Treatment for Multiple Myeloma

Multiple myeloma has long been considered an incurable but manageable cancer.

In recent years, researchers have had some notable successes in developing new treatments. People with multiple myeloma now have options that can reduce symptoms, slow disease progression, provide prolonged remissions, and improve life expectancy and quality.

But there is much more work to be done. While patients with multiple myeloma are living longer than they did two decades ago — in some cases, dramatically longer — the median life expectancy after diagnosis is about five years. 

Who Should Be Treated and Who Shouldn’t

With most cancers, the general rule for treatment is “the sooner, the better.” But with multiple myeloma, physicians generally don’t treat early or asymptomatic cancer. This condition is called smoldering multiple myeloma (SMM).

Of people with SMM, about 10 percent per year go on to develop multiple myeloma within five years of diagnosis. Some physicians have historically taken a “wait and watch” approach to symptoms rather than to immediately prescribe medication that can cause side effects.

Clinical trials are underway to see if treatment can improve outcomes for SMM patients at greater risk of progression to “active” myeloma.  

Drug Therapies for Treating Multiple Myeloma

Drug therapy is a cornerstone of myeloma treatment.

Physicians generally treat patients with one, two, or three drugs simultaneously. Some patients in intensive programs may be taking as many as six different drugs.

These may be administered orally, by injection, or through a catheter surgically placed in a vein.

Drug therapy has helped some patients achieve long-term remission, and has significantly slowed the progression of the disease in others. A small subset of patients may have such an extended remission that they are considered “functionally” cured.  

Key medication strategies include:

Chemotherapy Chemo drugs destroy cancer cells, typically by preventing them from growing and dividing. These medicines include:

  • Cyclophosphamide (Cytoxan, Neosar)
  • Doxorubicin (Adriamycin, Doxil)
  • Melphalan (Alkeran)
  • Etoposide (Toposar, VePesid)
  • Cisplatin (Platinol)
  • Carmustine (BiCNU)

Chemotherapy is often one part of a regimen that includes other categories of drugs.

Targeted Therapy This type of medication homes in on specific genes or proteins in the cancer or in the tissues around it that help malignant cells survive. Targeted drugs block the growth and spread of cancer cells while limiting damage to healthy cells (an issue with chemotherapy drugs).

Medicines include:

  • Proteasome Inhibitors Drugs such as bortezomib (Velcade), carfilzomib (Kyprolis), and ixazomib (Ninlaro) target specific enzymes in myeloma cells called proteasomes that digest proteins in the cells.
  • HDAC Inhibitors The drug panobinostat (Farydak) is an inhibitor of the enzyme histone deacetylase (HDAC). Panobinostat helps uncoil the DNA in myeloma cells and also activates genes that stop or slow cancer-cell growth.
  • Monoclonal Antibodies Elotuzumab (Empliciti) and daratumumab (Darzalex) bind to myeloma cells and mobilize the person’s own immune system to attack. These drugs also kill myeloma cells directly.
  • Immunomodulating Agents These drugs have been proven to be effective against multiple myeloma by stimulating the immune system. Thalidomide (Thalomid), lenalidomide (Revlimid), and bortezomib are approved to treat newly diagnosed patients. Lenalidomide, pomalidomide (Pomalyst), bortezomib, carfilzomib, panobinostat, ixazomib, elotuzumab, and daratumumab treat recurrent myeloma.

Other Drug Therapies Patients with multiple myeloma are often treated with steroids, such as prednisone or dexamethasone, either alone or in combination therapy. Steroids can both fight inflammation and kill myeloma cells.

Other medication can help prevent the bone damage caused by multiple myeloma from worsening. These drugs include bisphosphonates like pamidronate (Aredia), zoledronic acid (Zometa), and a monoclonal antibody called denosumab (Xgeva).

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Can the Gastric Bypass ALTERNATIVE regimen cure diabetes 2 & obesity?

Tina Simpson feels "cured" from diabetes type 2  & obesity using Don Karl Juravin's Gastric Bypass NO surgeryTina Simpson feels “cured” from diabetes type 2 & obesity using Don Karl Juravin’s Gastric Bypass NO surgery

Has Don Karl Juravin, not a doctor, invented a “cure” or a method to reverse diabetes type 2? Tina Simpson lost 92 lbs and lowered A1c from 10.3 to 5.7

The Gastric Bypass ALTERNATIVE changes my health, my life and my love life. Super thrilled to announce my graduation from Ugly Fat Club!”

— Tina Simpson

COMAL, TEXAS, UNITED STATES, February 15, 2018 / — Has Don Karl Juravin, not a doctor, invented a “cure” or a method to reverse diabetes type 2?

Ten years ago, Juravin invented the Gastric Bypass ALTERNATIVE, a regimen claiming to be “cheaper, safer and better than any bariatric surgery.”

Tina Simpson (51, TX) was 232 lbs, overweight by 92 lbs, with diabetes type 2 for 31 years. Tina’s A1c level was high and uncontrolled 10.3 despite taking four medications a day: Metformin 1000 mg twice daily, Glipizide 10 mg twice daily, Actos 45 mg once daily, and Januvia 50 mg daily. She also suffered from hypertension (Losartan 25 mg daily), high cholesterol (Tricor 145 mg daily) and hidradenitis.

Tina started using Gastric Bypass ALTERNATIVE on March 31, 2017 at 232 lbs and after losing her first 20 lbs on the regimen, she felt she no longer needed Januvia for her diabetes. Within six weeks she stopped taking the Tricor for cholesterol. At three months, Tina stopped taking any of the diabetes or hypertension medications as her A1c levels stabilized at 5.7 (normal) down from high 10.3. She lost 92 lbs in 6 months and achieved a healthy weight of 140 lbs, for which she received the 100% money back from Juravin.

So has Don Karl Juravin really invented a cure for obesity? for diabetes type 2? Tina Simpson may feel so and many of the 40,000 members in the Gastric Bypass ALTERNATIVE Facebook group

Diabetes type 2 care be reversed and not necessarily “cured”, states Don Karl Juravin, the inventor

12 Subtle Lupus Symptoms That Are Easy To Miss

Lupus can be tough to diagnose. If you notice a combination of these symptoms, ask your doctor if you could have the disease.

In 2015, when actress and singer Selena Gomez shared that she was battling lupus, it shed light on a commonly misunderstood chronic autoimmune disease. Two years later, the conversation around the disease continued after she shared she shared on Instagram that she had to undergo a kidney transplant due to lupus complications. But what exactly is lupus? And how can you tell if you have it?

Lupus, short for systemic lupus erythematosus, affects an estimated 1.5 million Americans, according to The Lupus Foundation of America, and it occurs when something goes wrong with the immune system. Normally the immune system produces antibodies that protect us from viruses and bacteria. But when you have lupus, the immune system can no longer decipher harmful germs from healthy tissue. In turn, it creates a protein that causes inflammation and pain, and damages healthy tissue including the skin, joints, heart, lungs, and in Gomez’s case, the kidneys.

Lupus affects an estimated 1.5 million Americans

Despite the fact that it can wreak so much havoc on the body, lupus isn’t easy to diagnose, partly because it’s rare that two patients experience the exact same symptoms. “We always say lupus patients are like snowflakes: No two are alike,” says Susan Manzi, MD, director of the Lupus Center of Excellence at Pittsburgh’s Allegheny Health Network, and medical director of the Lupus Foundation of America.

Additionally, the symptoms often masquerade as other illnesses. It’s not uncommon for people to seek medical assistance for something else only to eventually learn they have lupus. “People come in, and they say, ‘You know, I think I must have Lyme disease,’ or ‘I think I must have arthritis,’” because they’re tired and their joints hurt, says Robert Goldfien, MD, a rheumatologist with Kaiser Permanente in Richmond, California. On the flip side, some doctors don’t think about lupus when they see patients with common symptoms like joint pain and fatigue, Dr. Manzi says.

This means getting diagnosed may take a bit of effort and persistence on your end. Never be afraid to ask your doctor “Could it be lupus?”—especially if you’ve noticed a combination of these lupus symptoms. While there’s no cure for lupus, it’s can be managed with a combination of medications and lifestyle changes.

butterfly rash lupus
A butterfly-shaped rash that appears on both cheeks and across the bridge of the nose is highly suggestive of lupus.

You notice a butterfly-shaped rash on your face

If lupus has a calling card, it’s a sunburn-like rash that stretches across the nose and cheeks, in a shape resembling a butterfly. Its unique appearance is “highly suggestive” of lupus, Dr. Goldfien says. About 30 percent of patients with lupus get this rash, researchers say.

You have a fever that just won’t go away

Fever can be a sign of inflammation, and some patients may be feverish during a lupus flareup. While having a fever isn’t unique to lupus, if you have a fever that you just can’t shake or it keeps returning, it’s best to see a doctor—especially if you’ve noticed any of the other signs of the disease.

You get rashes or sores on your skin after going outside

Very often, people with lupus are photosensitive, meaning their skin is very sensitive to ultraviolet light. Breakouts typically occur on sun-exposed areas of the body, including the face, neckline, and arms. UV light exposure can also set off lupus symptoms or trigger a flare-up of the disease.

Dr. Manzi cautions her college-aged lupus patients who hit the tropics for spring break to slather on the sunscreen before heading outdoors. “They get intense sun exposure, they get a rash, they come home, the rash doesn’t go away, and then boom, boom, boom, all these other things start happening.”

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13 Foods That Cause Bloating (and What to Eat Instead)

Bloating is when your belly feels swollen or enlarged after eating.It is usually caused by gas or other digestive issues (1).

Bloating is very common. About 16–30% of people say they experience it regularly (2, 3).

Although bloating may be a symptom of a serious medical condition, it is usually caused by something in the diet (4).

Here are 13 foods that can cause bloating, along with suggestions on what to eat instead.

(People often confuse “bloating” with “water retention,” which involves increased amounts of fluid in the body.

1. Beans

Foods That Cause Bloating
Beans are a type of legume.

They contain high amounts of protein and healthy carbs. Beans are also very rich in fiber, as well as several vitamins and minerals ( 5).

However, most beans contain sugars called alpha-galactosides, which belong to a group of carbs called FODMAPs.

FODMAPs (fermentable oligo-, di-, mono-saccharides and polyols) are short-chain carbohydrates that escape digestion and are then fermented by gut bacteria in the colon. Gas is a byproduct of this process.

For healthy people, FODMAPs simply provide fuel for the beneficial digestive bacteria and should not cause any problems.

However, for individuals with irritable bowel syndrome, another type of gas is formed during the fermentation process. This may cause major discomfort, with symptoms like bloating, flatulence, cramping and diarrhea (6).

Soaking and sprouting the beans is a good way to reduce the FODMAPs in beans. Changing the soaking water several times can also help (7).

What to eat instead: Some beans are easier on the digestive system. Pinto beans and black beans may be more digestible, especially after soaking.

You can also replace beans with grains, meat or quinoa.

2. Lentils

Lentils are also legumes. They contain high amounts of protein, fiber and healthy carbs, as well as minerals such as iron, copper and manganese.

Because of their high fiber content, they can cause bloating in sensitive individuals. This is especially true for people who are not used to eating a lot of fiber.

Like beans, lentils also contain FODMAPs. These sugars may contribute to excessive gas production and bloating.

However, soaking or spouting the lentils before you eat them can make them much easier on the digestive system.

What to eat instead: Light colored lentils are generally lower in fiber than darker ones, and may therefore cause less bloating.

3. Carbonated Drinks

Improve your ankylosing spondylitis with these 8 diet tips and 14 exercises.

Ankylosing spondylitis (AS) can be improved with a healthy body weight and exercise. Ankylosing spondylitis is a type of inflammatory arthritis that mainly affects the spine and can lead to pain, fatigue, and stiffness. But research has shown regular exercise can help improve it.

The American College of Rheumatology (ACR) outlined recommendations for patients with ankylosing spondylitis. Principal investigator Michael Ward said “The ACR’s primary objective was to provide recommendations on optimal treatment for patients with AS and non-radiographic axial SpA [spondyloarthritis] that were based on quality evidence and took into consideration patient values and preferences. While the guideline does not cover all aspects of spondyloarthritis management, it provides a foundation based on the current best-available evidence.”

The guidelines not only discuss the broad spectrum of ankylosing spondylitis treatments. The investigators also included the Grading of Recommendations Assessment, Development, and Evaluation approach (called GRADE), which provides specifications for different patient groups, interventions, competing treatment alternatives and outcomes, grading the quality of evidence used, and basing recommendations on benefits and harm.

Recommendations are placed into one of six categories: recommendations for the treatment of patients with active AS (pharmacologic and rehabilitation), recommendations for the treatment of patients with stable AS (pharmacologic and rehabilitation), recommendations for the treatment of patients with either active or stable AS, recommendations for the treatment of patients with AS and specific impairments or comorbidities (such as advanced hip arthritis, severe kyphosis, acute iritis, and inflammatory bowel disease), education and preventive care recommendations; and recommendations for the treatment of patients with non-radiographic axial SpA.

Each category contains recommendations regarding pharmaceutical and non-pharmaceutical interventions followed by supporting evidence.

Treating AS Naturally: Ankylosing spondylitis diet tips

Following a healthy diet has been proven to help relieve symptoms associated with ankylosing spondylitis. Here are the foods most beneficial for those with ankylosing spondylitis—and foods that you should avoid in your healthy diet.

Foods rich in omega-3: These include chia seeds, fatty fish (sardines, salmon, and tuna), flaxseeds, and walnuts. A study found that omega-3 supplements reduced disease activity of ankylosing spondylitis in that it could help provide a modest effect on joint pain and inflammation.

Fruits and vegetables: Contains many of the vitamins and minerals necessary for overall health and well-being, they are also low in calories and high in fiber. The National Ankylosing Spondylitis Society (NASS) in the United Kingdom recommend eating fruits and vegetables of all different colors, as they contain many antioxidant compounds that help to protect against the disease.

Eat whole grains: These include brown rice, corn, quinoa, buckwheat, and oatmeal. Known for being high in fiber and nutrients, whole grains may aid in the reduction of inflammation. However, those with gluten sensitivity or intolerance may have triggered symptoms when consuming whole grains. It is advised to speak to a doctor before incorporating whole grains into your diet.

Eat calcium rich foods: Helps to strengthen weak bones, of which ankylosing spondylitis is known to cause. Foods high in calcium include dark leafy greens such as watercress and kale, broccoli, Chinese cabbage, low-fat dairy products, fortified plant milk, almonds, canned sardines with bones, and fortified cereals.

Use more herbs and spices: Garlic is known to have anti-inflammatory and antimicrobial properties. Ginger is known for being a great anti-inflammatory food. Turmeric, commonly used in Asian dishes, has also been shown to reduce inflammation.

Avoid excessive amounts of sugar, sodium, and fat: These tend to be highly processed foods that can lead to the development of inflammation in the body. It is a good idea to limit the amount of food that comes in boxes, bags, and cans whenever possible. Reading labels can give you an idea of what is in your foods. Look for added sugars, high sodium content, saturated fats, trans fats, and preservatives, and do your best to avoid them.

Limit alcohol consumption: Alcohol can interact with medication and cause additional effects. It is best to avoid alcohol altogether. Also, excessive alcohol consumption can lead to damage to the liver, stomach lining, and the small intestine. All of these structures are required for efficient absorption of vitamins and nutrients.

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The Cause Of Autoimmune Diseases Like Rheumatoid Arthritis Could Be In Your Fridge

Want healthy joints? Maybe put down that glass of milk.

A study from the University of Central Florida suggests that a bacterium easily acquired by consuming dairy products, beef, or produce grown in cow manure may trigger development of rheumatoid arthritis (RA) in those who are genetically predisposed to the disease.

About 1.3 million adults in the US and 400,000 in the UK suffer from pain, progressive joint deformity, and organ damage associated with RA.

The research was based on past findings indicating that irregularities in two related genes called PTPN2/22 increase the risk of the autoimmune disorders Crohn’s disease, Type 1 Diabetes (T1D), and RA. These chronic conditions arise when the body’s defensive cells mistakenly attack its own tissue due to unknown genetic and environmental cues.

“If mutations occur in these genes, the PTPN2/22 protein will not function correctly, thus leading to an overactive immune system that leads to autoimmune disorders,” lead author Robert C. Sharp told IFLScience.

Recently, team leader Dr Saleh Naser uncovered a link between the bacteria in question, Mycobacterium avium paratuberculosis (MAP), and both Crohn’s disease and T1D. It appears that the presence of MAP can act like an “on switch” for the abnormal PTPN2/22 in these patients, sending their cell recognition and inflammatory signaling systems into overdrive and cueing the emergence of symptoms.

Knowing that RA is also affected by the PTPN2/22 genes, Naser and his co-authors hypothesized that MAP plays a role in this mysterious disease as well.

“To our knowledge, this is the first study designed to elucidate the molecular cause of inflammation in RA in association with environmental triggers such as MAP,” the authors wrote in Frontiers in Cellular and Infection Microbiology.

They began by analyzing the DNA from blood samples of 70 RA patients and 48 healthy volunteers. Traces of MAP DNA were detected in 34.3 percent of subjects with any type of RA, whereas only 8.3 percent of people without rheumatoid arthritis showed evidence of past exposure to the bacteria. 

A species of Mycobacterium avium.

A species of Mycobacterium avium.

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15 Best Home Remedies for Heartburn (Acidity) during Pregnancy

Pregnancy may be a beautiful experience, but that does not mean it is not accompanied by a few inconveniences. Prime among them? Acidity. First things first, here is the why of it all. Your bloated uterus pushes up against your digestive system causing the acid in your stomach to push up to your throat. Every meal becomes a bit of a rollercoaster ride with the taste staying with you and annoying you for hours after every meal. You probably wonder what helps acid reflux when pregnant. Well, there are plenty of natural ways to get rid of heartburn while pregnantAs is the case with any condition there are plenty of home remedies for acid reflux during pregnancy to help alleviate your discomfort.

1. Say No To Fatty, Spicy, and Deep-Fried Food

Unfortunately, everything with fat, spice and deep-fried preparations are a big no-no. Your cravings may be demanding you grab a handful, but you will pay for it later. This cure for heartburn while pregnant is more of a piece of advice – abstain from these sinfully delicious foods as they trigger a reaction in your belly that increases acid production. Some even erode your sphincter allowing for easy backflow of acid to your throat and create a double whammy with easy reflux. Maybe a few morsels here and there just to stem the cravings, so you are not killing the father of your baby but remember not to overdo things!

2. Caffeinated, Carbonated Drinks and Chocolate

The same as the previous point, these elements encourage the production of acid in your belly and cause heartburn. While giving up chocolate may seem like blasphemy and upset your baby and you, you will both be a lot happier once you do. Either way, caffeine and carbonated drinks have been proven to be bad for pregnant women.

3. Gravity is Your Friend

Your body is built to keep things flowing downwards, and you can use gravity to your advantage. Prop yourself up on pillows when sleeping so your head is raised above your stomach and feet. This will force it downwards away from your throat and into your intestines. This is one of many timeless home remedies for acid reflux during pregnancy.

4. Eat Less

Another cure for heartburn while pregnant that may seem too horrible to hear is eating less. All you need to do is eat often with plenty of small meals composed of easy to digest ingredients. This has the added advantage of preventing morning sickness as well. Your stomach has less of an opportunity to generate an acid that climbs to your throat if it is busy digesting food.

5. Early Meals

A key element you should keep in mind involves eating early, so your stomach is not too full when you lie down. This will not push the acid back up and cause heartburn or acid reflux that will drive you insane all night. Make a note of the fact that you should eat no later than 3 hours before bed.

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10 Things To Know When Someone In Your Life Has Lyme Disease

Someone you know is sick with Lyme disease. It could be a friend, a family member, a significant other or just an acquaintance. Whoever it is, you have questions. Or maybe you don’t, but you want a better idea of what the heck is going on. This article will hopefully offer some explanation, and can probably be applied to a variety of chronic illnesses. I’m not a doctor (disclaimer!) but I have personal experience with many “invisible” illnesses and Lyme (unfortunately). I am the Commissioner and Secretary for the City of Danbury’s Commission for Persons with disAbilities, and I have been diagnosed with Lyme and Chronic Fatigue Syndrome. In addition, I am the Communications Coordinator for Lyme Connection. 

Lyme Connection, a 501(c)(3) nonprofit organization (formerly Ridgefield Lyme Disease Task Force), works with the community about prevention and early diagnosis and support patients. The goal is to connect patients with compassionate care, helpful services and fellow patients. Lyme Connection’s mission is to make the community a healthier place by preventing tick-borne diseases and supporting patients and their families throughout their illness. Everyone needs encouragement and validation to make it through what is often a daunting challenge. Please read on for the 10 things to know when someone in your life has Lyme disease

1. Lyme disease is an invisible illness. What does this mean? When someone with Lyme is feeling absolutely horrible they are likely looking no different on the outside than they do on one of their “really good days”. This disease usually does not present itself with obvious visible symptoms. Normally you will not see a Lyme patient with their legs wrapped up in casts or with huge bleeding gashes on their bodies. Our symptoms tend to be more internal. Things like extreme fatigue/weakness, joint and muscle pain, dizziness, nausea, anxiety and brain fog aren’t necessarily easily detected just by looking at a person. It can be hard to understand how a person can be feeling so horrible when they look “fine”. Often times, they even seem to be acting fine! 

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Parkinson’s disease – Diagnosis and treatment


No specific test exists to diagnose Parkinson’s disease. Your doctor trained in nervous system conditions (neurologist) will diagnose Parkinson’s disease based on your medical history, a review of your signs and symptoms, and a neurological and physical examination. Your doctor may suggest a specific single-photon emission computerized tomography SPECT scan called a dopamine transporter (DAT) scan. Although this can help support the suspicion that you have Parkinson’s disease, it is your symptoms and neurologic examination that ultimately determine the correct diagnosis. Most people do not require a DAT scan.


Your doctor may order lab tests, such as blood tests, to rule out other conditions that may be causing your symptoms.

Imaging tests — such as MRI, CT, ultrasound of the brain, and PET scans — may also be used to help rule out other disorders. Imaging tests aren’t particularly helpful for diagnosing Parkinson’s disease.

In addition to your examination, your doctor may give you carbidopa-levodopa (Rytary, Sinemet, others), a Parkinson’s disease medication. You must be given a sufficient dose to show the benefit, as low doses for a day or two aren’t reliable. Significant improvement with this medication will often confirm your diagnosis of Parkinson’s disease.

Sometimes it takes time to diagnose Parkinson’s disease. Doctors may recommend regular follow-up appointments with neurologists trained in movement disorders to evaluate your condition and symptoms over time and diagnose Parkinson’s disease.


Parkinson’s disease can’t be cured, but medications can help control your symptoms, often dramatically. In some later cases, surgery may be advised.

Your doctor may also recommend lifestyle changes, especially ongoing aerobic exercise. In some cases, physical therapy that focuses on balance and stretching also is important. A speech-language pathologist may help improve your speech problems.

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