Margaret's Corner

Busy days. Lots of work…teaching, translating…which doesn’t leave much time for research. Too bad, because I have quite a number of fascinating studies lying on my desktop…hope to get to them tomorrow…yes…

In the meantime, here is a photo I took just two days ago of Pinga, my baby, at play. She’s such a clown! And that reminds me of this video, posted today on my Facebook profile by Lori (thanks!): http://goo.gl/GggN5 Hehe. 

It’s really true that you learn something new every day. Until now, I thought that a cup of chamomile tea was useful only to help you relax. But it turns out that it might do much more than that.

A few days ago I received an alert leading me to a 2009 (!) study on chamomile and COX-2, which is one of the unbelievably bad guys in myeloma (just do a search of my blog for COX-2, which, among other things, is a predictor of a poor outcome in myeloma…). The full text is available for free online: http://goo.gl/5SJk2…Yes, it’s a bit technical, but if you read the important bits here and there, you will find out that chamomile inhibits a pesky inflammatory enzyme known as COX-2.

(Please note: there are quite a few of these natural COX-2 inhibitors. Again, do a search of my blog. For example, thyme oil, sesamin, ashwagandha, boswellic acid and apigenin. Oh, almost goes without saying: curcumin! )

Chamomile, the authors tell us, has been used for centuries as a medicinal plant for its anti-inflammatory and analgesic properties. It is consumed in the form of tea at a frequency of more than a million cups per day. Chamomile has been approved by the German Commission E for oral consumption in the management of various inflammatory diseases of the gastrointestinal tract, and for topical application in the treatment of various skin disorders and inflammatory disorders of certain mucosal surfaces, such as the oral cavity and ano-genital areas. Wow, I had no idea. And…and…and…more than a million cups A DAY? 

It has antioxidant, hypocholesteroemic, anti-parasitic, anti-aging, and anticancer properties. Again, I had no idea.

And there’s another thing. Until I read this study, my brain had not registered the fact that chamomile’s most active ingredient is APIGENIN…Remember my posts on apigenin (parsley, celery…) and myeloma? One by one, the lights go on…

Chamomile also (see page 6) inhibits iNOS, which means “inducible nitric oxide synthase.” iNOS is a pathway linked to inflammation, which is , quelle surprise (not), also involved in myeloma, and not in a good way, believe me.

Another good bit of news is that chamomile also inhibits something called PGE2, which is secreted by some types of myeloma cells (=the mutant RAS ones). PGE2 contributes to the cells’ resistance to melphalan, among other things. See: http://goo.gl/ArzGi Ah. 

And hey, check what the “Blood” study authors say at the end of the “Discussion” part: A recent study confirming the involvement of cox-2 and PGE2 in osteoclastogenesis suggests that up-regulated activity in mutant RAS myeloma could also contribute to progressive lytic bone disease. cox-2 inhibitors may, thus, be worthwhile agents for future therapy.

So the hyperactive COX-2 and PGE2 also seem to help myeloma cells destroy our bones. Not good! 

Let’s compare that to the Conclusions of our “chamomile” study: The mechanism of action of chamomile on the inhibition of PGE2 production was due to the suppression of the COX-2 gene expression and direct inhibition of COX-2 enzyme activity. This may be important in the prevention of inflammation and may contribute to the antiinflammatory, anti-neoplastic and immunoregulatory effects of chamomile. Yay! 

I don’t know if my type of myeloma is mutant RAS or not…I read that 30-40% of myeloma patients have this sort of mutation, which is linked to not-so-lovely things such as disease progression and resistance to treatments. Well, one thing’s for sure: I’m going to begin drinking chamomile. Organic only, of course! 

Can’t hurt…

Could help…

P.S. Note: from what I’ve read, the type of chamomile with the strongest medicinal activity is the German Matricaria Recutita. 

I actually don’t have a huge amount of free time today. But I’m on a break, so here’s a quick post.

First, Arezzo: yesterday we spent a lovely relaxing day with friends (photo no. 1 is of Arezzo’s sloping and splendid Piazza Grande), which ended with a superb afternoon tea. Yes, I know, there is no traditional three-tier cake stand on the table, but there were eight of us, and we were all quite hungry, so it made more sense to arrange the food on plates and platters.

As you can see, we had four different types of homemade sandwiches, heaps of scones (lower right corner), shortbread (lower left, next to more sandwiches, and upper right), apple pie (upper left corner), one of my best coffee cakes (big hit, I’m happy to report; it’s that dark thing, next to the apple pie, going clockwise), muffins, small fruit tarts, whipped cream instead of clotted cream (we can’t get that here), homemade jams, crème anglaise to go with the pie…and five different types of tea, including an herbal one. My favorite: Simo’s traditional scones, the absolute best! 

Art left a comment on my January 19 “Cancer vaccine” post that gave me some food for thought. He’s right: dexamethasone induces MUC1.

Well, without more ado, here is Art’s link to the relevant “Blood” article: http://goo.gl/bfC9m I checked PubMed briefly and, unfortunately, found that the “Blood” study is not an isolated case. Hmmm. I don’t know what to do with this info…So I’ll just leave it at that…

The other day I read an interesting Science Daily article on tears. Well, well, we learn something every day…Check it out: http://goo.gl/yPkYn Hey, too bad we can’t have those lysozymes latch their jaws onto a bunch of our blasted myeloma cells, eh!!!

This is something I am still checking out…a new target = myeloid-derived suppressor cells, or MDSCs, which play an important role in immune suppression: http://goo.gl/G6C8U Not surprisingly, curcumin prevents these pesky cells from interacting with cancer cells, which is obviously a good thing: http://goo.gl/9E8iq Will I ever cease to be amazed at the extraordinary properties of curcumin? Probably not.

Now for something fun: http://goo.gl/EBKLH

Well, I am also looking at other things, but my free time is up for now. So…off I go!

Update on Lucy, the Canada goose: she’s going home where she belongs! Yaaaaay! Not sure exactly when that’s going to happen, but the important thing is that it’s going to happen!!!  So happy about that! This bit of good news put a smile on my face first thing this morning…

Thanks to everyone who signed the petition, by the way! Without you, this result would not have been possible!

Let’s see. It was a lovely sunny day here in Florence. So Stefano and I went for a nice stroll in the center of Florence. These are some of the photos I took…

We spotted a coot swimming on the river Arno (can you believe that?) as well as several egrets, but the best part of our time in town was visiting the church of Santa Maria Novella (first photo). 

I hadn’t visited Santa Maria Novella in ages, mainly because in recent years Florence residents had to pay to visit it, and I thought that wasn’t fair. But last week a friend told me that it’s free now…for us (not for tourists). So today, since we were nearby, we went inside, and wow, it’s such a pretty church…I’d forgotten! Lots of important artwork, too (check  http://goo.gl/AZBYt).

Lovely day…really enjoyed it…and our quick and cheap lunch (falafel and hummus and yummy sauces) in our favorite kebab place just put the cherry on the cake.  

Okay. Just for laughs, now. Cat people out there, have you ever been stared down (for no apparent reason) by your cat/cats? Well, then check out this cat, hehe: http://goo.gl/92qqV

And many thanks to Lori for posting this on Facebook. Very funny. It’s a Super Bowl commercial (I’ve never watched a football game in my life, but I find the Super Bowl commercials very funny): http://goo.gl/BQryi

Tomorrow we’re visiting friends in the city of Arezzo. They are preparing and hosting a REAL British afternoon tea…yummy, can’t wait! We’re leaving early, so that we will have enough time to walk around Arezzo, another lovely Tuscan city…

So I should have more photos on Monday. Unless I decide to do a serious post, of course!

Once again, I would like to go way off topic to ask for your help in bringing Lucy, the Canada goose, home to her human family (for more info, see my January 17 2012 post). 

You (and your neighbours and friends and colleagues and…well, everyone!) can now sign an online petition to help Lucy: http://goo.gl/ym3nN. 

Two weeks ago, Lucy was free to fly/go wherever she wished…at any time. Now she is locked up, unable to fly. Does that make any sense? No…didn’t think so. 

So let’s send Lucy home…before she dies from all the stress (she’s being moved around a lot, apparently…Again, does that make any sense? Sheesh…)…

Please sign this petition and ask everyone you know to sign, too! Thanks! 

Back in mid November, a blog reader (thanks, J!) posted a link on my blog’s Facebook Page about the development of a cancer vaccine called ImMucin, which, and here’s the exciting part!, was being tested in clinical trials on patients with multiple myeloma. Very exciting news. 

Now, I’d known for a while that a vaccine was in the works. But the 2005 clinical trial testing the vaccine (same thing, same company etc.) had been “withdrawn prior to enrollment”…no explanations given. It might have been a simple sort of bureaucratic hiccup…I mean, they might simply have run out of funds or whatnot. But, lacking an explanation, I stopped following this “case.” 

And that is why I’m very grateful to J for bringing the vaccine to my attention again. I noticed that this second trial (still recruiting, btw) has added something to the mix, something called “recombinant human granulocyte-monocyte colony stimulating factor.” Drat, I don’t have the time right now to check on that…oh well. But it left a question in my mind, since the first trial was only going to test ImMucin by itself…hmmm…

I’m also verrrry grateful to another blog reader, L, for pulling together a whole bunch of links for me. Back in November, however, I have to confess that I was overwhelmed, so I postponed writing a post on this topic until I had more time to check out all L’s links and do more research. Of course, time passed, life got busy and eventually, well, I forgot about it (my deepest apologies both to J and L). 

Until today.

Today a third (!) blog reader sent me a link providing an update on the clinical trial: http://goo.gl/O4kRc (you can also check the Clinical Trials website: http://goo.gl/uNyMs). Here’s an interesting excerpt: The new vaccine works by activating the immune system by “training” T-cells to search and destroy cells with the MUC1 molecule, typically found only on cancer cells. More than 90% of common solid tumor cancers bear the MUC1 molecule, as well as many non-solid tumors, including lymphoma, leukemia and multiple myeloma.  

Okay, so we know that the vaccine blocks a thingy called MUC1. Well, back in November, my above-mentioned blog reader L had the absolutely brilliant idea of checking to see if there were any natural MUC1 blockers. Success! Wonderful L found a study (full text available online: http://goo.gl/3b0yn) showing that apigenin blocks MUC1.

I’ve written a few posts about apigenin, a compound that can be found mainly in parsley but also in other foods and herbs (do a Search of my blog for “apigenin”). The most important one would be my August 30 2011 post in which I reported about a Chinese study showing that apigenin kills myeloma cells on its own (full text available online for free: http://goo.gl/Rqs02).

L also sent me the link to a 2009 study linking MUC1 to the NF-kappaB pathway, which is one of the main bad guys in myeloma: http://goo.gl/RJ3JI As the study’s title suggests, MUC1 activates NF-kappaB, which is clearly BAD. The great news therefore is: if we can stop MUC1, we can block NF-kappaB, too. Theoretically. 

So, given all this great info about apigenin’s dual activity (= blocking MUC1 AND killing myeloma cells), why wait until 2017 for the vaccine to be available on the market? Why can’t some of us go ahead and increase our daily intake of apigenin? I’m referring to those of us who aren’t on any chemo or other drugs whose activity might be hindered by apigenin. And here I must tell you this: before imbibing huge quantities of apigenin via parsley or a supplement, please keep in mind that it might possibly interfere with the drugs you are taking. Wonderful L sent me a list that you can check out: http://goo.gl/p5MFK She also pointed out that parsley is loaded with vitamin K, which can interfere with coumadin or blood-thinning meds.

Bottom line: do your research…ask your doctors before taking anything…and please be careful. 

L also found out that dried parsley actually contains a higher amount of apigenin than fresh parsley. She calculated that 2.4 grams of dried parsley has the same amount of apigenin (300 mg) as 100 grams of fresh parsley. 

She didn’t stop there. She went into her kitchen and did some measuring for us (love that!). She calculated that each gram of dried parsley yields 135 mg of apigenin. And one gram of dried parsley = two level teaspoons. So that seems to be an easy way to get more apigenin into our body. I mean, two teaspoons of dried parsley added to a glass of water (L tried it and reported that the taste was okay) will give us 135 mg of apigenin, based on L’s calculations. 

My own very quick bit of research this morning led me to a Chinese study on EGCG and the wayward MUC1 protein: http://goo.gl/uCs0b So yay, we can add another readily available item to our natural, anti-MUC1 list.  

Well, this post is not exhaustive by any means, but it gives us a start, at least…

Your comments and contributions are greatly appreciated…Thanks!

This morning on Facebook I read a sad goose story. An outrageous story that I hope will have a happy ending. But in order for that to happen, Lucy, the Canada goose, needs your help. First, here’s the link to the newspaper article: http://goo.gl/KRVpY

There is no reason for Lucy to be killed. No reason at all. It makes no sense.

She should instead be returned to the Vander Wiel family in Fort St. James. Immediately. If, after reading the article, you agree with me, then why don’t we get a “Save Lucy!” campaign going? You can do what I did, that is, write to the Minister of the Environment, the Hon. Peter Kent, and ask him to intervene in this case. His contact information is:

Tel.: 819-997-1441

Fax: 819-953-0279

E-mail: Minister@ec.gc.ca

I also cc’d the generic Environment Canada address: enviroinfo@ec.gc.ca And I cc’d the Vancouver Sun reporter, Kelly Sinoski: ksinoski@vancouversun.com Same e-mail message. Easy peasy. 

When I belonged to Amnesty International, I learned to keep letters short and simple. So this is what I wrote (you can edit it, make it better and/or use it as you wish…hmmm, now that I have reread my message, I realize I could have done better…oh well, too late…but you can do better, of course!): 

This morning the first part of a blog reader’s message made me laugh out loud: 

Hi Margaret, When I first read the “early treatment” piece in the “Myeloma Beacon,” I said to my wife: “This will not sit well with Margaret.” I was right, and want to thank you for your righteous rage.

The message continues, but that’s the part that made me laugh. And so now it’s my turn to thank you (you know who you are!) for helping me start my day on a cheery note.

Today Stefano and I went birdwatching. Or rather, that is what we were hoping to do…but, as it turned out, there weren’t very many birds at the WWF’s Oasi di Gabbianello (near Barberino di Mugello, for those who know Tuscany a bit)…just a bunch of shivering coots huddled together on the ice (see below)…

But when we reached our favorite birdwatching hut, the first thing I set my eyes on was a group of five big wild boars crossing the pond, which is at an all-time low since it hasn’t rained in ages. Wowers! 

I asked Stefano what we should do if, while walking around the pond, we had a closer encounter with those boars: fall to the ground & pretend to be dead, scamper away as fast as possible, scream like banshees or…or what? He had no idea. Great.

So I just hoped that they wouldn’t mind our being there and taking photos. Luckily, they didn’t!

Oh, I’m fuming. I’m frothing at the mouth. I’m verrrry upset. 

This morning I read, then re-read after lunch, the “Myeloma Beacon”‘s January 13 interview with Dr. Ola Landgren: http://goo.gl/iZizX By the way, my comments will make much more sense if you read the interview first, so please click on that link before proceeding… 

Okay, here goes. I suppose it’s no secret that I’m strongly (and that’s a bloody understatement!!!) opposed to “early treatment.” From what I’ve read and been told by MM specialists, early treatment does NOT bring any benefits and could in fact make things worse. Much worse.

Of course, I’m referring to chemo treatment. 

Perhaps some valid treatments might appear on the horizon at some point in the future…treatments for smoldering folks, guaranteed not to poke what we MMers call “the beast”…guaranteed not to worsen our quality of life…But that is not the case right now. 

If you’ve been following my blog since early 2010, you may remember that on a number of occasions I’ve railed against the infamous SMM-chemo trial led by a group of Spanish researchers…a bunch of whom, including the head researcher Dr. Mateos (!), have verrrry close ties to Celgene Corporation, the multinational drug company that just happens to produce one of the drugs tested in the trial (see http://goo.gl/7DUUZ). 

Hmmm. Talk about going on bright red alert… 

I just asked Stefano if he would buy a camera from a company that tests its own products…no independent testing…well, you can imagine his reaction…!

He also remarked, “Hey, but just think…if Celgene were able to expand its market to SMM folks…”

$$$

But the Celgene connection is not the only reason I’m outraged that such a trial even exists…(FTR: the Spanish study has gotten bigger; it now includes 119 patients–57 in the treatment arm, 62 in the non-treatment one, average age = 61 and 65, respectively.)

HOW ARE THOSE SMOLDERING FOLKS DOING? AND HOW WERE THEY DOING BEFORE THE TRIAL?

In the Beacon interview, Dr. Landgren talks about “progression-free and overall survival benefits.” But what I would like to know is this: what about quality of life? What about toxicities? You may recall that some of the SMM patients enrolled in the Spanish study presented at ASH 2009 developed some “serious adverse events” or SAEs (for an overview of “SAE,” see http://goo.gl/JqBAH). A couple of patients left the study because of those SAEs.

That is not acceptable. NOT. 

Okay, I just looked up the ASH 2011 (updated) Spanish paper: http://goo.gl/gzVSA Oh sigh, I don’t have the time or will right now to examine all those numbers, but apparently there were no G4 toxicities (remember that G5 = death!), “just” a bunch of G3s. Now, I don’t know about you, but after reading that list of G3 consequences, I began getting a case of the itches. And then I read that “tolerability is acceptable.” Uhm. For whom? 

I repeat, HOW ARE THOSE SMOLDERING FOLKS DOING? AND HOW WERE THEY DOING BEFORE THE TRIAL?

I would like to avoid repeating or paraphrasing what I’ve already written on the Spanish study. But I would like to discuss something said by Dr. Landgren that shocked me right out of my socks this morning. He says that he doesn’t like the expression “high risk” (well heckaroni, WHO does?!!!)…not for smoldering patients, not for multiple myeloma patients. In his opinion, the former (= the high risk SMM people) should be called “early myeloma” patients.

WHAAAM! Well, that hit me right in the gut. I mean, we all know what a huge emotional impact words can have on us, right? Shit. (Sorry.)

“Early myeloma” may sound okay to someone who is healthy, but I doubt that it sounds okay to any of us smoldering folks. Truth be told, I don’t care one whit for “smoldering,” either…I prefer this sweet sound of “inactive.” Words…gee…gotta be careful…

But that was only my first reaction. Then I saw red. After all, statistics tell us that only a relatively small percentage of SMM folks progress to active myeloma. Okay, as far as I know, we don’t have any specific progression statistics about “high-risk” SMM folks, but (again, as far as I know) this expression was invented by the Spanish Celgene-connected authors. Well hey, I’m in that high-risk group, but my QOL is very high, and I haven’t progressed yet. And it’s now been more than six years. (Ooops, knocking on wood…)

Now, a few not-so-bad things came out of this interview.

• What Dr. Landgren says about treating “early myeloma” does make sense. That is, treat cancer in its early stages instead of waiting for things to get worse. (But, I repeat, NOT with current treatments! It’s too risky for us = the smoldering hot group. Why take the chance?) 
• When Dr. Landgren was asked if he thought early treatment in high-risk SMM folks would be the best option, he answered: “nobody knows at this time.” (Hah, no kidding. And did you notice that he repeated “nobody knows at this time” TWICE during the interview?). So he wouldn’t give lenalidomide and dexamethasone to his own smoldering patients. Good to know.

But then…in the next breath he says (and this sent my socks shooting way out into my neighbor’s yard…) that in the spring of THIS YEAR he is going to supervise a SMM study that will examine a treatment regimen involving eight cycles of carfilzomib, Revlimid, and low-dose dexamethasone followed by Revlimid maintenance for a minimum of one year. We are using carfilzomib instead of Velcade in order to increase the efficacy and at the same time reduce the side effects, in particular peripheral neuropathy [...].

What the…?????? 

Luckily, he added, Let me stress again, however, the need for more studies before any of these ideas start to be considered “standard of care.” Bloody hell. 

Reading stuff like this drives me bonkers. I mean, doesn’t it make much more sense to invest money in developing a curcumin analog (or another promising, similar, non-toxic, natural substance with proven anti-MM effects)? There is so much scientific evidence (and now, so many anecdotal accounts, too…Mine is not an isolated case anymore, thank goodness!) to back up the potential usefulness of curcumin in the treatment of myeloma at any stage, also in combination with chemotherapy (by the way, I refuse to use the expression “novel agents”…but that happens to be the topic of a post that I began writing a few days ago, so I won’t go into it now. Stay tuned…) 

Where was I? Ah yes. We need to find a way of giving curcumin an “umph!,” that’s all. Luckily, there are a few research teams that are investigating that right now…And I wish them LUCK! Now, that is the sort of trial I would love to participate in…a curcumin analog trial…

Well, I tell ya, my stomach is tied in a knot. The “early myeloma” business really upset me…And even now, close to dinnertime, after spending a lovely sunny cold morning planting tulip and other bulbs in our back yard, I am still a bit upset, which means I’m not thinking as clearly as I should be, and that I might possibly have misinterpreted a few things that Dr. Landgren said during the interview. In fact, I probably shouldn’t even go ahead and publish this post right now (Stefano suggested two minutes ago that I stop writing and join him in the kitchen, where he’s making dinner…), but I would really like to get some feedback from you guys…What do you think?

Let me conclude by asking: whatever happened to the concept “Early treatment is a very bad idea”?????

P.S. Sorry for any repetitions…no time to go over this draft…must go help with dinner…ciao!  

My Puzzola, = 11 years old, patiently waiting, with folded paws, for my blood test results…

Yes, I had blood tests done this morning…The nurse had a hard time poking the needle into my vein and ended up stabbing me a bit…ugh, I hate it when that happens…

Anyway, I’ll have my results at some point next month (the vitamin D test takes forever).

Oh, here’s something that intrigued me: my blood seemed redder and not as dark compared to previous tests. It also seemed more fluid. Is that good or bad or does it mean nothing? No idea. Whatever. 

We’ll find out in February…In the meantime, I’ll be outside, planting bulbs in our back yard.    

Today started out badly when I discovered that we didn’t have Internet access. I called our Internet provider immediately, only to be told that our area was experiencing a huge and very complicated cable problem of some sort, that technicians were already out working on it but that it might take 24 hours. From his tone of voice, it sounded as though all the Internet cables in Florence had been cut or burned or eaten by rodents or vampires…

Gasp.

24 HOURS WITHOUT INTERNET…WITHOUT ACCESS TO MY BLOG? NOOOOO! My first impulse was to go back to bed and sleep for 24 hours…

But I had other stuff to do today, lots of stuff, so in the end not having Internet access didn’t matter (and, as you can see, fixing the problem, whatever it was, hasn’t taken 24 hours, after all…).

After years of “doing it ourselves and breaking our backs,” this year Stefano and I finally hired a gardener to prune our trees and clear the summer and fall debris from both yards, the one in front and the bigger one in back. We realized that we really needed some professional help after noticing that our magnolia tree had grown taller than our house. Uhm. Yes. It needed some seeeeerious pruning, which clearly Stefano couldn’t do…way too dangerous. So we began setting aside the money needed for this gardening project. We finally hired a friend of a friend of a friend, a highly recommended guy called Paolo who began working here very early this morning. Fantastic experience. In addition to doing a splendid job, he had some excellent ideas on where to position our plants and so on. Ah yes, I’m thrilled to bits!

Now, talk about coincidences. In order to climb up and prune our jack-and-the-beanstalk magnolia, Paolo had to take down our bird feeder (quick note: the birds around here haven’t yet figured out what to do with this feeder…or perhaps they don’t like the seeds we fill it with…I mean, I really want to feed them, especially now that it’s cold, but they stubbornly ignore all my efforts…sigh). Anyway, point is, Paolo made a comment about the feeder, so we started talking about birdwatching, and, lo and behold!, it turns out that he’s a volunteer at the Oasi di Focognano, = the WWF bird sanctuary where Stefano and I go now and again (we were there last Saturday, in fact). Hah! Small world…

Not only that, but this brave man is also very much involved in the national anti-poaching project, which means he frequently goes off to places like Sardinia, where at least 300,ooo songbirds are killed every year (!), to remove the (incredibly cruel and illegal) bird and animal traps etc. Dangerous stuff, eh. Ah, Paolo had stories to tell…awful stories…I won’t repeat them here. At any rate, before he left for the day, I told him that we must stay in touch. I’d like to help with the anti-poaching project, if possible…

Anyway, after he’d left, I went into the bedroom and found Piccolo (9 years old) cuddled up on our bed next to Priscilla (7 years old). The lump that Piccolo is leaning against is actually little Pinga (3 years old, I think) who likes sleeping under a cover…summer or winter…

And that’s how we know it’s cold outside…

When the cats cuddle…

P.S. I’m having blood tests tomorrow morning. I’m trying not to think about it…