I’ve written quite a bit about cancer stem cells, especially myeloma stem cells (check my “Myeloma and Stem Cells” Page on the right), so I don’t need to go over the topic again…

To be honest, though, I hadn’t thought about myeloma or any-cancer stem cells in some time…until this morning, when a very interesting Google Alert led me to an open-access article (oh I just love open access!!!) on curcumin’s effects on stem-like esophageal squamous carcinoma cell lines. Ah yes, the expression “stem-LIKE” stopped me, too. But the study explains that these are cancer cells that behave like stem cells…for instance, they become resistant to conventional treatments and are quite aggressive, as well as being more metastatic…bleah. 

Well, we already know that curcumin inhibits some of the crucial cancer stem cell pathways–Notch, WNT and Hedgehog, that is. And we also know that there have been other cancer STEM cell/curcumin studies in recent years (off the top of my head, I can think of colon and breast cancer stem cell studies, e.g.)…

And now here is a NEW study, suggesting that curcumin targets esophageal stem-like cancer cells: http://goo.gl/6Cm8m 

Now, truth be told, I have only had the time to glance at this study, so I can’t and won’t comment on it…but I read enough to realize that this bit of news is really POSITIVE…

Now for a quick kitty health update.

Little Prezzemolo is still sneezing and has a bit of a clogged nose, BUT he has been eating like a horse, nah, like a couple of horses!, AND he has also started playing again, which are both incredibly positive signs. Indeed, when you look at this photo (oh he loves playing in his cat tunnel), you wouldn’t think this is a convalescent cat, eh? Yet just a few days ago he wouldn’t even glance at his toys…he was so incredibly weak (slept most of the time)…What a difference from today, when he just wants to play play play, but I have to be super careful not to tire him (and moi!) out too much…

As for Peekaboo, after a difficult, feverish weekend she has made an almost full recovery. Today her voice is back, and, like Prezzemolo, she is showing interest in her toys and has quite an appetite…

Soooooo…a few more days, and we’ll all be fine…(We need a few naps, though, let me tell ya! 😉 )

And just in time for Halloween, too! By the way, Happy Halloween, everyone… 

P.S. My thoughts go to those who have been hardest hit by the recent hurricane…Really awful…so sorry…

Early Wednesday morning, I was lying in bed, more than half asleep, with my arms wrapped around a loudly purring Priscilla (our 7-year-old tiger cat), when suddenly she sneezed. Violently. A spray of cat sneeze-snot hit me right in the face. I think there might still be a dent where my head hit the ceiling…

😉

Needless to say, I put Priscilla immediately on an oral antibiotic. Two daily doses in her food. Actually, for preventive purposes, I decided to do the same for our two eldest cats, too. 

So here is the current situation:

1. two cats, Prezzemolo and Peekaboo, are still quite ill and have to be taken (by yours truly) to the vet every day for shots of antibiotics and an anti-inflammatory somethingorother to keep down their fevers. Yes, they both have a fever…especially Peekaboo. They are both quite languid but eating, which is always a good sign. Peekaboo, our chattiest kitty, has completely lost her voice due to her tracheitis (inflammation of the windpipe) and is still coughing and sneezing;

2. one sneezing cat, Priscilla, also has a bit of a sore throat (we can tell by the way she gulps when swallowing) and is on an oral antibiotic, as I mentioned. Like Peekaboo, Priscilla has also lost her voice;

3. our two eldest cats, Piccolo and Puzzola, are being monitored carefully and are also taking an oral antibiotic…Thus far, fingers crossed!, they seem to be okay. Uhm, Piccolo did sneeze ONCE in the kitchen this morning, but I hope it was merely in reference to my recent lackadaisical housekeeping 😉 ; 

4. Pinga was on an oral antibiotic palatable paste BEFORE any of this happened, so I’m keeping her on it just to be cautious. Together with 12-year-old Puzzola, she’s the most active of our cats. 

–The good news: they all have an appetite. This means that I will soon be able to administer the antibiotic orally to ALL of them, without having to go through the stress (for the cats AND me) of taking two of them to the vet every day…Since winter is supposed to hit Italy tomorrow (temperatures are going to drop considerably, etc.), my current goal is to keep the cats at home and warm…

–The bad news: this situation isn’t going to end overnight, I fear. The infection isn’t just bacterial but also has a viral component. And, as we know, viruses can be stubborn beasties…

Now, the obvious question is: since we’d kept the new kitten completely separate from the adult cats from the very beginning, how did the latter get infected?

So that’s the story…thus far…

Just a quick update on our feline situation (mainly to explain why I might not be answering emails and so on…).

A few days ago, it seemed that the worst was over: Prezzemolo had begun eating and drinking and seemed to be recovering well.

Well, since then we’ve had quite a setback. Yesterday Prezzemolo didn’t eat a single bite of food. He did have a few sips of water, but that was IT for the day. And he was very lethargic, of course. There was nothing we could do but keep him warm and wait till this morning. We were extremely worried, since this meant that he didn’t have his antibiotic (it was supposed to go into his food, all crushed up, of course)…yes, very bad, I know! Anyway, first thing this morning we took him in to the vet who gave him a shot of antibiotics. Poor little thing…

But that’s not the end of it. Last night, out of the blue, Peekaboo, our five-year-old, began coughing a rather weird, raucous cough…So yes, she’s sick, too. This morning we took her (separately from Prezzemolo) to the vet who told us she has tracheitis (inflammation of the windpipe, or trachea, which can be really dangerous if not treated), luckily with no fever. Antibiotics for her, too. Another miserable cat…

Are the two illnesses connected? Probably…(In spite of all our precautions, hand washing etc.) I mean, Peekaboo has never been sick before. So this is too coincidental. Tomorrow I’m going to see if the vet can run some blood tests and/or sputum cultures on both cats. I’d really like to know what we’re dealing with, here…

At any rate, for the next 8 to 10 days I’ll be taking the cats to the vet (two separate trips, mind you…) for their shots. Stefano will help me whenever he can (today, e.g., he took the day off work…), but I’ll be doing most of the caregiving, since I’m the one who is at home the most. 

As long as the others don’t get sick…yikes…Sandy, please send some of that universal energy our way, will you? Thanks! 

Well, we will get through this, of course. And Peekaboo and Prezzemolo are going to be fine…It’s just…really hard to see them suffer like this…I mean, just ten minutes ago, the little one turned his head away when I put some yummy wet cat food under his nose to see if I could get him to take just a little bite…

Warning: today’s joke has some sexually explicit language…but it made me laugh out loud, and I think it will make many if not ALL of you laugh, too! 🙂

But first, a quick update on Prezzemolo’s state of health. Yesterday he was doing very poorly indeed. But today, when I got home from work, he was at his food bowl, EATING. I almost cried with happiness. He hadn’t had anything to eat or drink in 48 hours, you see, and we were super worried, even though our vet was positive that he’d be fine (evidently, she was right, I’m happy to say). Then he went over to his water bowl and had a nice, long drink (together with a few sneezes…). Well, he’s still sick, but he is definitely feeling better. And he’s breathing with his NOSE! Relief! Joy!

Okay, here’s the joke, sent to me by a blog reader, now a real-life, good friend: 

Sex and Grammar

For all my grammatically correct friends.

On his 74th birthday, a man got a gift certificate from his wife. The certificate paid for a visit to a medicine man who was rumoured to have a wonderful cure for erectile dysfunction. After being persuaded, he went to see the medicine man and wondered what would ensue.

The medicine man handed a potion to him, and, gripping his shoulder, warned, ‘This is a powerful medicine. You take only a teaspoonful, and then say ‘1-2-3.’ When you do, you will become more manly than you have ever been in your life, and you can perform as long as you want.”

 The man was encouraged.  As he walked away, he turned and asked, “How do I stop the medicine from working?”

“Your partner must say ‘1-2-3-4,'” he responded, “but when she does, the medicine will not work again until the next full moon.”

He was very eager to see if it worked so he went home, showered, shaved, took a spoonful of the medicine, and then invited his wife to join him in the bedroom. When she came in, he took off his clothes and said, “1-2-3!”

Immediately, he was the manliest of men. 

His wife was excited and began throwing off her clothes, and then she asked, “What was the 1-2-3 for?”

And that, my friends, is why we should never end our sentences with a preposition, because we could end up with…

a dangling participle.

No, I’m not sick. I’m fine (but worried). Our new kitten, Prezzemolo, is the one that’s ill. Two nights ago he began sneezing repeatedly, so yesterday morning I called our vet who told me to keep an eye on him and call her if anything changed. Things did change, unfortunately. First, he stopped being super active. Then I noticed that he wasn’t breathing through his nose but through his mouth…and finally, yesterday evening, he stopped eating and drinking. By then it was too late to call the vet. 

To make a long story short, after a restless night for two worried human parents, I took him to the vet first thing this morning. It turns out that the poor little critter has a high fever, a cold and a bit of bronchitis (luckily caught in time, so it’s high up). She immediately gave him a shot of antibiotics and cortisone…

Poor little sweetie. He looks so miserable. And he didn’t even meow on the way to the vet (and here I’ve always hoped to have at least ONE cat who wouldn’t meow in the car, hah…But this morning I would have been happy to hear at least a peep…). 

Anyway, he should be better in a few days. I’m with him almost all the time (whenever I’m not working, that is), so obviously I won’t be doing any research for the blog. I might post a few silly items, but nothing serious.

Just so you know…

Ciao!

UPDATE (October 19 2012): this morning Prezzemolo is breathing through his nose and catching up on much-needed sleep. The worst seems to be over. His human parents are much relieved! More soon! 

We just got back from the vet. The bad news is that our little Prezzemolo has coccidiosis, which is a common parasitic infection of the intestinal tract, especially in kittens. So this came as no huge surprise, though we were hoping that he’d get a clean bill of health…

We’ve already begun treating him for it. It’s no big deal, really, since it was caught early (but I read online that it CAN, if left untreated, lead to death, aaaaagh!), but we will have to postpone the meeting between Prezzemolo and the rest of his new feline family for a couple of weeks. Treating ONE cat is one thing; treating SIX cats, quite another!!!

There is good news, though: apart from the coccidiosis, the vet told us that he’s purrrrrrfectly healthy. So this is just a minor nuisance…Oh, except that Stefano and I will have to keep sleeping apart…uffa!

But—we’d do anything for our kitties…

P.S. Stefano took this photo of Prezzemolo yesterday…I howled with laughter when I first saw it (it looks like Prezzemolo is waving at the camera) and asked him if I could publish it on the blog…So here is an example of what Stefano can do with his big fancy camera! 😉 

I’d forgotten how tiring it is to be adopted by a new cat. The problem is trying to find a balance between spending time with the new kitty, so he can get used to us and learn to love us, AND paying enough attention to the other cats who don’t like what they smell and hear…

And also, as all cat lovers know, cats don’t like CLOSED DOORS. Peekaboo, perhaps our most curious cat, has really been trying to get inside the bedroom where Prezzemolo has been “segregated” since we got home yesterday afternoon. She scratches at the door (off and on) quite insistently and almost got in once, so we have to be super careful when entering or exiting the room. I don’t want any contact to take place between Prezzemolo and the others until the vet has given us the green, “he’s healthy!” light. 

Okay, so how did we get ourselves into this furry mess? 😉 Well, I’m a member of a Facebook group called “Adozione gattini Firenze,” which means “Kitty adoption Florence.” (It’s run by members of one of the famous Florentine cat shelters, located in Bagno a Ripoli, just outside of Florence.) It was there that I recently read the story of Amelia, a 2-month-old black kitten who had been adopted together with her little brother but then, shortly thereafter, was brought back to the cat shelter. Alone. The little brother stayed with his new family.

Well, Stefano and I were simply horrified. I mean, how can you keep one kitten but refuse the other? So we called the cat shelter and–through the lovely ladies who are in charge of it–the kitten’s new foster Mom. She and I chatted on the phone for some time. The problem with Amelia, it turns out, is that she is VERY shy and runs away from people. So her foster Mom and I thought that perhaps it wouldn’t be a good idea to plop her into a household with other five cats of which one, Pinga, is a bit on the aggressive side. Amelia didn’t need any new psychological traumas, in short.  

Then her foster Mom suggested another kitty for us. Another black kitty, as it turns out (this must be a good year for black cats!), who is a month or so older than Amelia and has a blind eye. The poor dear had developed an eye infection that hadn’t been treated in time (this happened before he was abandoned at the cat shelter, where his eyes were treated immediately), and that is how he lost sight in one eye. After hearing his sad story, we really wanted to adopt him, but there was a problem here, too. Basically, since our cats are all indoor cats, not even one of ’em is vaccinated, so we’d have put them at risk with this kitten. The cat shelter ladies were very open and honest with us about this, which I appreciated. Are you yawning yet? 😉

Well, the cat shelter ladies didn’t give up on us. They suggested we go see three 4-month-old kittens up at the cat shelter. Again, a sad story of abandonment. But the ladies were 100% certain that these kitties came from a home, which meant they wouldn’t bring any illnesses inside our no-vaccine house. And so yesterday afternoon we drove out to the cat shelter to have a look at the kittens: two little tigers and a black one. We decided to see which one would pick us…and it just so happened to be the one we liked the best, little Prezzemolo, who let Stefano pick him up, while his brother and sister hid underneath a piece of furniture. So he’s the one that came home with us. By the way, that’s how our vet chooses her dogs (or rather, is chosen by her dogs!): the one that jumps in the car is the one that goes home with her…

Stefano spent last night in my parents’ bedroom with Prezzemolo, and I slept in our bed with the other cats. Stefano and I don’t like to sleep apart, but this was for a good reason, of course. 

Prezzemolo is going to be a very handsome adult cat. He has gorgeous sleek fur. But right now he’s a baby that wants to play almost all the time. And so we play. That’s the best thing to do with a curious, growing, purring, happy kitten… 🙂

Update: I just read on FB that his brother and sister were adopted today. So happy for all of them! 🙂

Cat number six joined our crazy but very happy feline household today. It’s a long story, which I’ll save for a rainy day since right now we’re taking turns staying in my parents’ bedroom with the new kitty, a four-month-old black male that we’ve named Prezzemolo (= “Parsley” in Italian).

Actually, he hasn’t quite “joined” the family yet, since we are keeping the new kitty separate from our adult cats, for obvious reasons. I will take Prezzemolo to the vet on Monday. After that, if everything’s okay, we will slowly introduce him to the others. The entire process usually takes about a week.

Anyway, here’s Prezzemolo. Stefano was brushing him, and he was purring like mad and kneading. A big purrbox, this one! We’re in love with him already. Okay, I have to get back to him now. He’s crying. Ciao! 🙂

A blog reader, thanks!, gave me the link to this recent smoldering myeloma study, an Italian study published in July in “Cancer.” You can read the abstract here: http://goo.gl/3WpkE

If you skip down to the Conclusions, it’s clear what this is all about: smoldering patients with at least 60% plasma cells seems to be at a higher risk of progressing to active myeloma. The authors recommend that these folks be “treated soon after diagnosis.” By the way, at the end of the Discussion part of the full study, this “soon” changes to “right away.” Now, in my book, “right away” is not the same as “soon,” but…perhaps I shouldn’t be so bloody picky…hmmm. 

Anyway, other “progression” parameters that you can find in the abstract: hemoglobin equal to or less than 12-5 g/dL and monoclonal component equal to or more than 2.5 g/dL. 

Okay, let’s have a look at the full study, without going overboard.

In the first paragraph, the study reiterates what we smolderers already know or should know: that, statistically, the risk of progression is 10% in the first five years. Incidentally, I can’t help mentioning that I’m at year 7 now…7 years and going strong!!! 🙂

And then they ask the key question: how can you figure out which SMM folks are at higher risk of progression? And WHO will progress more quickly?

To this I would add my own questions: if it were possible to know the answers to those questions, would you really want to know? Would it change anything you’re doing?

As far as I’m concerned, I can answer that I wouldn’t want to know, since I know that stress is such a significant factor in myeloma progression. In fact, it seems to be of particular importance in the early stages of myeloma. [In 2007 I wrote about an important Ohio University study the effect of stress on myeloma…Have a look at my Page on “Myeloma and stress” (scroll down my Pages on the right…it’s in the Myeloma section).]    

At any rate, thus far, the Italian authors claim, it has been IMPOSSIBLE to determine who will progress and who won’t, or who will progress rapidly and who will progress slowly. Lots of different, complicated (expensive) systems have been suggested, they say, but…well, these systems simply DO NOT work, including the complicated one set up by a group of Spanish researchers (= yes, I’m referring to that awful Spanish SMM-chemo trial designed by a bunch of researchers, including many who are CLOSELY tied to Celgene, hellooooo??? This trial stinks 100 times more than a fish left in the pantry for a month…). Where was I? Ah yes, fact is, all the “progression” systems created thus far DO NOT WORK, according to the Italians.

Well. Well. Well! Interesting.

And this leads to an excellent point, a point with which I happen to agree wholeheartedly!, that treatment in the absence of any symptoms has NO BENEFIT in terms of overall survival. Hah.

I’ve been saying the same thing for years…

Vindication…

The standard for SMM care, the Italians say, IN THE ABSENCE OF RELIABLE ELEMENTS TO PREDICT DISEASE PROGRESSION, is close follow-up without treatment.

Precisely. Esattamente. 

The authors then mention a Mayo Clinic study published in August 2011 in the New England Journal of Medicine (see http://goo.gl/wzeE0), which states that In patients without end-organ damage at diagnosis but with 60% or greater bone marrow involvement, the clinical course is characterized by progression to symptomatic myeloma within 2 years. Such patients should be considered to have myeloma that requires therapy at the time of diagnosis.

Statistics at work…again. Remember the Stephen Jay Gould essay on statistics? If not, please go read it. It’s excellent. I have a direct link to it here on the blog (scroll down and look on the right; it’s under “Useful links,” almost at the end…) or you can look it up via its title: The Median isn’t the Message.

Well, my own bone marrow “involvement” was “only” 50% in 2005 (that’s what changed my diagnosis from MGUS to SMM, in fact), which is obviously lower than 60%. But I have a real-life smoldering friend whose bone marrow biopsy result was 70% in November, 2005. So she would fit right in with the progression-within-two-years group.

But here’s the thing: she has NOT progressed and has no CRAB symptoms. And she’s doing fine. Perfectly fine. 

So much for progression in TWO years…So much for statistics. 

Anyway, back to the Italian study. According to these authors, progression risk was based on the following: hemoglobin or HgB, m-spike (monoclonal component), bone marrow plasma cell involvement rate; Beta-2 microglobulin, ESR (erythrocyte sedimentation rate; = VES in Italian), serum calcium, gender and age.

Of these, the really important ones were HgB, m-spike and bone marrow plasma cell rate, especially if it was above, or equal to, 60%.

As I mentioned at the beginning of this post, the authors believe that the subset of patients with a 60% or higher BMB result should be treated “right away”…that is, before any CRAB symptoms appear.

OUT-RAGE-OUS. This is a perfect example of a sweeping, generic statement bordering on the ridiculous, if not the dangerous: “oh yes, uhm, let’s just give chemotherapy to any smolderer whose BMPC involvement is at least 60%…”

😯

Interesting bit of news: according to these authors, the best way to identify the subset of what they have identified as “quick-progression” SMM patients would be to do a bone marrow ASPIRATE, not a bone marrow BIOPSY. You can find two references to this in the abstract…e.g., where it says: BMB was more sensitive for the detection of BMPC involvement, even though BMA was a more reliable indicator of a rapid progression to sy-MM.

Well, at the end of the full study the authors go as far as to state that this BMA finding strongly suggests that BMBs is NOT helpful to assess SMM patients…

Holy cats, mackerels, kingfishers and puffins! 

Well, the post title says it all. I’ve been super busy. With fun and not-so-fun stuff (but nothing to do with my own health…no worries there, at least!).

I finally handed in the website translation…one of the hardest things I’ve ever done…but it’s over and done with, as the saying goes. Phew! 

A few days ago I started reading an interesting new study but haven’t finished writing my report on it yet. I won’t be able to work on it tomorrow, either. Tomorrow a friend and I are going out of town (we’re driving down to Monte Amiata, in southern Tuscany) to attend the funeral of another friend’s father who died in the hospital last night. The poor man had been in a lot of pain for quite some time…very sad…

I must say, this has not been a very good period. But I always see the light at the end of the tunnel. And that’s the main thing…

Okay, for a bit of cheer, here’s a photo I took just the other day of our eldest kitty, Puzzola (11 or 12 years old). Isn’t she pretty? (She’s lying on a cat toy, which sticks out on the right…in case you were wondering WHAT that was… 😉 )