Multiple Myeloma, a Cancer of the Blood Plasma and the Treatment of Arkansas

In the last 20 years, the Arkansas Treatment has been developed for patients suffering from multiple myeloma. An acquaintance of the author, who was treated with this chemotherapy regimen several years prior to his own diagnosis, had to travel to Arkansas for treatment. After being diagnosed with multiple myeloma in June 2008, the author was able to receive this chemotherapy regimen locally near his home in upstate South Carolina.

This treatment uses several different drugs during chemotherapy, followed by an autologous stem cell transplant. The complete treatment actually requires a tandem stem cell transplant (two in succession). Whereas years ago, the only treatment for multiple myeloma was the drug that targets cancer cells directly (and then targets many good cells as well), the various drugs used in this treatment target the cells’ ability to cancer cells to reproduce and encourage the body’s normal disease-fighting cells to kill them.

This treatment uses thalidomide as the main oral cancer-fighting drug, in addition to a cocktail of chemotherapy drugs that includes bortezomib, cyclophosphamide, etoposide, cisplatin, doxorubicin, and dexamethasone. A variety of other medications, such as antibiotics, to help the body’s impaired immune system, anti-nausea medications, and pain relievers (steroids) are given at the same time.

With older treatments targeting cancer cells directly, life expectancy for multiple myeloma patients was on the order of two to four years after diagnosis. Since those drugs negatively affected many good cells in the body, as well as cancer cells, the patients’ bodies took a huge hit every time the drug was administered. A high dose of the same (or similar) drugs is part of the stem cell transplant procedure. Following high-dose drug administration, the author’s white blood cell count was close to zero. Fortunately, the stem cell transplant immediately followed the high dose, so her body was able to recover from the high dose by creating new stem cells and new good blood cells.

Newer treatments, like the Arkansas Treatment, use drugs that indirectly target cancer cells. They try to turn OFF the ON switch that tells cancer cells to reproduce ad infinitum. They try to block the blood supplies that allow cancer cells to flourish. They try to block signals sent from cancer cells to normal disease-fighting cells in the body that say, in effect, “I’m a normal cell, leave me alone.” They try to encourage the body’s disease-fighting cells to go after those cancer cells and do their job, that is, eliminate them as unwanted cells in the body. Obviously, this is a layman’s explanation of the requested tasks of the drugs in this treatment regimen, but you get the idea.

Since these drugs are not expected to kill cancer cells directly, they are much less harmful to good cells in the body. This does not mean that they are harmless to normal cells in the body. They are still quite powerful chemicals that should not be used lightly. But they seem to each work well to perform the jobs that are asked of them. Life expectancies for patients receiving the Arkansas treatment are listed at more than ten years and rising.

There are significant side effects with this treatment regimen, but they seem to be worth it. In the author’s case, the two main side effects are heart muscle deterioration and peripheral neuropathy. The efficiency of the author’s heart deteriorated so much during the course of treatment that he was prevented from receiving the second stem cell transplant. Having read a lot of information on the Internet before and during treatments, I somehow missed the possibility that chemotherapy drugs could negatively affect the heart muscle. The efficiency of his left ventricle went from normal values ​​above 50% to 26%. At this low level, he was treated for congestive heart failure. However, the cardiologist said that in many cases, the heart can recover from chemotherapy-induced levels like this. This, in fact, has happened in the author’s case. The efficiency of his heart has once again increased to almost normal levels.

After heart efficiency problems were diagnosed, the author searched and found several articles that actually warned that some of the chemotherapy drugs used in this regimen can adversely affect the heart muscle. One of the drugs, in particular, was listed as likely to cause heart problems. When he asked one of the chemo nurses which of the drugs might negatively affect the heart, she replied, “Oh, they all probably do.”

Peripheral neuropathy is a significant complaint, but it does not appear to be a life-threatening problem. The author’s fingers and toes tingle and feel somewhat numb most of the time. Cancer drugs, and even cancer maintenance drugs, seemed to cause these problems. After stopping the main anticancer drugs, the tingling and numbness decreased a little, but not completely. There were days after chemotherapy treatments when the author’s hands hurt, especially when holding or touching cold objects. Today, they are tingling, but that feeling can be ignored most of the time.

The author’s body is currently “as clean as possible of cancer cells”, according to his oncologist. This doctor also commented during that visit that many do not appreciate the seriousness of that statement. “Years ago, half of the people who got multiple myeloma died within 3 years of diagnosis.” Those numbers are widespread now due to chemotherapy regimens like the Arkansas Treatment.