Tag Archive for: bone fractures

What Can Signal Hormone-Sensitive Advanced Prostate Cancer?

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What Can Signal Hormone-Sensitive Advanced Prostate Cancer? from Patient Empowerment Network on Vimeo.

Advanced prostate cancer patients may experience common symptoms, but what are they? Expert Dr. Yaw Nyame with the University of Washington explains the range of symptoms that metastatic patients may experience and common treatments for advanced prostate cancer.

See More from [ACT]IVATED Prostate Cancer

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 Advanced Prostate Cancer Clinical Trials _ Why Black and Latinx Participation Is Vital

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Transcript:

Lisa Hatfield:

What is advanced hormone-sensitive prostate cancer, and are there specific symptoms or warning signs to be aware of?

Dr. Yaw Nyame:

When we have prostate cancer that has spread beyond the prostate. We define that as advanced or sometimes we call it metastatic prostate cancer. And early on in that process, we can control and often kill many of those prostate cancer cells by taking away testosterone. Testosterone ends up being like the fuel that allows these cancers to grow. And so when we say a prostate cancer is hormone-sensitive, what we mean is it’s sensitive to testosterone, and by shutting off testosterone, we can effectively manage and or kill those prostate cancer cells.

Over time, when we shut off that testosterone, prostate cancers will learn how to produce internally their own testosterone or develop resistance or find ways to still survive in the absence of testosterone, and when that happens, we call that pheromone-resistant or sometimes you will hear the term castrate-resistant prostate cancer.

Advanced prostate cancers are going to be in a category of cancers where people may have symptoms, those symptoms aren’t always specific, they can range from difficulty urinating, having blood in the urine, having fractures of bones that have been invaded with cancer, weight loss, loss of appetite, and so that is sort of a broad spectrum of symptoms that someone could potentially experience with an advanced prostate cancer, but not all folks are going to have those particular symptoms, because oftentimes when you have severe prostate cancer-related symptoms, those are in pretty advanced stages, meaning you have a pretty high amount of cancer that is outside of the prostate.

My activation tip, when it comes to hormone-sensitive prostate cancer that is advanced, is to be informed about the latest therapies that we offer in this space, because it is constantly changing 15 years ago. The mainstay of treatment was just hormone blockade, and we put people on medications that took their testosterone away or offered them surgeries to take away testosterone from the testicles. We then added on these novel testosterone or androgen-blocking medications like abiraterone (Zytiga) or enzalutamide (Xtandi), which people will hear about when they look up the space of what their diagnosis, then we added on chemotherapy in the form of docetaxel (Taxotere), and now we’re doing combinations where we add the hormone blockade and medicine like abiraterone and chemotherapy, what we call triplet therapy as now first-line therapy.

And so this space is changing so much that when you have this diagnosis, you need to take a pause and do your homework so that you are prepared to have a conversation with your medical oncologist about whether you need doublet therapy, one of the two medications or triplet therapy, or if you even need to consider the addition of something like radiation to the prostate. All of these are standard of care, and it’s no longer just a one medication pipeline for treatment is really an individualized and complex therapy.

[ACT]IVATED Prostate Cancer Post-Program Survey

What is Smoldering Myeloma?

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What is Smoldering Myeloma? from Patient Empowerment Network on Vimeo.

What occurs during smoldering myeloma? Watch as myeloma expert Dr. Irene Ghobrial explains smoldering myeloma and progression, and patient and Empowerment Lead Lisa Hatfield shares her perspective of learning from smoldering myeloma patients.

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See More from START HERE Myeloma

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What is Multiple Myeloma (MM)

What is Multiple Myeloma (MM)?

 How is Multiple Myeloma Diagnosed and What Testing is Necessary After

Transcript:

Smoldering multiple myeloma, also known as SMM, is an early form of multiple myeloma when patients don’t experience issues or symptoms of the condition.

Dr. Irene Ghobrial:

Smoldering myeloma – and, the name says it; it’s almost myeloma, it has a higher chance of progressing to myeloma – in general, it’s about 10 percent per year, and usually, the bone marrow has more than 10 percent plasma cells…….3:04- 3:23 You want to make sure that patient is followed up carefully, and you want to offer, potentially, clinical trials because we want to prevent progression. The hope in the future is you don’t wait until you have lytic lesions, fractures in your bones, kidney failure, and then we treat. The hope is we treat you earlier, and we can make a huge difference in that early interception for myeloma. 

Lisa Hatfield:

So smoldering myeloma, or SMM, smoldering multiple myeloma, is the precursor to multiple myeloma. Not every person who has smoldering is going to move right into myeloma. They have high-risk smoldering myeloma, which is not the same as high-risk multiple myeloma. It’s really important if you’re diagnosed with smoldering myeloma, to find a specialist.

And the reason why is we have a couple people in one of my support groups who were diagnosed with smoldering myeloma. And depending on the provider you talk with, some choose to treat smoldering myeloma. Some choose to watch and wait and monitor that myeloma. The other important thing to know is there are many clinical trials out there for smoldering myeloma patients. And your provider, particularly any specialists you may have contact with, even if it’s just for a consult, they can help navigate you to those clinical trials that might be best for you. Some of them require you to be close to a large medical center. Some of them allow you to live at your local location and  just travel maybe once a month or once every couple of months. But it’s really important to talk to a specialist about those clinical trials to see if that would be something that would be of interest to you.

What Are the Beginning Stages of Multiple Myeloma (MM)?

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What Are the Beginning Stages of Multiple Myeloma (MM)? from Patient Empowerment Network on Vimeo.

What happens in early stages of multiple myeloma? Watch as early multiple myeloma is explained as expert Dr. Rafael Fonseca details what occurs in the body, and patient Lisa Hatfield shares the symptoms that she experienced early in her myeloma journey.

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See More from START HERE Myeloma

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What is Multiple Myeloma (MM)

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 Where Should I START Following My Myeloma Diagnosis

 What is Smoldering Myeloma

Transcript:

Dr. Rafael Fonseca:

These cells live predominantly inside the bones in the space we call the bone marrow. They can do a number of things that actually lead to the symptoms and to the clinical presentation. As they grow in the bone marrow, they take some of that real estate. A person may experience fatigue and that is because they have anemia. The myeloma cells are also very characteristic because they can erode into the structure of bones, so destruction of bone is another feature that we see in patients with myeloma. That can be either seen on X-rays or sometimes people will present with symptoms related to bone pain or discomfort with movement or weight bearing. Those are signs that we look for.

Lisa Hatfield:

For me, early on with myeloma, I really had none of the classic symptoms. All  of my blood work was coming back normal. I would see my regular primary care physician every two years. My lab work was coming back normal. Nothing really stood out. I wasn’t anemic. My kidney function was okay. What did stand out over the course of two years was I was experiencing progressively worsening pain in my hip. It felt like kind of a pinched kink pain in my hip to the point where it progressed to the point where I could barely walk was when I finally talked to my primary care doctor. And requested very strongly to have a scan done, and that’s when I was diagnosed with myeloma.

So the primary reason I went in was for the pain to begin with, and my doctor did look at the pain. He tried to assess it several times over the course of two years. But it wasn’t until I had the MRI that showed a large plasmacytoma on my spine when I realized that something was wrong. A couple other signs that I did have looking back now that I complained about to my doctor and I thought were rather curious, I shrunk a little bit. I shrunk in height. My daughters were laughing, and they’re like “Mom, we’re just growing.” But I did shrink in height by about 2-1/2 inches from the compression fractures in my spine and the plasmacytoma that had eaten away at my spine. And then another thing that a lot of people don’t talk about is sometimes people will have foamy urine. We don’t like to talk about body functions.

But it’s important to know that if you experience that, there are proteins that they can find that  are called Bence Jones proteins that are a sign of multiple myeloma. So if you notice anything unique like that – foamy urine, extreme fatigue, anemia in your blood tests,  it’s definitely worth asking your doctor about. And also relentless, persistent pain in your hips, in your back, in your ribs, any of those areas, it’s worth talking to your doctor about just to assess those thoroughly to make sure there’s not something more significant going on.

If myeloma  goes undiagnosed and untreated, the cancer cells can make a patient experience:

  • Lowered immune function due to white cells being crowded out, resulting in frequent infections
  • High levels of protein in the urine and  blood, which may cause kidney damage
  • Build-up of cancer cells in the bones, which can cause bone weakening, bone pain, and bone fractures

Understanding MGUS & Smoldering Myeloma: What’s the Difference?

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Understanding MGUS & Smoldering Myeloma: What’s the Difference? from Patient Empowerment Network on Vimeo.

Myeloma expert Dr. Irene Ghobrial explains the difference between the precursor conditions, MGUS (monocloncal gammopathy of undetermined significance) and smoldering myeloma, including how these conditions are detected.

Dr. Irene Ghobrial is Director of the Clinical Investigator Research Program at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School. Learn more about Dr. Ghobrial.

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Transcript:

Katherine Banwell:

Dr. Ghobrial, what is MGUS? 

Dr. Irene Ghobrial:

So MGUS, or monoclonal gammopathy of undetermined significance, is a precursor or the stage before myeloma happens, and it’s actually a very common disease or entity in many, many of us as we get older. In fact, maybe 5 percent of the population over the age of 50 would have this early MGUS. 

It doesn’t mean that it’s cancer. It’s a precursor to cancer, and we can talk more about it as we go on. 

Katherine Banwell:

All right. Is it the same as smoldering myeloma, or is that something different? 

Dr. Irene Ghobrial:

It’s not. It’s an earlier stage than smoldering myeloma, and it’s hard to actually make the right definitions. But currently what we say is if you have more than 10 percent cancer cells or plasma cells in your bone marrow, then it’s smoldering myeloma. And by the name, smoldering, it’s almost myeloma. It’s ready to go on fire, but it’s not there yet.  

MGUS is before that, and the difference is that the chance of progression from MGUS to myeloma is only 1 percent per year, so many, many people will never progress to myeloma. While smoldering myeloma, just because there are more cancer cells in the bone marrow, has a higher chance of progressing, which is 10 percent per year. And in some people, a very high chance of progression of 50 percent in two years. 

And we want to make sure that we catch those cases early and not wait for myeloma to happen. 

Katherine Banwell:

How would you define myeloma? 

Dr. Irene Ghobrial:

So, myeloma is currently defined as the same thing. The number of plasma cells in the bone marrow could be above 10 percent or more, or you have a protein in the blood. But the problem is that you’ve already had problems. You’ve had symptoms of end organ damage, so we have either high calcium, bone lesions, or bone fractures, anemia, kidney failure.  

And then now or more recently, we added a few more things to tell us these people are going to really develop myeloma soon. So, it used to be part of smoldering myeloma, now it’s part of the definition of myeloma, so that we can treat patients earlier, which is if your light chain level is very high, above 100 for a ratio, or if you have multiple lesions by something called an MRI or a PET CT scan instead of the traditional X-rays, or if your bone marrow has a lot of the plasma cells, more than 60 percent. 

And these were new definitions to make sure we don’t wait too much until people have an organ damage or symptoms and then we treat them. And you’ll hear from us that we think we should be treating people even earlier than that.