Myeloma Atlantic

New Support Group in Nova Scotia

2010-08-21T19:56:00.000-07:00

New Support Group in Nova Scotia

Following the Myeloma Canada Information Workshop held in Halifax on June 10, many in attendance expressed the need to have a local support group. Julie Salsman and Trish MacDonald agreed to take on the challenge and have led the formation of the Nova Scotia Multiple Myeloma Support Group.

The next group meeting will be on September 13, 2010 starting at 7:00 pm at the Atlantic Superstore in Lower Sackville, NS

For additional information, please contact Trish at (902) 678-9378 or Julie (902) 462-8670; otherwise at:

novascotia.multiplemyelomasupp@gmail.com.

Myeloma and Safety in the Myeloma Survivor

2010-08-20T17:25:00.000-07:00

The author is a member of the IMF Nurse Leadership Board (NLB) AND A LEADER OF THE NLB Functional Mobility and Safety task force, answers questions about optimal functioning, fall risk and plan activity for newly diagnosed multiple Myeloma patients, patients undergoing treatment and long term survival Mobility challenges vary among survivors but problems with a lack of mobility or activity affect the quality of life and also may be a hindrance to continuing treatment. This article can be found at Page 12 in the publication Myeloma Today Summer 2010 Volume 8 Number 3

Sandra Rome

MOBILITY AND SAFETY IN THE MULTIPLE MYELOMA SURVIVOR

Myeloma Today in conversation with Sandra Rome

The NLB manuscript is being prepared for health care professionals. What can you share with the patients and caregivers who read Myeloma Today?

People with myeloma are surviving longer due to newly available treatment options. Not unlike other cancer survivors, long-term myeloma survivors must deal with issues that include treatment, recovery from therapies, and the effects of the disease itself. Optimal functioning is key to the quality of life of long-term myeloma survivors.

Multiple myeloma causes anemia and bone disease in as many as 90% of patients. The impact of the side effects at diagnosis and throughout treatment includes decreased mobility, pain, metabolic disturbances from bone loss, neurological compromises, weakness, and fatigue. Mobility challenges vary among survivors, but problems with a lack of mobility or activity affect quality of life and also may be a hindrance to continuing treatment.

The purpose of my section of the NLB Survivorship Care Plan is to provide the health care professional with information on mobility, fall risk, and planned activity as an integral part of the myeloma patient’s plan of care. The intent is to provide tools for nurses and physicians assessing and evaluating the newly diagnosed myeloma patient, the patient undergoing treatment, and the long-term survivor.

Patients with myeloma may experience physical changes related to treatment. Some of these changes include peripheral neuropathy, muscle wasting, fatigue, and gastrointestinal problems. These, along with other patient factors, may interfere with daily mobility, safety, and the ability to function safely.

Myeloma patients have particular risk factors related to falls as compared with other individuals ≥ 65 years, regardless of their health status. A myeloma patient may have one or more fall risk factors (e.g. visual problems, orthostatic hypotension, gait and balance problems, medication side-effects, and degenerative joint disease), so a single factor might not necessarily predict a patient’s risk for falling. Given the bone problems in myeloma, falls more frequently lead to bone fractures.

What are the recommendations of the NLB regarding mobility?

We recommend that an evaluation of the patient’s baseline history and physical assessment is performed with a focus on neurologic function, muscle strength and balance, and visual acuity. Laboratory tests and other health conditions and medications should be reviewed in terms of the impact on the patient’s functioning. MRIs or other imaging studies may be indicated prior to prescribing an exercise program. Bone density scans are beneficial for evaluation at diagnosis and annually for guiding the use of bisphosphonates, a class of drugs that prevent the loss of bone mass. Since a patient’s condition can change over time, it is crucial that baseline as well as ongoing assessment be performed at every encounter with the healthcare team.

What are some NLB recommendations regarding physical activity?

Planned physical activity and/or exercise should be part of an overall health program that includes nutrition, weight management, and potential complementary therapies, such as support groups. All assessments prior to an activity or exercise plan should include patient’s previous activities and exercise preferences, which may be unique and varied.

There are three types of exercise: aerobic, resistance, and flexibility. The choice of exercises depends on the person’s goals, health status, exercise history, and cancer experience. Studies with myeloma patients have included an aerobic component, usually walking, but in some instances, running or cycling plus strength resistance training using exercise stretch bands.

Activity may improve physical fitness, which may improve physical functioning. Studies have shown the feasibility of exercise in all categories of cancer survivors. The benefits of adequate physical functioning and exercise have been shown to have physical as well as psychological benefits. Physical activity has been shown to improve cardio-respiratory fitness during and after cancer treatment, symptoms and physiologic effects during treatment, and vigor post-treatment.

Positive effects of exercise in cancer patients include improved sleep quality, mood, overall quality of life, functional and physical measures, as well as a reduction in cancer-related distress and cancer-related symptoms. Emotional benefits, such as decreased tension, depression, irritability, pain, and fatigue, and higher levels of invigoration and relaxation have been observed with moderate stretching exercise, such as yoga. Exercise may improve treatment completion and possibly reduce toxicity. It may help patients with advanced-stage disease improve physical strength and health, reduce fatigue, and improve emotional status.

Exercise intervention studies in myeloma survivors who participate in exercise programs show that it can be done safely. Even myeloma patients undergoing aggressive treatment, such as a stem cell transplant, can safely participate in an individualized strengthening and endurance exercise program.

It is clear that improvement in functional ability, strength, and balance reduces an individual’s risk of falling and having a fall-related injury. For patients with mobility problems and potential risk of falling, the following should be specifically addressed:

• Immediate needs for safety (hospital fall-precautions program, in-home assistance, use of assistive devices)

• Treat or manage the underlying disorder or problem, e.g. neuropathy

• Adjust medications

• Recommend an exercise program that includes training in gait and balance, and stretching

• Assessment and modification of daily routines

• Safety of home environment

What precautions should be considered?

Patients need to be educated as to when they need to modify or abstain from their exercise regimen. For example, when they have a fever, patients should avoid group participation; if they have low platelets, a greater concern for strenuous activity and maintaining security of balance needs to be emphasized. Patients with balance problems may need to use a chair or wall for balance

Patients must be cautioned to listen to their own bodies and abstain from activities that cause discomfort. Clinicians should recommend safe activity as part of the plan of care for every patient. On the one hand, a patient who had been active previously may not want to adhere to restrictions such as calling for help or using a walker. On the other, a sedentary individual may not understand the importance of exercise on bone health. Safe mobility and physical activity programs need to be tailored to the needs of each individual patient.

In any setting, the immediate need for patient safety (e.g. prevention of falling) should be the priority, and the patient’s environment should be assessed and modified to maximize safe mobility (e.g. rug placement, handrails, and grab bars).

What about ongoing assessment and readjustment?

Cancer rehabilitation is seldom linear; myeloma survivors may have varied problems and symptoms over time, such as pain, neuropathies, etc. Ongoing patient assessment of risk of falling, physical activity, medications and their side-effects, laboratory and diagnostic tests, nutrition, and adequate management of other health issues is essential.

Maintaining a weekly exercise log helps patients track the frequency, intensity, and duration of the exercises they perform. Based on patients’ documented exercise performance, programs could be altered to best accommodate their physical functioning (e.g. if the patient is feeling very fatigued the intensity of the exercises can be lowered accordingly).

Any closing comments?

Whatever is recommended or endorsed as exercise or activity needs to be carefully evaluated by the patient’s healthcare providers. Patients and their family members should be instructed to tailor the patient’s activities based on daily health status and communicate with the healthcare team regarding any questions or concerns they might have

Manitoba Approves Funding for Revlimid

2010-08-18T00:24:00.000-07:00

There are two provinces holding out: Nova Scotia and Prince Edward Island and they excuse themselves saying the drug is too expensive. The old question comes back: What is the value of a human life?

I have been receiving Revlimid due to the generosity of the manufacturer Celgene and it has been saving my life. (Ed)

Manitoba last week became the eighth province to approve funding for Revlimid® (lenalidomide) in combination with dexamethasone, as second-line therapy for the treatment of patients with multiple myeloma.

In October 2008, Health Canada approved Revlimid in combination with dexamethasone for the treatment of multiple myeloma patients who have received at least one other treatment regimen. Prior to the drug’s approval, there were few effective, once-daily oral treatment options for patients with this aggressive blood cancer.

Notwithstanding overwhelmingly positive clinical evidence, Nova Scotia and Prince Edward Island remain the only provincial holdouts denying access to patients who do not have private drug insurance, but who require Revlimid. Myeloma Canada, together with local support groups, will continue the campaign to force decision makers in these two provinces to follow the lead now set by every other Canadian province.

John Lemieux, President of Myeloma Canada stated, "Manitoba’s unique requirement for a Utilization Management Agreement slowed the process, but the government has now made the right decision. Denying public funding for a critical drug like Revlimid blocks access to a treatment that has been proven to prolong the lives of multiple myeloma patients. Universal access to drugs like Revlimid across the whole of Canada is a core goal for Myeloma Canada. The myeloma patient community won’t accept a patchwork quilt approach to provincial listings of this drug. Nova Scotia and Prince Edward Island will have to come on board."

About Multiple Myeloma

Multiple myeloma, a cancer of the bone marrow, is an incurable but treatable disease. The cancer starts in plasma cells, which are produced in the bone marrow. In myeloma, abnormal plasma cells, called myeloma cells, grow uncontrollably, crowding out the normal blood cells in the bone. This can bring on symptoms such as fatigue, recurrent infections and severe pain resulting from bone fractures. The disease disturbs the body’s balance of minerals and prevents organs, such as the kidney, as well as nerves, from functioning properly. In Canada, approximately 2,000 people are diagnosed with multiple myeloma every year.

About Myeloma Canada

Myeloma Canada, the only national organization exclusively devoted to the Canadian myeloma community, is dedicated to supporting people living with multiple myeloma.
The mission of Myeloma Canada is to: provide educational resources to patients, families, and caregivers; increase awareness of the disease; accelerate research efforts; and promote improved access to new therapies, treatment options, and health care resources. Myeloma Canada works with regional support groups and key myeloma experts to strengthen the voice of the Canadian myeloma community. Myeloma Canada works in close affiliation with the International Myeloma Foundation, the world’s oldest and largest myeloma organization. For more information or to find out how you can help please visit our website at www.myeloma.ca.

Catastrophic drug coverage for Canadians

2010-08-11T02:51:00.000-07:00

BACKGROUND

This article below expresses the view of the federal Liberals led by Liberal leader Dion and the position of the federal Conservatives is unclear. This article is intended to get the issue in front of the public as since this position was taken there have been many changes in the cost of providing drugs for Canadian in after care. Added to this list must be Multiple Myeloma. I hope this furthers the debate and as we in Atlantic Canada suffer most under the current arrangements. Our organizations must respond positively and engage our governments so that we do not face the prospect of patients dying because their provincial governments can not or will not provide funding. I am a multiple myeloma patient and the revlimid that keeps me alive is provided though the generosity of the manufacturer Celgene

A plan for catastrophic drug coverage for Canadians

A new plan for catastrophic drug coverage would ensure Canadians living with serious life threatening or chronic illnesses – such as cancer, diabetes, and arthritis and multiple myeloma – can focus on their health instead of worrying about their finances.

All Canadians should have access to the drugs they need when they face serious illness but for many, the needed medications are so expensive or used in such quantities that they cause financial hardship.

More and more new treatments for serious illnesses are oral drug therapies, instead of hospital treatments, and so are not covered under the public health plans in most provinces. While they may be more targeted and effective than older therapies, these drugs are increasingly expensive.

For example:

The average drug treatment for kidney cancer costs between $6,000 to $7,000 per month;
It can cost between $40,000 to $60,000 for a standard course of treatment of colorectal cancer; and new, innovative medications for rheumatoid arthritis cost about $20,000 per year.

A new Liberal government will ensure that drug costs are not a barrier to quality health care by creating a $900 million catastrophic drug plan.
Creating a plan for catastrophic drug coverage will ensure all Canadians suffering from debilitating illnesses have access to much-needed drugs no matter where they live.

Currently, Canadians receive different coverage across the country depending on the province they live in. There is no minimum standard of coverage. As a result, coverage is not consistent across the country. The Liberal Party does not believe that Canadians should face dramatically different health coverage and financial burdens based solely on geography.

Canadians in the Atlantic provinces face particular hardship. This is unacceptable and betrays the principle of universality that has been at the core of our health policy for decades.

A new Liberal government will work with the provincial and territorial governments, in consultation with health experts and patients, to establish a level of catastrophic drug coverage that should be provided as a national minimum. Provinces that currently provide drug coverage that meet this new standard will be compensated by the federal government. For provinces that do not meet the standard, a new Liberal government will work with the provincial government to ensure that adequate coverage is provided.

Spending on prescription drugs is growing faster than any other category of health expenditures. After hospital care, Canada spends more on drugs than on another major category of the health care system. Since 2000, the total public and private expenditure on prescription drugs has grown by approximately 12 per cent annually.
With these increasing costs, provincial health spending is even further stretched and other health programs may suffer.

The federal government will assist the provinces to ensure Canadians across the country have consistent access to drugs.

Provincial and territorial health ministers called for the federal government to provide protection against catastrophic expenses at a meeting earlier this month.

We agree with the provinces and territories that catastrophic drug coverage is as essential to Canadians as physician and hospital coverage and agree that the federal government has a funding responsibility to establish a minimum standard of drug coverage for all Canadians.

The Role of Food in our Health

2010-07-29T06:36:00.000-07:00

Frank;

Since I feel you are a great researcher,

I am sure you have considered and looked into how our food affects our health. I have read and loaned out a book by Dr. Roger L. DeHaan entitled We Don't Die; We Kill Ourselves our food is killing us. He has also written a second book "Restoring the Creation Mandate".

I find that physicians don't have any training on nutrition. I am still learning and it seems the more I find out the more there is to learn.

Just thought you would be interested and perhaps could find these books at your library or on line.
God still is the great physician and healer and I believe He is using Christians to help us get back to what he intended for us. God Bless.

Linda Charters, St. Stephen, New Brunswick

PS Another book by Steve Meyerowitz on Wheatgrass Nature's Finest Medicine (cleanses, nourishes, rejuvenates, and heals).

My husband and I have been taking Wheatgrass since winter.

Pills, Patients & Profits

2010-07-13T23:19:00.000-07:00

Pills, Patients & Profits

The CTV W5 program in which I appeared aired on the CTV network on March 27, 2010. Some say they haven’t seen it; yet some tell me they have seen it many times. The consensus seems to be that the program struck a nerve of accuracy among cancer patients and the Canadian public. The link below will enable you to view it again or for the first time.

If you have any comments you wish to share, feel free to do so on the blog, or make you comments available to me at the Email address below:

Frank.boyd@bellaliant.net.

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20100326/w5_pills_100326/20100327

MYELOMA CANADA INFORMATION WORKSHOPS

2010-05-12T00:50:00.000-07:00

MYELOMA CANADA INFORMATION WORKSHOPS

Myeloma Canada continues its outreach to patients and caregivers across Canada with the first-ever information workshops to be held in Nova Scotia and Newfoundland. These sessions, which are free and open to the public, provide a valuable opportunity to learn more about multiple myeloma as well as to meet other patients and caregivers.

Halifax: June 10 (1:30 – 5:00 pm)

Royal Bank Theatre at the Halifax Infirmary
1796 Summer Street
Click here to view the complete Halifax agenda.

St. John’s, NL: June 12 (1:00 – 4:30 pm)

Lecture Hall E, School of Nursing
The General Hospital, 300 Prince Phillip Drive
Click here to view the complete St. John’s agenda.

Refreshments will be provided.

To register, please contact Myeloma Canada at (888) 798-5771 or by email: info@myelomacanada.ca

Myeloma Canada Information Workshops are supported by unrestricted educational grants from OrthoBiotech and Celgene Canada

Revlimid Commences

2010-04-29T10:30:00.000-07:00

The Nova Scotia government has decided to make Revlimid available to all Nova Scotians who are in need of it and who cannot afford it. This has been a long time in coming and it is my sincere wish that those who need it will benefit from its use.

I have had calls from Nova Scotians wanting access to Revlimid and I have passed on information to the callers. I suggest that you speak to your oncologists to see if you will benefit from its use and your oncologist will be aware of the application process.

I commenced use of Revlimid on May 1, 2010 as today is my mother's birthday. My mother would want me to stand up for the rights and benefits of other Nova Scotians and Canadians
and as a faithful son that is what I would do regardless of the consequences.

I want to also thank everyone who wrote letters to the heath department in Nova Scotia and many Canadians for the hundreds of encouraging letters and emails I have received from you.

Your generosity has fueled my passion and made my resolve non-negotiable where lives of Canadians and Nova Scotians are involve.

I want to thank the members of my church, Emmanuel Baptist Church, for their prayers and support an in particular my friend Leeman David and the Kings, a men's support group of our church, who meet monthly in the parlour.

Of course I praise Jesus for his influence in my life -- always being there when I need him. He is bold and he's brave and he watches over me as in Psalm 91, my mother's favourite Psalm, "He that dwelleth in the secret place of the most High shall abide under the shadow of the Almighty . . ."

Yesterday, I took one pill and when I awoke this morning my voice was back to normal -- I wasn't soprano any more but baritone once again. However temporary, this improvement may be, I'll take it for as long as it lasts.

Sincerely,

Frank

Left click photo to enlarge.

Revlimid Now Available in Nova Scotia

2010-04-14T15:22:00.000-07:00

For years Frank Boyd has battled to get Revlimid used in Nova Scotia and at great and enormous self sacrifice it has finally happened. This is thanks also to the many supporters across Canada and the United States, who through CTV's W5 took enough interest to let their feels show tp politicians across the land.

Who says Canadians cannot unite when are principles values and our beliefs are challenged by anyone?

I understand the new arrangement means that anyone in financial need may access revlimid for their use.
Many doubted that it could be done, but there's a core of activists in Canada who will not be denied. The process to access the drug is rapid and both Celgene Corporation and the Myeloma Canada as well as those in the Nova Scotia government and those involved in "The Time to Live Campaign" I should thank for living up to Canada's Medicare principles. In particular I want to thank the host, producers researchers, and technicians of CTV'sW5 for challenging all of us by producing this program: "Pills, Patients and Profits." A job well done.

Please do not sit back on our small victories keep looking ahead because the cost of health will not get any less expensive and we need to be ready when we must move forward again. Congratulations Nova Scotia!

Frank Boyd

Right Click photo to enlarge

Frank Boyd Multiple Myeloma Story on CTV's W5

2010-03-24T14:19:00.000-07:00

Left: Frank Boyd (now) Son and father (Below)

As many of you know I have not told my cancer story, but CTV's W 5 convinced me that it was the right thin to do.

I have a social conscience and I believe in the Canada's Medicare system, a system which in my youth I have written journalistic articles in defense of its importance and now it needs a champion.

Its importance in Canadian social life is like the last spike in our economy; we cannot allow it its fairness to be destroyed so the average Canadian must speak out. So on W5 I have come out in defense of Medicare for personal and national reasons.

I hope you'll tune in on W5 on CTV's network on Saturday March 27, 2010 (Eastern Time) at 7 pm and in the appropriate time slot across the nation.

Cancer Care Nova Scotia: Chemotherapy - “Zero Tolerance for Errors”

2010-03-10T12:22:00.000-08:00

Chemotherapy - “Zero Tolerance for Errors”

Patient safety comes first. It is at the forefront in the minds and hearts of health providers, health administrators, patients and their families. In fact, the importance of patient safety can be traced back to the Hippocratic Oath historically taken by doctors who swear to the ethical practice of medicine. Believed to have been written by Hippocrates in the 5th Century B.C., First do no harm is phrase well known and understood by most. It is the guiding principle for all who work in health care.

While ensuring patient safety in all health settings is a priority, mistakes sometimes occur. When mistakes involve chemotherapy, the result can be serious, even fatal.

“Chemotherapy is toxic,” says Larry Broadfield, Manager of CCNS’s Provincial Systemic Therapy Program. “It needs to be to kill the cancer cells. But, in the wrong dosage or delivery, it can cause a number of very serious and unexpected side effects.”

Canadians faced the ultimate tragedy four years ago when an Alberta woman died after receiving the wrong dose of chemotherapy. “The Alberta Cancer Board’s courageous and honest response to this tragedy helped us all realize that while we are human and mistakes will happen, there are processes we can put in place to prevent and minimize the likelihood of errors, particularly fatal errors, from happening,” says Larry.

Just how significant the error rate is in the delivery of chemotherapy remains unclear, although one recent study of three U.S. outpatient cancer treatment centres found that 7 per cent of adults and 19 per cent of children taking chemotherapy drugs were inadvertently given the wrong dose or experienced other mistakes involving their medications.

One thing is certain. The tragedy that occurred in Alberta served as a warning signal to the rest of the country. Decisive and immediate action is necessary to ensure the cancer system has the appropriate safeguards in place to protect patient safety and minimize the chance for error. For these reasons, the Canadian Association of Provincial Cancer Agencies (CAPCA) has formed a national committee, the Chemotherapy Safety Working Group, to explore the issue – and identify areas for improvement and enhancement. CAPCA is expected to release its findings from their first research study on chemotherapy safety this fall.

In Nova Scotia, in addition to participating on CAPCA’s national committee, local hospitals across the province are reviewing how chemotherapy is delivered and exploring possible changes to improve the safety of chemotherapy delivery.

As the provincial program responsible for enabling safe, high quality care, Cancer Care Nova Scotia is providing leadership and working to make practices more safe. In 2008, the first pharmacy technicians graduated from CCNS’s Online Chemotherapy Preparation Program. This groundbreaking initiative, a partnership with the Nova Scotia Community College, helped to standardize methods used for chemotherapy preparation. Since its introduction, almost 100 per cent of pharmacy technicians have completed the program. A process is also in place to ensure new pharmacy technicians entering the workforce complete the program.

“Until CCNS developed this program, there was no common approach to training pharmacy technicians on chemotherapy preparation,” says Larry. “Today pharmacy technicians have the skills and standards training they need to confidently and safely prepare chemotherapy for patients.” The Chemotherapy Preparation Program is just one in a series of skill-based education programs CCNS is developing and delivering to provide health professionals with the necessary skills to ensure safe, high quality care.

For example, work is also underway to develop and deliver chemotherapy education to nurses and pharmacists across the province. These programs will begin to be offered later this year.

Other work includes the development and implementation of improved standards for the safe delivery of chemotherapy in hospitals and chemotherapy units. Following introduction and implementation of standards, CCNS also plans to work with district health authorities to implement an appropriate monitoring process to ensure standards are being followed.

“It’s all about having the right checks and balances in place for all players involved in chemotherapy delivery to minimize as much as possible the opportunity for error,” says Larry.

“Ultimately, the number of mistakes don’t matter. One is too many. As health professionals, patients, families and a health system, we have a zero tolerance for errors involving chemotherapy.”

5 Tips for Staying Sane With Cancer

2010-02-25T09:09:00.000-08:00

By Marie Suszynski
Medically reviewed by Pat F. Bass III, MD, MPH

Cancer Survival and Your Mental Health

Seek out listening ears. Acknowledging your feelings and expressing them can go a long way when you’re depressed, afraid, or anxious about your health. Birdsall recommends seeking out understanding friends, family members, clergy members, or health care providers such as counselors or therapists who will allow you to openly talk about your feelings.

“We live in a society that encourages us to stuff our emotions and not talk about things that are bothering us,” Birdsall says. “The more we hold it in, the more we internalize that anxiety.”

Talking to someone who’s supportive and will listen and acknowledge your emotions is a huge part of staying emotionally healthy, he says.

Get creative. Writing, painting, or creating music are all great stress relievers and outlets for the stress and anxiety you may be feeling as a cancer survivor. Birdsall encourages his patients to do whatever helps them relax and relieve anxiety on a regular basis.

Lace up your sneakers. Exercise is a great stress reliever, Birdsall says. Experts say that people who exercise are less likely to have anxiety and depression. Do it almost every day of the week to get optimal benefits.

Keep moving forward. A key aspect of processing your emotions is to then use that energy to move forward, whether you’re still in treatment or you’re in remission. Use the energy to learn about the type of cancer you have and your treatment options, to seek out cancer support groups, or to help raise money that will benefit people who have the type of cancer you had.

Keep it up over the long-term. Don’t just follow these steps while you’re in cancer treatment or in remission. Tackle the stress of being a cancer survivor on a regular basis, even if it’s been years since your cancer went into remission, Birdsall says.

Stress is cumulative, he says. A little bit is fine but building it up can do more damage to your mental health.

Taking steps to relieve stress and anxiety can help clear your mind and maintain good emotional health when you're being treated for cancer — and after you’ve beat it.

From the care pages:

http://cms.carepages.com/CarePages/en/ArticlesTips/HelpfulTips/stay-sane-fighting-cancer.html

Body Could Fight Cancer

2009-04-28T04:58:00.000-07:00

Canadian scientists find way to trigger immune response

By HAYLEY MICK The Globe and MailTue. Apr 28 - 4:46 AM

TORONTO — Canadian scientists have discovered how to trigger an improved immune response to cancer that — if researchers’ hopes come true — could lead to treatments that use a patient’s own cells to hunt down and destroy tumours.

The findings, published online Sunday in the journal Nature Medicine, demonstrate the exciting potential of immunotherapy in cancer treatment, says principal investigator Pamela Ohashi, a researcher at

Toronto’s Princess Margaret Hospital.

"If we learn to do this right, (cancer) will be just like having symptoms for a cold or flu. It will be allowing the body to attack the tumour, and in that sense, you won’t have to do chemotherapy and all those treatments."

Ohashi and colleagues from Toronto, Germany and the U. S. combined a vaccine with a naturally occurring substance in the body called interleukin-7 (IL-7), a protein that helps white blood cells ward off disease.

The combination dramatically extended the lives of mice with pancreatic cancer. Those that received treatment for two weeks died in 120 days, compared with the 80-day lifespans of those that did not.

"It essentially bought the mouse what would be the equivalent of years (of time) in humans," said Tak Mak, a co-author of the study who, with Ohashi, heads the Campbell Family Institute for Breast Cancer Research.

While the vaccine component triggered the immune response, Researchers discovered that IL-7 helped white blood cells work more effectively in killing the tumour. It also broke down several barriers that would normally stop the white blood cells from attacking the body’s own tissue.
"It allowed (the white blood cells) to get to the tumour site and stay there and do their job," Ohashi said. Since IL-7 operates throughout the body, the treatment could be applied to others cancers, she added.

The promise of using the body’s own defences to fight cancer has intrigued scientists for years.

Not only is the human immune system better equipped to specifically target diseases inside the body, but immunotherapy treatments would also spare cancer patients from the side effects of more traditional therapies that can be invasive, such as surgery, or toxic, such as chemotherapy.

A legion of vaccines are being studied and tested around the world to treat brain, lung, skin, kidney and other cancers — with some success. The HPV vaccine, for example, is now being administered to young girls to prevent cervical cancer.

But most cancers are not caused by viruses, Ohashi said. So researchers are now looking for ways to trigger the immune system to attack cancers after they appear in the body.

One of the reasons IL-7 is generating so much excitement, Mak added, is because it has already been found to be non-toxic in humans. Another naturally occurring immune component called IL-2 can be effective in fighting kidney cancer, he said. But when administered to mice, it’s so toxic that it often kills off the mouse before it eradicates the tumour.

"If we learn to do this right, (cancer) will be like having symptoms for a cold or flu."
PAMELA OHASHI cancer researcher.

Primary OfficePrincess Margaret Hospital

10th Floor Rm. 1030

620 University AveToronto,

OntarioCanada M5G 2C1

pohashi@uhnres.utoronto.ca

More on Craig Lane...

Good morning..my 1st update in over 2 weeks........

After 27 days, Craig is OFF the life-support. (the ventilator is still on stand-by) but a little positive news.Now he is getting some oxegen thru his trach. They changed his trach yesterday to a smaller one and the next step is to get it capped. After that he should be able to talk. He is off sedation but still on pain-killers so he still has not opened his eyes and no response when we talk to him. Hopefully that will all change soon. He's not out of the woods by no means but its looking up. he now has been moved to isolation in the ICU b/c his white blood counts are really low. Its been 4 days since they drained fluid from his belly so that's good. They drained 16 liters in 2 days earlier this week.

I want to sincerly thank all of you who been so supportive to us at this very stressful time.

May God bless each and everyone of you,

Take care,

Jean, Austin and all the Lane family....

PS..Craig has said many times since he has been sick that if you don't have your health, family & friends, you have nothing....and he's right

Drug Coverage Options On Caring Vocies Tonight

2009-04-21T05:11:00.000-07:00

Please join us Tuesday on http://www.caringvoices.ca/ Drug Coverage Options
This event is hosted by the General Cancer community.

Date/Time: April 21, 2009 at 1:00 PM ESTDuration: 1hrs

Drug coverage is a very real concern that many cancer patients and caregivers have to face. Join Pharmacist Sophie Kim and Social Worker Valerie Heller from Princess Margaret Hospital to learn about drug coverage options available to you.

Moderators: Sophie Kim, Valerie Heller

Craig Battling Strongly Future Brighter

2009-04-15T03:48:00.000-07:00

Craig's brother Jason sent this report on Thursday, april 9, 2009 (Ed. note).

Hi,

Craig went into the OR this morning at 11am (they had a few cancellation so they were able to schedule him in there this morning). Within an hour they had the temporary tracheotomy in place, and everything went fine. He is resting well, and everything else (blood pressure, heart rate) are stable. They cut back on some of his blood pressure meds (phenylephrine) so that is looking good. As long as his blood work continues to look good, they will continue with 2 chemo treatments next week.

The plan is now to continue to monitor everything, and ween him off the sedation and gradually ween him off the ventalator too. They will monitor this daily, and it sounds like they can tweak this once they see how he is reacting to it. Gradually they can ween him off the sedation and ventalator and get him to a point where he is breathing on his own. It also sounds like he may have the trach in when he leaves the ICU as well (for a short period of time anyway, then he can get that taken out).

They did drain 1 L from his belly today, and they continue to give him the albumen protein too. It had been 2 days since they drained any fluid. His belly is still swollen, but they don't want to be draining too much. At this point now, we're wondering if the chemo or the other medication will start taking affect and eventually help with the absorption of the nourishmnet so the fluid doesn't come back. I would think that'll be a longer process over the weeks/months ahead.

Jason

More on Craig Lane's Condition Wednesday Update

2009-04-01T15:53:00.000-07:00

Wednesday, April 1, 2009 update:

Craig is still sedated, on the ventalator, resting well, with blood pressure, heart rate at normal levels. His blood pressure did drop a bit, so they did a CT scan as a precautionary measure, and the results were all good. No problems.

They put a clamp on the tube that was draining the fluid from his belly, and the tube draining fluid from his lung will likely be removed tomorrow. They did a bit of physio to get him moving his limbs.

They continue to monitor to see if he's absorbing the nourishment and the extra protein they are giving him.

Jason

Craig Lane's Photo From Webshots

2009-03-30T05:54:00.000-07:00

Left, Craig's mother Jean Lane.
The link below connects to a photo of Peoms Multiple Myeloma patient Craig Lane from Newfoundland, who the entire multiple myeloma community sends best wishes for a speedy recovery. Craig if there is anything further we can do to help you, please let us know. Thank you Jason and Jean Lane, Lady Newfoundland.

Frank Boyd (Ed.)

Craig pictures from art photos on webshots

Updates On Craig MM POEMS Patient

2009-03-29T18:38:00.000-07:00

This from Jason,today Sunday, March 29, 2009; I have requested a photo of Craig, Frank Boyd Ed.

Jason here. Just got back from a long day at the hospital. I stayed over last night. it was a pretty quiet night, but by 6am Craig was feeling some anxiety due to the pain. His hip was sore with the way he was lying on the bed. So he was agitated and his oxygen level was low. The nurses took him down to the ICU around 2pm and he's been there since. His blood pressure is low, so they are monitoring that too. His heart rate was high, but he is resting now and that has come down. His oxygen levels are back to 100% and he just got some pain medication. He is feeling discomfort, but they will monitor his condition tonight. They will also do a chest CT scan to make sure there's no blood clotting or infection where the drainage tube is. He's getting lots of attention in the ICU so that's good. He has lots and lots of visitors, but only family can go into the ICU. Hopefully the levels will be stable over night and he can go back up to the 4th floor room (if not tomorrow then on Tuesday). We'll keep you posted.Jason

This from Craig's Mother Jean on Wednesday, March 25, 2009

Hi Frank..Thanks again for your help. I have heard from many MM and POEMS patients. Craig's main Dr came in today and said she was talking to Dr Angela and she gave her some suggestions but Dr Angela didn't think they should use thalidomide. They are coming in tomorrow to explain it all to us.
Today Craig had his 3rd amount of belly fluid removed (21 liters in all 3) but they have left the tube in and have it clamped and will let some more off in a couple days. He has been in hospital 82 days lying flat on his back...he's starting to go stir-crazy..Its been hard for us as well. His brother is coming tomorrow from BC for the second time.We are missing home but will stay on as long as it is neccesary.

Many Thanks for all who have helped,

Jean Lane

We are not put on this earth to see through one another, but to see one another through.

POEMS PATIENT'S MOTHER THANKS MYELOMA COMMUNITY

2009-03-24T13:13:00.000-07:00

Alan Suher, CT, USA

In 1998 I woke up with all of my toes numb. This was the beginning of what would be six months of doctors, tests, more doctors and more tests. I feel very lucky that after only a half year a new Neurologist, I had an appointment with, came to a possible conclusion that I had POEMS Syndrome. He said if he is right the illness is beyond him, but he had about four doctors, in various states, that he felt were familiar with POEMS. Thanks for your help Alan, Frank

Myeloma patients from across North America banded together to help a Newwfoundland POEMS patient they have never met. The patient's mother thanks everyone as she writes:

"Hello Frank..I just wanted to let you know I spoke to the Dr. this morning and this afternoon she came in to say she had called Dr. Angela and spoke with her secretary and left a message..Its 11PM and we just got home from the hospital since 10 this morning..

Thanks for all your help and the help of others who have emailed me,

Jean"

We are all pulling for Mrs. Lane's son and I will give you updates on his progress. Meanwhile I want to thank the myeloma team for a team effort. RUFF! RUFF! RUFF!

Multiple Myeloma Patient, Richard Brown, a Top Curler

2009-03-22T17:27:00.000-07:00

Canadian wheelchair curling championship begins Monday, March 23, 2009 in Lower Sackville.

Nova Scotia’s best wheelchair curlers will take on a strong field at the Canadian Wheelchair Curling Championship beginning Monday at the Lakeshore Curling Club in Lower Sackville.

One of these champion curlers, Richard Brown, underwent a stem cell transplant last February 2008 at the same time as I did. Richard and his lovely wife Sharron are delighted that Richard is going to get to play, and so am I.

Brown, 62, was an able-bodied curler at the club level, curling out of Mayflower for 17 years, before a spinal tumour led to surgery in late 2007.

His condition, multiple myeloma, is treatable, but incurable, and he now has titanium rods in his spine. However, extensive rehabilitation at the Nova Scotia Rehab Centre has allowed him to get around with the help of a walker and, more recently, canes.

This is his first year playing the wheelchair game.

"It’s a lot different because there’s no sweeping," said Brown. "You have to be pretty accurate with your throwing, a lot more accurate than you are in the able-bodied game."

Good luck Richard and Sharron and let us know how you are doing. We are all so proud of you.

Frank

POEMS Re-visited Advise from Jeffrey Hoffen and Alan Suher

2009-03-22T13:00:00.000-07:00

Just receive is some very crucial information regarding POEMS from Alan Suher. Please vidsit his website at: http://poemssyndrome.info/. I have forwarded his email to Mrs. Lane and her son.

For those who need this valuable information here is what Alan wrote:

Hi,

My name is Alan Suher and I diagnosed with POEMS in 1998. During these 10 years I have learned a lot and I am glad to pass some information on to you. Being in a hospital that has never treated a POEMS patient is not a good situation. In all honesty they don't know what to do because they haven't run this course before. They will do a lot of "trail and error stuff" and that is not the answer.

My recombination's:

Have the doctor in charge of the case contact Dr Angela Dispenzieri the Mayo Clinic in Rochester, MN (USA). The phone number is 507-284-2479. Dr. D. is one of the few doctors in the world that understand POEMS and how to treat it.

Sign up on ACOR.ORG and communicate with other POEMS patients. What could be more helpful then being able to talk to others that have already gone through this route?
Finally, go to the website POEMSSYNDROME.INFO This is a website I recently developed for POEMS patients.

These are my suggestions. If I can me of further assistance, please write me at suher@cox.net
Good luck,

Alan Suher in CT (USA)

Thank you Alan and Jeffrey Hoffen

Here is what Jeffrey wrote:

Hi Mr. Boyd

I saw a quick note about someone with POEMS who might need assistance. A website and community of POEMS patients does exist. The web site was generally put together by Alan Suher (email below).

You can contact him, or me, for further information. Dr. Dispenzieri at Mayo is the leading expert on POEMS. Also, if patient can not get to Mayo I would recommend an Academic tertiary care hospital-one that is affiliated with a medical school. This is a complex disease.

JH

AN APPEAL FOR HELP WITH MM/POEMS

2009-03-21T03:15:00.000-07:00

I received this email from Mrs. Lane and her aooeal for help. I am asking anyone out there who has pertinent information to help. Here's Mrs. Lane's eamil:

I saw your email on the Myeloma website for Atlantic Canada. My son, age 46 was diagnosed in November with CIDP. After 2 months not getting any better, he was admitted to hospital on January 6th and has been there every since. He was diagnosed with MM and several days later told he also has a rare syndrome POEMS..Its now been 2 1/2 monthas and he has had several treatments,Dex ( steriods) 13 radiation treatments and is now on chemo for 4 treatments, 14 days apart. The hospital is now in the process of getting thalitomide from the US.He has severe polyneuropathy and is bedridden 24/7..This is the 1st case of POEMS for the hospital so this is all new to them as well as us.Any information would begreatly appreciated,Thank You,Jean Lane.

I offered this help, but I am also asking that you out there who read this post to also help:

Dear Mrs. Lane,

Pray is a powerful thing but in order to help yourselves you and your son need to know what it is you are dealing with. There are many resources at your disposal, among which is the Mayo Clinic online. There you may find out what you are dealing with. Information is your greatest strength; another are the people with POEMS and they are perhaps your greatest resource.

With the first part, reliable information is paramount. I suggest you go online to (click the link below; you may have to ctrl click it):

www.mayoclinic.org/poems/symptoms.html

Don’t let it frighten you; above all you need faith and belief in your son’s recovery or medical control by your doctors of what he has. Another source of information is NINDS.

National Institute of Neurological Disorders and Stroke (NINDS) find CIDP Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

www.ninds.nih.gov/disorders/cidp/cidp.html

Click on this link. Again do not let this frighten you, you must control you emotions.

Finally, you must seek out those who have your son’s condition and the IMF is the best location I can think of and its list server is the location to find help. Here is the link to the IMF

http://myeloma.org/main.jsp

When there go to find support; there’s a link at the top of the page. Get on the List Server where other MMers communicate. Ask for help, information on your son’s condition and those with it will respond and overwhelm you with information and therapies. Remember, you are not ALONE; there’s HELP. Don’t give up, PRAY and get into ACTION. I have copied this to my friend Susan and she can help you also.

I sincerely hope this helps,

Frank Boyd
Susan Trites

(902) 463-0070

IF ANY OF YOU CAN HELP PLEASE EMAIL ME AT:
frankboyd@airfire.ca

ONJ Osteonecrosis of the jaw

2009-03-19T19:16:00.000-07:00

Osteonecrosis of the jaw in patients with multiple myeloma treated with zoledronic acid.

Cetiner S, Sucak GT, Kahraman SA, Akı SZ, Kocakahyaoglu B, Gultekin SE, Cetiner M, Haznedar R.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey.

Intravenous bisphosphonates-the potent inhibitors of osteoclast-mediated bone resorption are among the most commonly prescribed drugs in the management of multiple myeloma (MM). Zoledronic acid (ZA) is a new generation potent intravenous bisphosphonate that has been approved for the treatment and prevention of bone lesions, and/or hypercalcemia associated with MM. Osteonecrosis of the jaw (ONJ) is an emerging serious side effect of the new generation bisphosphonates with a growing number of reports related to this pathological entity. ONJ usually appears following oral surgical and dental procedures but sometimes occur spontaneously. These cases are mostly seen and treated by dentists and oral surgeons. The aim of this study was to discuss the frequency, characteristics, risk factors, management and histopathological features of ZA induced ONJ based on the literature and illustrated with five own cases. Thirty-two patients with MM who received ZA for a median period of 26.5 +/- 18.7 months (min: 5 months, max: 76 months) were evaluated. ONJ was detected in five patients and mean drug duration time was 34 months. The frequency was 15% and the patients were usually symptomatic. There was no significant difference in terms of the duration of ZA in patients with and without ONJ. Management of these established cases were performed with medical treatment, minor debridement, sequestrectomy, and combining bone resection with autologous platelet rich plasma. Our data indicate that ZA therapy has a major role in the development of ONJ a fact that should be considered by physicians treating MM patients.

Elderly Multiple Myeloma Patients

2009-03-19T11:38:00.000-07:00

New generation pharmacotherapy in elderly multiple myeloma patients.

Ataergin SA, Kindwall-Keller T, Berger NA, Lazarus HM.

Gulhane (GATA) Faculty of Medicine Department of Medical Oncology and Bone Marrow Transplantation Unit, 06018, Etlik, Ankara, Turkey.

BACKGROUND: Observational databases have demonstrated that the overall prognosis of multiple myeloma patients has markedly improved over the past decade, yet the greatest strides have been attained in younger rather than older patients. OBJECTIVE: To review recent clinical trials that include new generation agents (thalidomide, lenalidomide and bortezomib) and autologous stem cell transplantation in older multiple myeloma patients. RESULTS: Conventional regimens such as melphalan plus prednisone can be improved with the addition of thalidomide or bortezomib: more patients attain complete and near-complete remission, and progression-free survival rates are nearly doubled. In addition, autologous hematopoietic stem cell transplantation studies show that this treatment approach can be used successfully in selected older myeloma patients in whom the toxicity profile of autotransplant and resulting overall survival may be similar to that obtained in the younger patient group. CONCLUSIONS: In the advanced-age population, implementation of new therapies results in significant benefits in older as well as younger patients.

Emerging Therapies for Multiple Myeloma

2009-03-19T11:28:00.000-07:00

Emerging therapies for multiple myeloma.

Podar K, Tai YT, Hideshima T, Vallet S, Richardson PG, Anderson KC.
Dana-Farber Cancer Institute, Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Boston, MA 02115, USA. klaus_podar@dfci.harvard.edu

Multiple myeloma (MM) is a clonal plasma cell malignancy clinically characterized by osteolytic lesions, immunodeficiency, and renal disease. There are an estimated 750,000 people diagnosed with MM worldwide, with a median overall survival of 3 - 5 years. Besides chromosomal aberrations, translocations, and mutations in essential growth and tumor-suppressor genes, accumulating data strongly highlight the pathophysiologic role of the bone marrow (BM) microenvironment in MM pathogenesis. Based on this knowledge, several novel agents have been identified, and treatment options in MM have fundamentally changed during the last decade. Thalidomide, bortezomib, and lenalidomide have been incorporated into conventional cytotoxic and transplantation regimens, first in relapsed and refractory and now also in newly diagnosed MM. Despite these significant advances, there remains an urgent need for more efficacious and tolerable drugs. Indeed, a plethora of preclinical agents awaits translation from the bench to the bedside. This article reviews the scientific rationale of new therapy regimens and newly identified therapeutic agents - small molecules as well as therapeutic antibodies - that hold promise to further improve outcome in MM.

PMID: 19249983 [PubMed - in process

MULTIPLE MYELOMA FACT SHEET

2009-03-18T16:04:00.000-07:00

What is multiple myeloma?

Multiple myeloma is an incurable yet treatable cancer of the blood in which plasma cells are overproduced in the bone marrow. Plasma cells are a type of white blood cell found in bone marrow that produces the antibodies to help the body fight infections.[i] Multiple myeloma occurs when abnormal cells develop in the bone marrow and divide uncontrollably, eventually crowding out healthy blood cells. Over time these cells can spread to the solid part of the bone, causing fractures and pain.

Fast Facts

Multiple myeloma is the second most prevalent blood cancer after non-Hodgkin's lymphoma and accounts for 1.3 per cent of all new cancer cases in Canada and 1.9 per cent of all cancer deaths.[ii]

According to the most recent Canadian Cancer Society statistics, of the approximately 6,000 Canadians living with the disease, about 1,350 will die this year and 2,100 new patients will be diagnosed across Canada.

Once considered a disease of the elderly, the average age at diagnosis of people with multiple myeloma is the early 60s, with many patients much younger.
Multiple myeloma affects slightly more men than women.

Causes and risk factors

Despite the tremendous amount of work that has gone into the search into the cause of myeloma, to date no cause of this disease has been identified. However, a possible link between exposure to chemicals, pollutants, radiation, or other environmental risk factors and a greater risk of developing myeloma has been suggested.[iii] In most cases, individuals who develop multiple myeloma have no clear risk factors.

Symptoms and diagnosis

There are often no symptoms in the early stages of myeloma. In some cases, myeloma may be discovered by accident during routine blood testing. When present, symptoms may be vague and similar to those of other conditions.

The growth of malignant plasma cells in the bone marrow crowd out healthy blood cells and impact the body in a number of ways, including:

Producing fewer red blood cells, which can result in anemia and fatigue;
Suppressing healthy white blood cell production, which can lead to recurrent infections;
Attacking and weakening of bones, which may lead to osteoporosis and result in considerable pain and potential fractures;
Affecting normal kidney and nerve functions.

Because myeloma is a very complex disease, patients may experience all or none of the above symptoms. The diagnosis of multiple myeloma is often made by way of a routine blood test for other conditions. The existence of anemia and a high serum protein may suggest further testing.[iv]

[i] Canadian Cancer Society. What is multiple myeloma? Available online at:

http://www.cancer.ca/Ontario/About%20cancer/Types%20of%20cancer/What%20is%20multiple%20myeloma.aspx?sc_lang=en Accessed February 17, 2009.

[ii] Myeloma Canada: Cause and Incidence; http://www.myelomacanada.ca/en/incidence_prevalence.htm?t=1 Accessed February 17, 2009.

[iii]Myeloma Canada. Stronger together. (pamphlet). Fall 2008.

[iv] Myeloma Canada. Diagnosis. Available online at: http://www.myelomacanada.ca/en/diagnosis.htm Accessed on February 17, 2009.

ANGUS REID POLL RESULTS: CANADIANS ON CANCER

2009-03-18T15:48:00.000-07:00

A SURVEY OF PRECEPTIONS AND ATTITUDES OF CANADIANS TOWARD CANCER AND ACCESS TO MEDICATIONS

SUMMARY OF FINDINGS

KEY FINDINGS
A recent national survey shows that Canadians are divided on how confident they are about having access to the necessary medications, if they were diagnosed with cancer. In fact, 43% of respondents indicated they were not confident that they would have access to the cancer medications they would need.

· Although they are divided in their confidence about having access to the necessary cancer medications, Canadians are optimistic in that they tend to see cancer as something you can live with (64%), as opposed to something you will necessarily die from.

· Greater access to cancer treatments ranked second only to reduced wait times among a list of four potential priorities for government health care spending.

· After being told about the current public insurance coverage for cancer treatments in Canada, the vast majority of Canadians (86%) stated that provincial government programs should pay for all cancer medications approved by Health Canada for those eligible - even if it meant a re-allocation of health care dollars. 84% of respondents felt that all of the provincial governments should have a common list of cancer drugs that they cover instead of having different coverage lists in each province.

· Very few (15%) correctly identify multiple myeloma as a blood cancer. A third (33%) mistakenly identified it as a type of skin cancer and another third (36%) admitted to not knowing what it is.

SURVEY METHODOLOGY

The findings reflect results of a nationwide online survey of adult Canadians conducted by Angus Reid Strategies on behalf of Myeloma Canada. The study was conducted among a randomly selected, representative sample of 1,002 adult Canadians. Below is the breakdown by region:
· British Columbia: n=140
· Alberta: n=123
· Manitoba/Saskatchewan: n=63
· Ontario: n=356
· Quebec: n=224
· Atlantic: n=96

The data were collected between November 14 and 16, 2008. The margin of error for results based on the total sample of 1,002 is +/- 3.1%, 19 times out of 20. Results have been statistically weighted according to Statistics Canada’s most current education, age, gender and region Census data to ensure a representative sample of the entire adult population of Canada.

- 30 -

For more information, please contact:
Rosalind O’Connell
Hill & Knowlton Canada
(416) 413-4773
rosalind.oconnell@hillandknowlton.ca

Myeloma Canada's Post-ASH Myeloma Web Conference

2009-02-12T02:07:00.000-08:00

THE POST-ASH MYELOMA WEBINAR IS HAPPENING A WEEK FROM TODAY: FEBRUARY 18

IF YOU HAVE NOT YET REGISTERED, CLICK ON THE LINK BELOW TO COMPLETE THE ONLINE REGISTRATION FORMREGISTRATION IS FREE

DON’T MISS OUT ON THIS UNIQUE OPPORTUNITY TO LEARN ABOUT THE LATEST RESEARCH AND ADVANCES IN THE TREATMENT OF MYELOMA

http://www2.eventsvc.com/myeloma/021809

In its continuing efforts to provide valuable information and updates to the Canadian myeloma community, Myeloma Canada is presenting a national web conference (webinar) highlighting the advances in myeloma research presented at the recent American Society of Hematology (ASH) meeting held in San Francisco.

The annual ASH meeting is the most important international gathering of clinicians and scientists where the latest research findings in the management of multiple myeloma and other blood disorders are presented and discussed.

Dr Christine Chen of the Princess Margaret Hospital in Toronto and member of Myeloma Canada’s Scientific Advisory Board, will lead the presentation. A 30-minute question and answer session will follow.

Date
Wednesday, February 18, 2009

Time
British Columbia & Yukon: 4:00 pm (Pacific)
Alberta: 5:00 pm (Mountain)
Saskatchewan & Manitoba: 6:00 pm
(Central)Ontario & Quebec: 7:00 pm
(Eastern)Maritimes & Labrador: 8:00 pm
(Atlantic)Newfoundland: 8:30 pm

Requirements
Telephone
Computer
Internet connection

Registration
Registration is free. You are required to register in order to receive the toll-free call-in number and participate in the conference.Simply click on the following link to complete the online registration form.

http://www2.eventsvc.com/myeloma/021809

You are invited to pass this information along to anyone who would benefit from the information that will be presented in the webinar.

------ End of Forwarded Message

Caring Voices Website

2009-01-05T16:06:00.000-08:00

Caring Voices is an online community for cancer survivors. You can use this site to access current resources, learn about upcoming survivorship events, take part in chats and discussions and meet other survivors just like you. Below is this week's schedule of events. To use this site you need to register as a user and it is well worth your while to register. Ed.

Please join us this week on http://www.caringvoices.ca/

Managing Your Fatigue with Renewed Strength
This event is hosted by the General Cancer community.
Date/Time: January 06, 2009 at 8:00 PM EST Duration: 1hrs

-----------

Join Dee Miller, personal trainer and founder of Renewed Strength to discuss how strength and mobility training can help you manage some of the side effects of your cancer treatment. Renewed Strength is a non profit company dedicated to providing strength and mobility training to individuals that have recently gone through cancer treatments such as radiation, chemotherapy and surgery. Radiation Therapy: Your Questions, Before, During and After Treatment, Moderator: Dee Miller.

This event is hosted by the Breast Cancer community.
Date/Time: January 07, 2009 at 12:00 PM EST Duration: 1hrs

------------

Do you have questions relating to radiation therapy treatment for breast cancer? Or perhaps you would like to share your radiation therapy experience with other breast cancer survivors who are about to begin or have started their treatments? Please join this open chat about Radiation Therapy treatments for Breast Cancer with Shannon Pearson, Clinical Specialist Radiation Therapist.
Moderators: Shannon Pearson
And Looking Ahead . . . . . .Talking Sticks: Meet other Survivors Online

This event is hosted by the Breast Cancer community.
Date/Time: January 13, 2009 at 8:00 PM EST Duration: 1hrs

------------

Join this open chat for breast cancer survivors who have something they want to talk about or who just want to chat with others who understand their past, present or future experiences.
Moderators: Karen Portelli Spirituality and Cancer

This event is hosted by the General Cancer community.
Date/Time: January 14, 2009 at 12:00 PM EST Duration: 1hrs

---------------

"Spirituality is that part of each individual that longs for meaning, integrity, beauty, dignity, love, acceptance and hope." For many, a diagnosis of cancer brings these themes to the surface in a way they may not have been experienced before. Some have experienced attention to spirituality and it's many expressions to be a foundational resource to cope with life's challenges. You're welcome to join in a time of reflection and discussion regarding that which may have been a support or a challenge to you, personally, in the area of spirituality, and to learn from the experiences of others.

Moderators: Sharon Konyen
A special event in collaboration with Wellspring!Putting Yourself First

This event is hosted by the General Cancer community.
Date/Time: January 14, 2009 at 7:30 PM EST Duration: 1.5hrs.

---------------

With a cancer diagnosis, the need to put yourself first can be a change and a challenge. Join us to discuss various self-care strategies and how to cope with demands and expectations (including saying 'no') in order to create a space for healing. Moderator: Paula Servin, MSW, RSW.Presented on behalf of Wellspring Cancer Support Centres, http://www.wellspring.ca/

Moderators: Paula Servin
Talking Sticks: Open Chat for Survivors

This event is hosted by the Breast Cancer community.
Date/Time: January 16, 2009 at 12:00 PM EST Duration: 1hrs

My Journey -- Ken McClintock

2008-11-27T11:40:00.000-08:00

Hello everyone. I want to thank all of you who have been so thoughtful in answering my questions and providing your support. It really does help to know that others have dealt successfully with the same issues.

I moved to Singapore in 2006 to work on a project. I remained in good health and led an active lifestyle until early August of this year, when my journey began. I had become increasingly bothered over the previous eight months by a longstanding sciatica issue. My regular doctor suggested physio which I tried on a couple of occasions but was never convinced that it had any long term benefit. On the recommendation of someone in my office, I went to see a local Chinese doctor schooled in Traditional Chinese Medicine (TCM) and western medicine. He was supposed to be a bit of a miracle worker, and quite a character. A character indeed he was. He reminded me a bit of the nutty professor. His advice was to sit up straight, stand up straight, don’t drink tea or coffee, breath deeply……and get an MRI done!

He arranged for an MRI at a local hospital within the next week. What started off to be what I had thought was a routine MRI to identify which vertebrae was causing the sciatica issue, turned out to be a horrible shock. I was told that I had a tumour on my lumbar vertebrae! My vision of a long and happy retirement immediately vaporized!

Following consultation with my regular doctor, I was referred to an orthopaedic surgeon at the National University Hospital (NUH), a large teaching hospital here in Singapore. I was admitted to hospital the next day and underwent a series of tests.

Within the next week, I was redirected to a haematologist/oncologist, as the results of the blood work (and other factors) pointed to MM. Additional blood testing and a bone marrow biopsy confirmed the diagnosis (stage II MM) by the beginning of the next week, at which point I was started on my treatments. The entire process following the first “routine” MRI took two weeks! I was certainly grateful to have been able to get that level of care and service in such a short period of time. As it was, waiting to hear the outcome of the tests within those two weeks was difficult.

My treatments included Dexamethasone, Thalidomide and Velcade, with a host of other peripheral medications to address the side effects, as well as Pamidronate every five weeks. No action was taken related to the lesion on my vertebrae. The consensus was that it would heal itself. I ended up in hospital three times, twice for high fever (38.8 deg) and once for blood clots. Now, after three months of treatment, I am experiencing significant neuropathy.

The good news is that a recent Myeloma panel indicated that I have achieved nCR! Although I will continue with one more cycle of Velcade, my doctor has stopped the Thalidomide. Following my final Velcade cycle, I will also discontinue the dexamethasone. So I should have a good Christmas.

The medical attention I have received in Singapore has been wonderful. The facilities are modern, and the doctors (many trained in the West) and nurses are professional and up to date on latest treatments. Even the hospital food is good. I had three choices each from a Chinese, Western and Muslim menu, for each meal! To top all that, my doctor gave me his cell phone number and told me to call him anytime (24/7), even when he went on his vacation!

Based on my experience to date, I plan to have my stem cell transplant in Singapore. It is planned for February, with collection in January. Following recovery, I will move back to Halifax and enjoy life! I will keep you posted on the progress.

The Multiple Myeloma Handbook for Canadians

2008-11-27T03:33:00.000-08:00

The Multiple Myeloma Patient Handbook is available through Myeloma Atlantic FREE of charge and you are invited to request one by sending your request to myelomaatlantic@mailfire.ca.

Please include your name, full mailng address, telephone number. Right click the cover of the book above for a full view of the Handbook. Tell us what you think of the Handbook by making a comment. People tell me they love it.

Ken in Singapore

2008-11-14T03:28:00.000-08:00

Ken is a Canadian working and living in Singapore where he is undergoing treatment for multiple myeloma. I have asked Ken to stay in touch with us regarding his treatment and his needs. Here's what Ken had to say in a recent email:

Hi Frank

I will be pleased to provide input to the blog as requested. I might pass it by you first to get your feedback on it before posting. As a clarification, I wanted you to know that I did not travel to Singapore specifically to be treated for MM. I came here to work in 2006 and was diagnosed whilst I was here. I did, however, make the decision to remain here for treatment, instead of returning to Canada, which I will address in the writeup.

On another note, I am trying to get an indication of the impacts I can plan for following Stem Cell transplant. I believe I will be in the hospital for about 3 weeks then will be on watch for about 3 months. I then plan to return to Canada afterwards. But I would like to know if there will be a gradual recovery after leaving the hospital (ie…will I be able to golf, exercise, lead a pretty normal life) within one two or three months etc.

I don’t seem to be able to find anything on the websites to help. If you think I can get a response from the blog, I will post it there.

Thanks & Regards Ken

Here's what I wrote back to Ken:

Hi Ken,

I am so pleased to hear from you and that you will provide input; it will be helpful to others as well as yourself. The questions you have posed are great ones. I am told that golf for example is too hard on your bone structure, exercise is encouraged. If you have an lytic lesions those bone structures can be compromised going forward as in the case of my right arm which I lost the use of but which now is back but not as strong as before.

As regards recovery the best approach is not to expect too much from yourself, just ride with it. Your CBC blood counts will be important and at first you can expect to have them monitored daily. At first you will be very weak and you will hope to God that period will pass and it will. My transplant was done in January this year and since July I was back to work full time but I am not typical. You will learn there is nothing typical about MM every single one of us is different. Do you have a caregiver? If not get one as there will be times when you will not be able to think properly. Are you on your own, or is there some one with you, you can trust? This is important.

I need your mailing address I can send to you the Canadian Multiple Myeloma Patient Handbook if you do not have one already. I am sure you are familiar with the International Myeloma Foundation website: http://www.myeloma.org/. You no doubt have the Canadian counterpart Myeloma Canada: http://www.myelomacanada.ca/.

There’s a great site on what you can expect from the chemo impact on your body. One I know to be excellent is: http://www.chemocare.com/. Ken for side effects after transplant please review: http://www.cancerbackup.org.uk/Treatments/Stemcellbonemarrowtransplants/Sideeffects/Sideeffects.

If you are going to be using Neupogen in the collection stage you might want to know about it, here’s a site that might help:

http://chealth.canoe.ca/drug_info_details.asp?channel_id=0&relation_id=0&brand_name_id=3490&page_no=2#AdverseEffects.

Start with this and if I can help in any other way I will. Regarding your postings, send them to me by email and I will post them for you in your own words in a full page or pages. Members have expressed concern to me about you being away from home and they want to help. Some may have emailed you already, I hope you don’t mind they want to follow your treatment to make sure you are safe and they also will lend assistance where they think they can. They need to know what’s happening with you, so keep your postings coming.

Whenever you are ready I’ll post your comments, observation and plot the course of your recovery and I know they will post thoughts and considerations to help you or they will email you directly. I hope this is helpful.

All the Best,

Frank

If anyone has further suggestions for Ken please post as a comment below or email them to me and I will post your comments or suggestions on a page.

Approach to Multiple Myeloma - The Canadian Perspective

2008-11-10T02:12:00.000-08:00

Dr. Donna E. Reece,

Princess Margaret Hospital, Toronto, Canada

Every year, about 2,000 Canadians are diagnosed with multiple myeloma (4 per every 100,000 people). So we estimated that in any year, about 6,500 people are living with this disease. The median age of multiple myeloma patients is about 65 years, although its incidence in younger adults appears to be increasing.

There are a number of factors which determine which drugs are available in Canada for treating multiple myeloma. First, to be used in Canada, the drug must be approved by Health Canada as safe and effective. Second, in order that people can access the medication, there must be funding by the provincial health insurance programs. Myeloma drugs currently approved for use in Canada include melphalan, cyclophosphamide, bisphosphonates (pamidronate, zoledronic acid and clodronate), Velcade (bortezomib) for front-line combination therapy or second-line therapy and lenalidomide (Revlimid). Thalidomide can be obtained through special access programs.

Traditionally, initial therapy for multiple myeloma has been to decide between autologous stem cell transplant (ASCT) or melphalan and prednisone. Editor note: See Table summary above (Right Click Image above to Enlarge) The paper was presented at the Ortho Biotech Multiple Myeloma Patient Advisory Board Conference at the past weekend in Toronto, Ontario. Address your congratulations to: the Manager National Community Relations: Ms. Sue Robson, R.N. at mailto:asrobson@obica.jnj.com

ASCT Eligible Patients:

New approaches before ASCT are being investigated to see if achieving high rates of CR/nCR or VGPR (very good partial response) prior to transplant will improve outcomes. Multiple induction regimens containing novel agents are being tested. Canadian trials include DBd (Doxil + Velcade + dexamethasone) and CYBORD-D (cyclophosphamide + Velcade + dexamethasone).

Studies are also under way looking at the best way to treat patients with specific genetic mutations. The translocation t(4;14) mutation, in which parts of chromosomes 4 and 14 incorrectly attach to one another, occurs in 15% of myeloma patients, frequently among younger individuals with the IgA lambda subtype. It is often associated with another genetic mutation (13q deletion). When this mutation is present, although the myeloma may respond well to therapy it also relapses quickly, which makes it an aggressive disease to treat. In cases of relapse, the disease appears to respond better to either bortezomib or lenalidomide. For this reason, a trial is currently underway among newly-diagnosed myeloma patients that involves induction therapy with bortezomib, doxorubicin and dexamethasone for 4 cycles, followed by CYBOR-P for 8 cycles and dexamethasone maintenance therapy. ASCT is not performed as part of initial therapy in this trial, due to the strong activity of Velcade in this subtype of myeloma. Another mutation that is currently being studied is TP53, in which a copy of a tumour suppressor gene is missing. TP53 deletion occurs in a number of forms of cancer, including myeloma.

"Transplant Uncertain" Patients"

A number of trials are looking at induction therapy in "transplant uncertain" patients. This approach most commonly has used continuous suppression with immunomodulatory agents (IMiDs, such as thalidomide or lenalidomide) and dexamethasone. The ECOG trial used thalidomide and dexamethasone; the overall response rate was 63% with a CR rate of 8% and the median time to progression was 22 months. The ECOG E4A03 study compared Revlimid and either high or low doses of dexamethasone. Although the overall response rate was better in the higher-dose dexamethasone group (82% vs. 71 %), there were also more early deaths. The optimal dose of dexamethasone, therefore, remains uncertain although we know that continuous full dose appears detrimental. In a small subset of patients in the ECOG E4A03 trial who subsequent underwent ASCT, results were similar between the two groups. However, it must be kept in mind that the comparison between Revlimid plus dexamethasone and ASCT was not studied in a randomized fashion.

Another approach for "transplant uncertain" patients has been the use of 6-8 cycles of combination regimens that usually contain chemotherapy drugs with novel agents such as thalidomide, velcade and/or Revlimid, followed by a treatment break. This approach has not been as well-studied, and the results compared to ASCT are unknown at present.

Melphalan-based Approaches

A number of studies have combined traditional melphalan + prednisone (MP) therapy with other agents. Three, including the IFM 99-06 trial, found that in elderly patients adding thalidomide makes the therapy more effective. In another trial, it was found that adding Velcade also increased the effectiveness of therapy, compared to MP alone. However, adding thalidomide or Velcade also increases toxicities or side-effects, such as low white blood counts, blood clots or peripheral neuropathy.

At this point, it's not known whether adding a novel agent (such as thalidomide or Velcade) is as effective as when you give it during initial therapy or later, after relapse. More evidence is needed on how to proceed with high-risk patients, such as those with specific genetic mutations. Recent Canadian trials include the NCIC MY 11
study, an Ortho Biotech trial of melphalan, prednisone and Velcade (bortezomib) and the Celgene MM020 international trial (comparing three regimens: lenalidomide + weekly dexamethasone until progression, lenalidomide + weekly dexamethasone for 18 months, vs. MP + thalidomide).

Summary:

New agents and combinations are becoming available for all age groups and are contributing to better survival for myeloma patients. The optimal approach for induction and disease progression has yet to be defined, however. We suspect that different approaches may be needed for different patient groups (e.g., those with and without specific genetic mutations). Research is trying to match the best therapy with the different disease sub-types. Funding limitations remain a problem; access programs and clinical trials are means by which patients may obtain new medications before public funding is provided.

Barbara Hammack Survivor Story I'M A SURVIVOR!

2008-10-24T21:50:00.000-07:00

Editor's note: I have exchanged emails with Barbara, who has agreed to allow Myeloma Atlantic to re-produce her heroic story and Barbara also promises an update on her battle with Multiple Myeloma, one with which we are all too familiar. Therefore, dear readers, expect more from Barbara.

Barbara Hammack
August 2007

Whenever I am privileged to speak to a newly-diagnosed myeloma patient, I always start by saying, "I was diagnosed in 1991." Once they quit gasping, I know I have already given them they hope they need.

Nothing can prepare someone for learning they have an incurable disease, much less one that they had never even heard of. I was first told that I had a "suspicious" high protein level in July 1991. My internist had been following this level since I had become his patient in 1987 (my previous doctor never included protein levels in his blood work for me). Then I heard "smoldering multiple myeloma" for the first time as a "possible" diagnosis. I really didn't understand much then, but the only literature available back in those "dark ages" said that I had a 1 - 3 year survival chance. This was totally unacceptable to me, since I was only 45 and was a single parent to two children. So, in February of 1994 when the myeloma reached a point when it needed to be treated, I knew I was in for the fight of my life.

In 1994, the only chemotherapy regime was melphalan and prednisone. Once that worked, my oncologist said that the only hope for a longer survival would come from a bone marrow transplant, still considered "experimental" by many people, including insurance companies. So I fought my insurer and won THAT battle. When I entered Georgetown University Hospital in Washington DC in November 1994, they advised that I also do a very new component: have my stem cells transplanted as well as my bone marrow. Now, in hindsight, I was truly a pioneer for one of the biggest tools today in the myeloma arsenal. But then, all I cared about was winning my own battle.

Which, at least as of now, I am continuing the good fight. It's been the typical roller coaster that many people use to characterize their experiences with myeloma. My transplant kept me out of trouble until 2001, when I began taking thalidomide. After eight months, my disease was under control, and since I'd started to have some very minor neuropathy, I stopped taking it. Then in September 2003, with some indication of disease progression, I went on a new protocol using melphalan, arsenic trioxide, and ascorbic acid (MAC). Again, this worked quite well and I stopped this combination in June 2004. But, as always is the case with myeloma, I again needed treatment and began taking revlimid/dexamethasone in October 2005.

Up and down; down and up. Revlimid was discontinued in June of 2006, and I went coasting along, with no treatment other than monthly aredia, until just recently. Though my M-spike and IgG are relatively low, these counts have been steadily progressing for several months. My oncologist's strategy with me is to always keep me out of danger, so I will start taking just Revlimid in the next few weeks. He and I agree that this should be the most benign of the plethora of treatment options; knowing that there are so many more tricks to pull of out that great myeloma hat as I need them.

In fact, I'd say that the biggest thing I've been able to appreciate over the years is how much the treatment of myeloma has changed from my first encounter some 16 years ago. My oncologist told me several years ago that every six months of life buys a new treatment, and he is pretty much on target. I've watched that "1 - 3 year survivable" rate extend to the point where NO ONE knows how long myeloma patients will live because we are all just starting to live longer and longer. To look at the "end point" is having tunnel vision, and wasting energy that could be used to, well, just get about one's life.

Of course, life with myeloma isn't the same as life before we ever heard those words. But then again, life is constantly changing, and we are always in flux as we adjust to having a baby, having an empty nest, having a job promotion, deciding to retire...you know, all that "normal" stuff. I've learned not to get too far ahead of myself, and to try to remember what TODAY'S problems are, rather than playing the "what if" game. Life does indeed go on...the sun still comes up every day, whether we have myeloma or not. On the mornings when I decide that I might as well get up (is there a choice??) I can usually find something that makes that day worthwhile.

We CAN survive myeloma; some of us for a very long time. I'm all for living with myeloma instead of dying from it. I truly don't know what else to do.

Copyright 2007
BCH

Copyright © 2008 Galen Foundation
Web Design and Hosting by proVanceTek LLC

Phase 2 Study of Patients with Multiple Myeloma

2008-10-23T16:34:00.000-07:00

Celgene Corporation and Acceleron Pharma Initiate Phase 2 Study of ACE-011 in Patients with Multiple Myeloma

CAMBRIDGE, Mass. – October 16, 2008 – Celgene Corporation (NASDAQ:CELG) and Acceleron Pharma, Inc., a biopharmaceutical company developing novel therapeutics that modulate the growth of tissues including bone and muscle, today announced the initiation of a Phase 2 clinical study of its lead compound ACE-011 in patients with multiple myeloma. ACE-011 is being developed to treat bone loss associated with multiple myeloma and other cancers. The clinical study is designed to assess the safety and efficacy of ACE-011 in multiple myeloma patients with osteolytic bone lesions. Celgene Corporation will make a $5 million milestone payment to Acceleron in accordance with the terms of the collaboration agreement between the two companies.

“We are excited to begin the first ACE-011 Phase 2 study in multiple myeloma patients suffering from cancer-related bone loss,” said Matthew Sherman, M.D., Chief Medical Officer of Acceleron. “We have encouraging results from Phase 1 studies with ACE-011, and believe that it holds promise as a novel bone-forming agent to treat the serious and debilitating effects of bone loss resulting from progression of tumors in myeloma or other cancers. Acceleron plans to present results from the Phase 1 studies at scientific and medical conferences later this year.”

The Phase 2, multi-center, randomized, double-blind, placebo-controlled study is designed to assess the safety and efficacy of multiple doses of ACE-011 in multiple myeloma patients with osteolytic bone lesions. The study will be a multi-center trial conducted in Russia and patients will be treated with standardized anti-myeloma therapy consisting of melphalan, prednisone and thalidomide and randomized to receive either monthly doses of ACE-011 or placebo for up to three months. This study is funded in part by a grant from the Multiple Myeloma Research Foundation.

About ACE-011

ACE-011, a soluble form of the activin receptor type IIA (ActRIIA), is a biologic therapeutic that inhibits signaling through the ActRIIA receptor. By blocking signaling though ActRIIA, ACE-011 stimulates bone formation. In numerous animal models of diseases involving bone loss, ACE-011 significantly increased bone mineral density, improved bone architecture, increased bone formation rate and bone mechanical strength. In Phase 1 clinical studies in healthy volunteers, ACE-011 had an encouraging safety profile, increased biomarkers of bone formation and increased bone mineral density. ACE-011 is being jointly developed by Acceleron and Celgene Corporation for the treatment of cancer-related bone loss.

About Multiple Myeloma and Metastatic Bone Disease

Multiple myeloma is a cancer of the blood in which malignant plasma cells are overproduced in the bone marrow. When functioning normally, plasma cells are part of the immune system that helps fight infection and disease. In multiple myeloma, the malignant plasma cells form tumors that affect the function of the bone marrow and cause damage to the surrounding bone. This bone damage leads to severe bone pain and fractures of the bone which are disabling and often require surgery or radiation therapy.

Metastatic bone disease is a serious complication that develops when solid tumors metastasize, or spread, from the originally affected organ to bone. These tumors secrete factors in the bone allowing tumor proliferation and causing debilitating bone lesions. Many patients with breast or lung cancer will have tumors that metastasize to the bone and these patients will suffer from severe bone pain and fractures.

About Celgene/Acceleron Collaboration

On February 20, 2008, under the terms of the agreement, Celgene and Acceleron announced that they will jointly develop, manufacture and commercialize Acceleron’s products for bone loss. Celgene made an upfront payment to Acceleron of $50 million, which included a $5 million equity investment in Acceleron. In addition, in the event of an initial public offering of Acceleron, Celgene will purchase a minimum of $7 million of Acceleron common stock.

Acceleron is responsible for initial activities including research and development through the end of Phase 2a clinical trials as well as manufacturing the clinical supplies for these studies. In turn, Celgene will conduct the Phase 2b and Phase 3 clinical studies and will oversee the manufacture of Phase 3 and commercial supplies. Acceleron will pay a share of the development expenses and is eligible to receive development, regulatory and commercial milestones of up to $510 million for the ACE-011 program and up to an additional $437 million for each of the three discovery stage programs. Both companies will co-promote the products in North America. Acceleron will receive tiered royalties on worldwide net sales.

About Celgene

Celgene Corporation, based in Summit, New Jersey, is an integrated global biopharmaceutical company engaged primarily in the discovery, development and commercialization of novel therapies for the treatment of cancer and inflammatory diseases through gene and protein regulation. For more information, please visit the Company's website at www.celgene.com.

About Acceleron

Acceleron is a privately held biopharmaceutical company committed to discover, develop, manufacture and commercialize novel biotherapeutics that modulate the growth of bone, muscle, fat and the vasculature to treat musculoskeletal, metabolic and cancer-related diseases. Acceleron’s scientific approach takes advantage of its unique insight into the regenerative powers of the Growth and Differentiation Factor (GDF) family of proteins. ACE-011, a novel bone forming agent, is the Company’s lead program and is being developed to reverse bone loss in diseases such as cancer-related bone loss. In addition, the company is advancing through preclinical development product candidates that increase muscle mass, control angiogenesis and inhibit fat accumulation. Acceleron utilizes proven biotherapeutic technologies and capitalizes on the company’s internal GMP manufacturing capability to rapidly and efficiently advance its therapeutic programs. The investors in Acceleron are Advanced Technology Ventures, Bessemer Ventures, Flagship Ventures, MPM BioEquities, OrbiMed Advisors, Polaris Ventures, QVT Financial, Sutter Hill Ventures and Venrock. For more information, visit www.acceleronpharma.com.

CONTACT:

Acceleron Pharma:

Steven Ertel, 617-649-9234 Paul Kidwell (Media)

Vice President, Corporate Development Suda Communications LLC, tel: 617-296-3854

Celgene Corporation:

Greg Geissman, 908-673-9854

Associate Director, Public Relations

NEW ORAL THERAPY FOR blood cancer approved in Canada

2008-10-23T03:25:00.000-07:00

Unprecedented Overall Survival Data for Revlimid® gives Renewed Hope to Multiple Myeloma
Patients with Advanced Disease

OAKVILLE, ON – (October 6, 2008) – Health Canada has approved Revlimid® (lenalidomide), a new treatment with proven ability to increase overall survival and slow disease progression, in combination with dexamethasone, for the treatment of multiple myeloma patients who have received at least one therapy. Prior to approval, there were few effective, once-daily oral treatment options available for patients with this aggressive blood cancer.

"The clinical data shows that patients treated with Revlimid and dexamethasone have superior response rates and for a longer duration, experience slower progression of disease, and survive longer than we have ever seen before,” said Dr. Darrell White, Hematologist, Nova Scotia Cancer Centre, Dalhousie University. “This Health Canada approval means that we can now treat many more patients with this incurable form of cancer.”

Multiple myeloma (MM) is a rare, progressive and fatal blood cancer with significant morbidity and mortality [i]. Incidence increases with age and median age at diagnosis is between 63 and 70 years of age. Of the estimated 6000 Canadians suffering with the disease, approximately 1000 will die this year and 2000 new patients will be diagnosed at treatment centres across Canada.

“There is no cure for multiple myeloma, but new oral cancer therapies, like Revlimid, are a step towards changing multiple myeloma into a manageable chronic disease and thus improving patient quality of life,” said Dr. White.

“Revlimid, a once-daily pill, is the only treatment that was able to control my cancer after many attempts, including bone marrow transplants,” said Derek Hunter, a multiple myeloma patient from Saint John, New Brunswick who was diagnosed in 2003. “My greatest hope is that other patients will be given the same chance at life by having access to this great treatment.”

The Health Canada approval was based on the results of two Phase III clinical trials, published in the New England Journal of Medicine, evaluating Revlimid with dexamethasone in previously treated multiple myeloma patients which showed an increased overall survival rate and slowed disease progression[ii]. Revlimid will be available in 15 mg and 25 mg oral capsules for the treatment of multiple myeloma after one prior therapy.

About REVLIMID®

REVLIMID is an IMiDs® compound, a member of a proprietary group of novel immunomodulatory agents. REVLIMID and other IMiDs compounds continue to be evaluated in over 100 clinical trials in a broad range of hematological and oncological conditions. The IMiDs pipeline is covered by a comprehensive intellectual property estate of issued and pending patent applications in the US, EU and other regions, including composition-of-matter and use patents.
About Multiple Myeloma
Multiple myeloma is the second most common blood cancer and represents approximately 1% of all cancers and 2% of all cancer deaths. The Canadian Cancer Society reports that there are about 6000 Canadians living with multiple myeloma, and approximately 2000 new cases are diagnosed each year.[iii]

Multiple myeloma (also known as myeloma or plasma cell myeloma) is a cancer of the blood in which malignant plasma cells are overproduced in the bone marrow. Plasma cells are white blood cells that help produce antibodies called immunoglobulins that fight infection and disease. However, most patients with multiple myeloma have cells that produce a form of immunoglobulin called paraprotein (or M protein) that does not benefit the body. In addition, the malignant plasma cells replace normal plasma cells and other white blood cells important to the immune system. Multiple myeloma cells can also attach to other tissues of the body, such as bone, and produce tumors. The cause of the disease remains unknown.

About Celgene

Celgene Corporation is an integrated global biopharmaceutical company engaged primarily in the discovery, development and commercialization of novel therapies for the treatment of cancer and inflammatory diseases through gene and protein regulation. For more information, please visit the Company's website at http://www.celgene.com/. Revlimid is a registered trademark of Celgene Corporation.

Revlimid® was granted the Prix Galien USA 2008 Award for Special Therapeutic Development on September 24, 2008. The Prix Galien Award recognizes the technical, scientific and clinical research skills necessary to develop innovative medicines and is considered to be the highest accolade for pharmaceutical research and development.

-30-

[i] Canadian Cancer Society/National Cancer Institute of Canada. Canadian Cancer Statistics 2008. Accessed October 1, 2008 at http://www.ncic.cancer.ca/vgn/images/portal/cit_86751114/14/35/195991821ncic_stats2004_en.pdf
[ii] New England Journal of Medicine, November 22, 2007
[iii] Canadian Cancer Society. Canadian Cancer Statistics 2008. http://www.cancer.ca/

Media Contacts:
Tara Knight / Celeste Brown
Hill & Knowlton Canada
(416) 413-4774 / (416) 413-4651
Tara.knight@hillandknowlton.ca / Celeste.brown@hillandknowlton.ca

MYELOMA CANADA ENDORSES HEALTH CANADA’S APPROVAL OF REVLIMID Revlimid signals new hope for Canadians with bone marrow cancer

Today marked a major step forward for the Canadian myeloma community with Health Canada’s approval of Revlimid in combination with dexamethasone for the treatment of multiple myeloma patients with relapsed or refractory disease.Myeloma Canada issued the following press release endorsing this long-anticipated decision by Health Canada. Attached is the press release issued by Celgene, the manufacturer of Revlimid.Myeloma Canada will continue to monitor further developments as Revlimid makes it way through the Joint Oncology Drug Review (JODR) process. For information on JODR, please click on the following link:http://www.myelomacanada.ca/en/joint_oncology_drug_review.asp

MONTREAL, QC – (October 6, 2008) – Myeloma Canada endorses Health Canada’s decision to approve Revlimid® (lenalidomide), a new treatment for multiple myeloma, clearly demonstrating their commitment to fighting this incurable form of cancer. Revlimid is an oral medication that has demonstrated an ability to extend overall survival of multiple myeloma patients and slow the progression of the disease for patients who have failed other treatments.

“Health Canada’s approval of Revlimid is welcome news for Canadians living with multiple myeloma,” says Myeloma Canada President John Lemieux. “Scientific advances in treatments of blood disorders are helping patients live much longer and have a better quality of life. We are extremely pleased to hear about this approval as it supports doctors in providing the best possible care to all patients.”

About Multiple Myeloma

Multiple myeloma, a cancer of the plasma cell, is an incurable but treatable disease. The cancer starts in plasma cells, which are made in the bone marrow, and develop into antibodies that help fight infections. In myeloma, abnormal plasma cells, called myeloma cells, grow uncontrollably, crowding out the normal blood cells in the bone. This can bring symptoms such as fatigue, recurrent infections and pain resulting from bone fractures, which disturb the body’s balance of minerals and prevent other organs, such as the kidney and nerves, from working properly. In Canada, approximately 2,000 people are diagnosed with multiple myeloma every year.

Myeloma Canada

Myeloma Canada is a non-profit organization, with registered charity status dedicated to supporting people living with multiple myeloma and is the only national organization exclusively devoted to the Canadian myeloma community. The mission of Myeloma Canada is to: provide educational resources and support to patients, families, and caregivers; increase awareness of the disease; and promote improved access to new therapies, treatment options, and health care resources. Myeloma Canada works with regional support groups and key myeloma experts to strengthen the voice of the Canadian myeloma community. Myeloma Canada works in close affiliation with the International Myeloma Foundation, the world’s oldest and largest myeloma organization. For more information or to find out how you can help please visit our website at http://www.myelomacanada.ca/.

Canada / Myélome Canada

Uniquely devoted to Canada's myeloma communityExclusivement au service de la communauté canadienne du myélome

Mailing Address/Adresse postale:

PO Box / CP 326

Kirkland, QC,

H9H 0A4

(514) 570-9769

Email/Courriel: info@myelomacanada.ca

Web: www.myelomacanada.ca