Monthly Archives: January 2009

Healthful food combinations…

The most recent Cancer Compass newsletter (http://tinyurl.com/bnxwyy) gives us some good food combination ideas. For instance, if you are preparing a spinach salad, add a mandarin orange to it or, another suggestion (=mine), some lemon juice. The vitamin C contained in citrus fruit not only makes spinach taste better but also helps our bodies absorb the iron present in this vegetable and other leafy greens.

 

My note: an excellent way to eat spinach, the Italian way, is to steam it (lightly), then toss it in a separate pan with a bit of olive oil and chopped up garlic (or whole garlic, if you prefer). Stir it all up for a few minutes, then take it off the heat and add lemon juice. It’s an easy peasy tasty method that can be applied to any leafy vegetables–chicory and kale, for instance. Another suggestion: to absorb more of the iron contained in red meat, I always eat it with a green salad or steamed broccoli/spinach flavoured with olive oil and…lemon juice.

  

Spinach is in season now, and I have been buying it freshly picked at the local farmers’ cooperative. A bit of a drag to clean (best to let it soak for a while), but such a delightful food, and sooo good for us. I recently tried a new Indian recipe for lentil and spinach curry, adding more turmeric and ginger than the original recipe recommended, and it was so delicious that even my father-in-law, who eats only Italian food and is suspicious of anything remotely exotic, had three helpings.

 

Back to Cancer Compass (you can sign up for the free newsletter, btw). Another good food combination: broccoli and tomatoes. Too bad they aren’t really in season together. After reading Barbara Kingsolver’s new book (“Animal, Vegetable, Miracle”), I am sticking to local vegetables in season. At any rate, when we add, e.g., olive oil to tomatoes and other carotenoids, we are helping our bodies absorb their healthful nutrients.

 

Carotenoids, by the way, can be found in foods as diverse as carrots, apricots, sweet potatoes, spinach, kale, pink grapefruit, salmon, milk and egg yolks. Odd list, huh? Well, just have a look at the World’s Healthiest Foods excellent page on this topic: http://tinyurl.com/cqhzo3. Interesting WHF suggestion: cayenne pepper or hot chili pepper added to carotenoids also enhance nutrient absorption. Hmmm, not at all a bad idea!

 

The Cancer Compass article ends with more than a hint of disapproval toward fat-free salad dressings. I was very happy to read this part, since I have always thought that fat-free foods taste like cardboard. Years ago, in the U.S., I tried fat-free or 1 or 2% fat milk. Horrible, tasteless, might as well drink water (= better for you, too). Hence, in my opinion, it is better to eat less but have some…fat. Obviously, I refer to the “good” fats. Anyway, according to the article, the reason to use “fat” salad dressings is that olive oil, for instance, makes many healthful nutrients more bioavailable to us…nutrients such as lutein in the green peppers, the capsanthin in the red peppers, the lycopene in the tomatoes, even the limonene in the lemon. There you go. So…go ahead and enjoy a bit of fat!

 

I love the article’s final suggestion: The best way to spot synergy on your plate — and to ensure a nutritious meal — is to make sure it has a minimum of three colors and contains healthful fat (avocado, olive oil or nuts).

 

Note: this is my 500th post (!). And, since I began this blog, I have had 1705 comments. Wowie!

That annoying little tick tock

In response to my previous post, a myeloma list friend (thank you!) privately sent me the blog posts written by Virginia MacLean (1963-2007), who was diagnosed with myeloma in 2003 but postponed treatment in order to have a child. Like my list friend, I found Virginia’s story very compelling. Her blog can still be viewed here: http://tinyurl.com/2q3upe This is her first post, which contains many of my own sentiments (clarity, attitude change, e.g.):

 

Virginia’s Own Words

by Virginia. Sunday, March 5, 2006

 

Three years ago today. That’s the day it all changed. I didn’t admit it then. I guess that’s a self-preservation sort of thing. You want to believe it will be better for you than the odds say it will be. And at first you don’t feel any different than you did a day earlier so you really don’t believe the diagnosis in some sense. But three years later there is no denying it. You have this disease and it isn’t going away. And like it or not, it is going to progress in you just the way it does in everyone it invades.

 

But you have to pull your thoughts together and remember that it ALL changed three years ago … and not all of it was bad.

 

I was diagnosed with cancer 8 weeks before my 40th birthday. Everyone was asking me how I was handling turning 40. I told them I had been given an early birthday gift – the gift of clearly seeing the value of all the days I had left to live. Cancer causes an immediate attitude change. If you have the strength to look forward with optimism in the face of a cancer diagnosis, you are given the gift of clarity. Never had my purpose in life and the goals I had set for myself been clearer.

 

The average age at diagnosis for someone with myeloma is 70. So when I told my doctors I decided to postpone treatment in order to have a child, they did not know how to react. None of them had experience with this situation and there was precious little in the formal literature to guide them. Some were quietly sullen. Others more open with their disdain. “We can’t tell you what will happen. A pregnancy could stimulate the growth of these cancer cells.”

 

But a few were supportive of a patient willing to look forward to life in the face of such a significant challenge. There was the issue of me being single and without a significant other … but that is another story. Being on my own only made the decision more my own. And so, 22 months later, when doctors had predicted I would likely need the next level of treatment, I instead gave birth to a happy, healthy baby girl. No stimulated growth in these cancer cells. Being pregnant actually reduced my IgG to near normal levels. So Paige did her part in helping keep me alive. And she does it again every time I walk in the door and she gleefully screeches and reaches out to greet me. And now it is my turn to return the favour. My turn to work on being there for one more day, one more milestone. But more importantly, it is my job to show her how to find joy in the milestones we have together however many or few they are. Maybe she is really the one who will teach me that. Either way, we are in this together and for that I am eternally grateful.

 

The marketer in me knows that everything in life comes down to nothing more than a point-of-view. So here is my point of view on cancer: Cancer can cause my death, but it can only take my life if I let it. I don’t plan to do that.

 

The following are excerpts from her explanation of myeloma. Because of length issues, I cut out the stats, but you can go read them on her blog. 

 

What is myeloma anyway?

by Virginia. Thursday, March 9, 2006

 

Let’s take a step back here for a minute to answer the burning question: What the heck is myeloma anyway? I had no idea three years ago. And even now, the more I learn the less I understand … which is probably why the issue of curing this disease has eluded researchers all this time. But as a starting point, here is my rudimentary explanation of what it all means to the best of my understanding.

 

Myeloma is a cancer of the bone marrow. The evidence of myeloma can be seen in the blood, but the issue is in the marrow – in the place where that blood is born so to speak. Here is how things are supposed to work vs. how they actually work with myeloma.

 

Our bodies have an ingenious system for helping us fight infection. Plasma cells in our blood produce antibodies (which chemically are proteins) that attach to the infection. This signals other cells that the infection is bad and needs to be removed from the body. Brilliant. The problem with myeloma is that malignant cells develop which appear to be plasma cells but they are not rejected by the body. So literally these malignant plasma cells crowd out normal red and white blood cell production. This in turn results in bone destruction because it interferes with another nifty trick our bodies can perform.

 

New blood pathways can be created as needed. So for example, if you get a black eye and a capillary is crushed — no problem. Your body just creates a new capillary nearby and re-routes the blood. And you eye heals good as new. But with myeloma the need for new pathways keeps increasing. Each new blood pathway literally blows a microscopic hole in your bone and over time that leads to significant and painful destruction of the bone.

 

And that’s really it. One little mutation in one cell in your bone marrow for some unknown reason and BOOM …. everything is off kilter permanently.

 

[…]

 

In general, I like having some idea of the timeframe even though I know a number of things could adjust the actual dates up or down for me personally. Knowing the likely outcome gives me something to beat. And it also gives me the clarity to focus on what is important now and just forget about fighting and beating all the time. Because all that fighting and beating is tiring and in the end just enjoying the life you have is really more important.

 

But it is always there in the back of your mind. That annoying little tick, tock.

Pregnancy and myeloma

This is not an easy topic…but okay, here goes…(ah, no, I am not pregnant).

 

A blog reader recently sent me a message via my blog contact form (by the way, I get a huge amount of correspondence every day, so please forgive me if I don’t answer every single message. I do my best, but…). She is 37 years old and contemplating pregnancy…thing is, she was diagnosed a year ago with SMM. She has been stable since then, has no CRAB symptoms, but is concerned that the myeloma might take off during or after pregnancy.

 

Good question. Soon after Stefano and I started living together, I bought a whole slew of pregnancy books. Well, we never tried to conceive…for a variety of reasons. Then, in 1999, the year we got married, I was diagnosed with MGUS. I was 38 years old. Even though at the time I didn’t really understand (or, more likely, probably denied) the possible implications of MGUS, I must have had a gut feeling about it (perhaps he did, too), since we simply stopped talking about babies. And a few years ago I gave away all my pregnancy books. No regrets…not anymore, at any rate.

 

Well, I didn’t really have any useful advice for my blog reader, so I told her that, if she wished (she did), I would write a post about pregnancy and myeloma and ask all the women who read my blog: did you get pregnant after a MGUS, SMM or MM diagnosis? If so, could you tell us how things went, etc.? If you don’t want to post a public comment, please contact me via the blog contact form. I will respect everyone’s privacy.

 

What I found online was not very encouraging. There don’t seem to be many studies on this topic, which is confirmed in a 2008 Letter to the Editor of the “Annals of Hematology” (http://tinyurl.com/cbkahz): reports of MM in pregnancy are rare, with eight cases arising during pregnancy reported in the literature to date. Here we report the case of a young woman who presented with an aggressive form of MM during the third trimester of pregnancy with spinal cord compression. Whether pregnancy-related factors contributed to the aggressive nature of our patient’s disease is unclear. However, they add, Both interleukin-6 and insulin-like growth factor-1 (IGF-1) promote the survival of malignant plasma cells and intriguingly, raised serum levels of these cytokines have been reported in pregnancy.

 

I found another study, published in 2004 and titled “Multiple Myeloma with a Pathologic Fracture During Pregnancy” (http://tinyurl.com/c29cun). This appears to be the first reported case of myeloma presenting as a pathologic fracture during pregnancy as well as the first reported cancellation of a planned vaginal delivery because of tumor infiltration of the spine and pelvis. Well, the study is clearly written, so there is no need for me to give a summary here. But I would like to point out that Fifteen months post partum, a painful lytic lesion arose in the tibia, potentially heralding the onset of progressive disease. Whether or not this situation was caused by the pregnancy is not known, of course.

 

The title of a third study (http://tinyurl.com/dy3hpt), published in 2007, is not exactly encouraging: “Renal failure complicating myeloma in pregnancy.” This study states that there have been nine cases reported of myeloma complicating the pregnancy or the post-partum period. Again, as with the previous study, you can go read it on your own. It’s quite straightforward. Sadly, three months after giving birth, this 32-year-old patient didn’t survive a treatment complication: septicaemia.

 

In the study’s Discussion, the authors tell us that none of the nine reported cases of myeloma diagnosed during pregnancy had a prior diagnosis of MGUS. They suggest that pregnancy may have contributed to the progression from MGUS to MM, since it may increase the availability of growth factors for MM cells. One of them is the infamous IL-6, by the way.

 

A 2006 “Immunology” Swedish study (http://tinyurl.com/av7tfs) confirms the close link between growth factors and pregnancy. The researchers examined cytokine responses in both allergic and non-allergic women during pregnancy and two years after delivery. They found elevated spontaneous innate cytokine levels (IL-1beta, IL-6) regardless of allergic status. This interesting, rather technical study ends with this statement: Our finding that women have lower total IgE levels 2 years after pregnancy than in the third trimester also shows that the immune system seems to be modulated by pregnancy, and that the effect is long-lasting.

 

I also found two other studies that may not be useful at all and also are quite dated (some of the language…no comment!), but perhaps still worth mentioning. The first is a 1966 “Blood” full report (http://tinyurl.com/cepza9). The second was published in 1990 and bears the title “Multiple myeloma in pregnancy: a case report” (abstract: http://tinyurl.com/cg7ey6). One positive titbit is that the babies in both studies were born healthy…I wonder if they grew up to be healthy adults. Too bad there was no follow-up.

In conclusion, I really do wish I had some positive information for my blog reader. Unfortunately, though, I do not.

I would really appreciate any comments and personal stories, good or bad, that might help my blog reader make a decision. Thank you!

Olive oil compounds kill leukemic cells

The blog reader (thanks, PvM!) who sent me all the cytogenetic studies on myeloma also provided me with a few studies on the cancer-killing compounds found in olive oil. Even though I have already dealt with the anticancer properties of olives, see my page on oleanolic acid, which is extracted mainly from olive leaves, I hadn’t seen this particular study, published in November 2008 in “The Journal of Nutrition” (full study: http://tinyurl.com/cprfho) and carried out by an Italian team from the University of Perugia, the lovely provincial capital of one of my favourite Italian regions, Umbria.

 

The researchers examined the effect of a virgin olive oil phenol extract (PE) on proliferation, the cell cycle distribution profile, apoptosis, and differentiation of the human promyelocytic cell line HL60. Phenols, incidentally, are rather acidic chemical compounds. Curcumin, for instance, is a phenolic compound from turmeric; so is capsaicin (<chilli peppers). And olive oil happens to be full of antioxidant phenolic compounds.

 

An interesting point: there is a clear association between the consumption of olive oil and a reduced risk of certain types of cancer: breast, ovary, prostate, colon and larynx. Olive oil has also been shown to suppress spontaneous liver tumorigenesis in mice and reduce skin carcinogenesis when applied topically both before and after exposure of mice to UV light. Hmmm, I didn’t know that…well, well… 

 

In this study, the researchers incubated the leukemic cell line HL60 with PE, the above-mentioned olive oil extract (a complex mixture of phenols)…and, abracadabra!, after a few days, 100% were NECROTIC, even at rather low concentrations. One hundred percent! Put simply, PE not only inhibited proliferation of the leukemic cells but also killed them.

 

The researchers state (my emphasis) that Another important result of the present investigation is that PE can induce differentiation in HL60 cells. Although several previous studies showed that phenols present in wine and tea can induce differentiation in promyelocytic cell lines, as well as in other systems, to the best of our knowledge, our results are the first to show such an effect exerted by phenols from olive oil. Important, indeed!

 

Another significant excerpt: the researchers state that there is still no evidence that olive oil can protect against leukemia. But, they add, In the present study, a clear anticancer activity of some phenolic compounds isolated from olive oil was demonstrated. Such activity was evident at phenol concentrations relatively higher than those observed in vivo after a normal daily intake of olive oil; however, it is possible that the regular low life-time intake of olive oil results in an overall protective effect.

 

I grew up in Italy, which has a national obsession, rightly so!, with high quality (=extra virgin) olive oil. I can give up lots of things, but it would be almost impossible for me to live without olive oil. It’s more important to me than chocolate! But, thinking back on all the years that I lived in the U.S. and Canada, I almost certainly used very little olive oil, and certainly not the high-quality stuff that we get now from Italian friends who have their own organic olive grove. It made me wonder…

 

Of course there are a lot of Italians with leukemia and myeloma, so I don’t mean to imply that my years without the protective effect of olive phenols led me to develop MGUS and then SMM. But wouldn’t it be interesting (impossible, I know!) to see how many Italian leukemic patients have a high versus low olive oil intake? Oh well, just a silly thought…

Anyway, this was certainly an interesting study. Another related one, sent by the same blog reader (thanks again, PvM!), examines the metabolism of olive oil phenols in humans. Since the full study is available online (http://tinyurl.com/cfjl6f), I will mention only that we absorb a great deal of the olive oil we swallow…and this bit of information could be useful for a future olive oil/curcumin experiment, since, as we know, curcumin dissolves in fats and oil. To be honest, the thought of experimenting with olive oil had crossed my mind some time ago, and I know some blog readers already mix curcumin with olive oil, but I hadn’t considered it very seriously because of the omega 6/3 ratio. But now…well, we shall see…

Interesting titbit: a 2007 Spanish study (see: http://tinyurl.com/dbfg7q) showed that the phenolic compounds in olive oil, just like curcumin, killed eight strains of H. pylori (see my page on H.pylori and MGUS), even three that were resistant to antibiotics. Based on their results, these researchers think that olive oil might be used as a chemopreventive agent for peptic ulcer or gastric cancer, but this bioactivity should be confirmed in vivo in the future. Extraordinary…

P.S. my new blog banner is a photo I took this morning of the view from our bedroom window.

Spanish links

Today a good friend wrote to tell me that Spanish Wikipedia has a link to my blog. My first reaction was HAHAHAHAHAAAA, very funny!, good one! (oh yes, I laughed out loud.) But then I checked…and sure enough, in “Enlaces externos”(=external links) under “Bio-disponibilidad de Curcuma,” there is a link to my page on the bioavailability of curcumin: http://es.wikipedia.org/wiki/Curcumina

 

My blog…on Wikipedia???…I am (still) much amused. And pleased, I admit.

I have been working on a handful of drafts on different topics, from cytogenetics to olive oil extracts, but Stefano’s fun aunt is staying with us right now, and her visit takes precedence over everything else. For a few more days…

Because we like it

Part One.

After publishing my third year curcumin anniversary post, I realized that I hadn’t mentioned that 2009 also marks two other anniversaries:

 

1.     Ten years ago I was diagnosed with MGUS, the benign predecessor of multiple myeloma. Ten years…

2.     In May of this year, Stefano and I will be celebrating our 10th wedding anniversary. If we can find a reliable cat sitter and save enough pennies, we plan to take an anniversary trip to the UK in early June.

 

Part Two.

An amusing thing happened today during one of my English classes. Of course, it involved Colleague C, who else? (If you would like to read more of her quips, just do a Search for “Colleague C” on my blog.)

 

I was about to explain the differences in use of the verbs “see, look and watch.” First, though, as is my habit, I asked my students if they could think of any. Colleague C piped up immediately: usually, we use “see” because we like it. We use “look” when we look for our keys. And we use “watch” when we watch T.V.

 

Trying (unsuccessfully) to suppress a giggle, I asked: is that it?

 

Colleague C, pretending to be surprised: yes.

 

[She was kidding, of course…but it got us all laughing]

And now I am going to take the rest of the afternoon off to watch CNN International’s coverage of President Obama’s inauguration, which, incidentally, was one of the topics all of my students were enthusiastically discussing in class today. They happily informed me that “oggi è l’Obama Day.”

Third year anniversary

This morning I was tidying up my bookcase when I came across my 2006 calendar…and noticed that I began taking curcumin on January 16th 2006. Wow. That was three years PLUS 2 days ago. Oh bother, I missed my third year curcumin anniversary by two days! How did that happen?

 

Going through the calendar reminded me of all the things that happened to me in 2006. In addition to “discovering” curcumin, I became a permanent citizen of Italy. So, in many ways, 2006 was a magnificent year. But in others, it was not so…magnificent.

 

My next door neighbour, a friendly, cheerful and kind man in his early 50s, had been diagnosed in the spring of 2005 with acute lymphocytic leukemia (ALL). He began doing chemotherapy straight away, within a week or so of his diagnosis. That summer, he almost died not once but twice…not from the leukemia but from a toxic reaction to the drugs. On both occasions, his wife was told that he wouldn’t make it through the night. But make it he did…each time.

 

In the fall, his doctors surprisingly (from my current viewpoint) recommended that he go ahead and have an allogeneic stem cell transplant. He agreed. A donor was found in Germany, and the transplant took place in late January of 2005 or early February of 2006. I remember that he was still home when I told him about curcumin. He was interested and said he might consider taking it after the transplant.

 

That never happened.

 

He had a toxic reaction to one of the anti-rejection drugs, cyclosporine, as I recall. I will spare you the details of his long agony. During that dreadful period, I spent a lot of time with his family, trying to be cheerful and encouraging. I didn’t go visit him in the hospital (only his wife and children were allowed to see him under extremely restricted circumstances), but I remember that he phoned me on one of his rare “good” days. That was our last conversation.

 

He died on April 19th, 2006. Exactly one month later, on May 19th, I came down with pleurisy (I came close to dying, myself…took me months to recover).

 

Looking back, 2006 was not an easy year. But I survived. And I found curcumin. I just wish that Massimo were here, too…taking curcumin and helping me with my research (he was a biologist, an enthusiastic plant expert…)…eh, today’s post brings back painful memories.

 

To end on a more cheerful note…on this anniversary, a special note of gratitude goes to Prof. Bharat Aggarwal who works at the MD Anderson Cancer Research Center in Texas. Without his encouragement, I might not have tried the amazing yellow-orange powder…

Turning yellow

Very busy days. No time to do research, no time to post. My cytogenetics draft is driving me mad, so I have set it aside for a few days, as my father wisely taught me to do. (The only problem with that is that I now have a HUGE file filled to the brim with unfinished or unpublished drafts…eh!) At any rate, today I will address another issue, one that has popped up again recently.

 

Last month I received a message from a myeloma list friend informing me that she began taking curcumin because her IgA was steadily increasing. On curcumin, she wrote, her IgA was still increasing but at a lower rate, which she found encouraging.

 

At that point she was taking three grams of curcumin a day. When she tried increasing to four grams, she noticed that, and I quote, yellow dye was being excreted from my skin. I noticed it when I dried my face and there was yellow on the towel. I also noticed that my nails were yellow. I know you have been taking curcumin at a higher dose for quite a while and wondered if you had that side effect and whether it bothered you if it did. In any case, I’ve reduced the dose to 2 grams a day and at that dose it seems OK–no yellow nails.

 

Last year, a blog reader/dear friend also reported a similar problem with the colour yellow. He was sweating yellow during the night…to the point of staining a brand new set of sheets.

 

Then, just a couple of days ago, I received a contact message from a blog reader informing me that her husband seems to be turning yellow. It was time for me to look into the matter.

 

The first of the three cases may be connected with the actual handling of curcumin, although my friend didn’t think so. But, in addition to being used for many medicinal purposes in India, turmeric (from which curcumin is extracted) is also used as a textile dye. Very true, curcumin stains like crazy. Whenever I handle the yellow-orange powder, I stain everything I touch. No matter how careful I am, curcumin always “outsmarts” me. My hands turn yellow. Everything I touch or wear turns yellow. And one day, jumping onto the kitchen counter just as I was measuring out my daily amount of curcumin powder, Piccolo, my male cat, managed to stain the white underside of his paws. Eh, he didn’t care for that at all and almost licked himself into a trance. His paws remained yellow for a few days…he was very upset.

 

Well, I finally did an online search to see if I could come up with an explanation of sorts. Almost immediately, I found a thread that dealt with this problem. Super!, I thought. Someone reported that Within 8 hours of taking one Curcumin capsule, however, the fingers on my right hand will begin to yellow along with small yellow splotches on the palm. The real strange thing is, my mother developes the exact same yellowing on her right hand. I know it’s not from handling the capsules, so does anyone have any clue what is causing this?

 

Other thread readers offered various suggestions and ideas, but then, at the end, the person who had introduced the yellowing topic confessed: Let the truth be told. I am a moron. Yep, it was just from the excess powder that was outside the capsules. It was even all around the top of the bottle, so simply opening it would get a small amount of the residue on my hand. I also know why I only noticed it in the morning. My apartment is lit with “yellow” light so I couldn’t see it. It was only until I went out on my deck in the morning with my coffee that I could notice the staining!

 

I reported this story because I thought it might be useful: even curcumin capsules can stain your fingers yellow. It still doesn’t seem to explain my three blog readers’ “yellowing” experiences…

In conclusion, all I can say is that I have never had inexplicable yellow sweat, yellow skin or yellow anything… The yellowing of my hands, face and clothes has always been caused by my own carelessness.

I am puzzled, I confess. I thought that perhaps those affected by yellowing should have their liver function tested (always a good idea, as part of a regular check-up)…I should note, though, that curcumin has a protective effect on the liver. I give up.

Any other thoughts?