Therapy

Many different types of drugs are used to treat myeloma. People often receive a combination of drugs, and many different combinations are used to treat myeloma. Each type of drug kills cancer cells in a different way:

• Chemotherapy: Chemotherapy kills fast-growing myeloma cells, but the drug can also harm normal cells that divide rapidly
• Targeted therapy: Targeted therapies use drugs that block the growth of myeloma cells. The targeted therapy blocks the action of an abnormal protein that stimulates the growth of myeloma cells.
• Steroids: Some steroids have antitumor effects. It is thought that steroids can trigger the death of myeloma cells. A steroid may be used alone or with other drugs to treat myeloma.

You may receive the drugs by mouth or through a vein (IV). The treatment usually takes place in an outpatient part of the hospital, at your doctor's office, or at home. Some people may need to stay in the hospital for treatment.
The side effects depend mainly on which drugs are given and how much:

• Blood cells: When a drug used for myeloma treatment lowers the levels of healthy blood cells, you're more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team will check for low levels of blood cells. If your levels are low, your health care team may stop therapy for a while or reduce the dose of drug. There are also medicines that can help your body make new blood cells.
• Cells in hair roots: Chemotherapy may cause hair loss. If you lose your hair, it will grow back, but it may be somewhat different in color and texture.
• Cells that line the digestive tract: Chemotherapy and targeted therapy can cause poor appetite, nausea and vomiting, diarrhea, constipation, or mouth and lip sores. Ask your health care team about medicines and other ways to help you cope with these problems.

The drugs used for myeloma may also cause dizziness, drowsiness, numbness or tingling in hands or feet, and low blood pressure. Most of these problems go away when treatment ends. You may find it helpful to read the NCI booklet Chemotherapy and You. You may also want to read the NCI fact sheet Targeted Cancer Therapies.

You may want to ask your doctor these questions before having induction therapy:

• Which drugs will I get? What will the treatment do?
• When will treatment start? When will it end? How often will I have treatments?
• Where will I go for treatment? Will I have to stay in the hospital?
• Will I have side effects during treatment? What side effects should I tell you about? Can I prevent or treat any of these side effects?
• Will there be lasting side effects? How long will they last? What can I do about them?
• How often will I need checkups?

Stem Cell Transplant

Many people with multiple myeloma may get a stem cell transplant. A stem cell transplant allows you to be treated with high doses of drugs. The high doses destroy both myeloma cells and normal blood cells in the bone marrow. After you receive high-dose treatment, you receive healthy stem cells through a vein. (It's like getting a blood transfusion.) New blood cells develop from the transplanted stem cells. The new blood cells replace the ones that were destroyed by treatment. Stem cell transplants take place in the hospital. Some people with myeloma have two or more transplants.
Stem cells may come from you or from someone who donates their stem cells to you:

• From you: An autologous stem cell transplant uses your own stem cells. Before you get the high-dose chemotherapy, your stem cells are removed. The cells may be treated to kill any myeloma cells present. Your stem cells are frozen and stored. After you receive high-dose chemotherapy, the stored stem cells are thawed and returned to you.
• From a family member or other donor: An allogeneic stem cell transplant uses healthy stem cells from a donor. Your brother, sister, or parent may be the donor. Sometimes the stem cells come from a donor who isn't related. Doctors use blood tests to be sure the donor's cells match your cells. Allogeneic stem cell transplants are under study for the treatment of multiple myeloma.
• From your identical twin: If you have an identical twin, a syngeneic stem cell transplant uses stem cells from your healthy twin.

There are two ways to get stem cells for people with myeloma. They usually come from the blood (peripheral blood stem cell transplant). Or they can come from the bone marrow (bone marrow transplant).
After a stem cell transplant, you may stay in the hospital for several weeks or months. You'll be at risk for infections because of the large doses of chemotherapy you received. In time, the transplanted stem cells will begin to produce healthy blood cells.
You may find it helpful to read the NCI fact sheet Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation.

What is Multiple Myeloma

What is Multiple Myeloma?

Multiple myeloma is a type of cancer. Cancer is a group of many related diseases. Myeloma is a cancer that starts in plasma cells, a type of white blood cell. It's the most common type of plasma cell cancer.

Normal Blood Cells

Most blood cells develop from cells in the bone marrow called stem cells. Bone marrow is the soft material in the center of most bones.
Stem cells mature into different types of blood cells. Each type has a special job:

• White blood cells help fight infection. There are several types of white blood cells.
• Red blood cells carry oxygen to tissues throughout the body.
• Platelets help form blood clots that control bleeding.

Plasma cells are white blood cells that make antibodies. Antibodies are part of the immune system. They work with other parts of the immune system to help protect the body from germs and other harmful substances. Each type of plasma cell makes a different antibody.

Normal plasma cells help protect the body from germs and other harmful substances.

Myeloma Cells

Myeloma, like other cancers, begins in cells. In cancer, new cells form when the body doesn't need them, and old or damaged cells don't die when they should. These extra cells can form a mass of tissue called a growth or tumor.
Myeloma begins when a plasma cell becomes abnormal. The abnormal cell divides to make copies of itself. The new cells divide again and again, making more and more abnormal cells. These abnormal plasma cells are called myeloma cells.
In time, myeloma cells collect in the bone marrow. They may damage the solid part of the bone. When myeloma cells collect in several of your bones, the disease is called "multiple myeloma." This disease may also harm other tissues and organs, such as the kidneys.
Myeloma cells make antibodies called M proteins and other proteins. These proteins can collect in the blood, urine, and organs.

Myeloma cell (abnormal plasma cell) making M proteins.