“Curcumin for monoclonal gammopathies. What can we hope for, what should we fear.” My comments on the Vermorken study, 2012. Part III.

Work always seems to get in the way of posting anything serious, including this final rant, uhm…I mean, final part of my three-part series on the 2012 Vermorken et al study. But I finally got to it, even though I really should be working, y’know…Cat food is expensive! 😉

Here goes! 

CHAPTER FIVE. The part that really got my knickers tied in a knot is in paragraph 5.2…the part about immunosuppression: Patients with MGUS, but less so than those with myeloma, have an increased risk of infection. See my March 22 2013 post for my own experience…no point in going over it again. 

Speaking of “again,” here the authors again (AGAIN!!!) bring up the case of ONE, SINGLE MGUS patient that they’d already used as an example back in 2010. You’ve got to be bloody joking. Boyohboy, you should have seen my face when I read this part. 😯 I mean, could they possibly have done no better than THAT, after TWO FULL YEARS of research (since 2010, I mean)??? Could they not have come up in the meantime with ANYONE ELSE, even a member of their own team forcryinoutloud!, to test their shaky-at-best theories on turmeric or curcumin (I wrote both because in their 2010 study, they seemed a bit muddled about the difference between the spice and its active ingredient)? If I had access to a lab, as they most certainly did, I’d be testing myself all the time and recruiting other people willing to be tested…I mean, you can do a lot in TWO YEARS. A lot…

Anyway, as they had already told us in 2010zzzzz, the above-mentioned patient’s daily intake of turmeric for intestinal complaints repeatedly led to bronchitis. Now wait a sec. Turmeric is used to treat bronchitis in Ayurveda, so this part makes subzero sense. But I’ve already written about this particular study (see my late March, early April 2010 posts), so I’ll leave it at that… 

Oh wait, except I wanted to note that, while the authors of this study lament the fact that the Australian MGUS curcumin trial had only a small number of participants (25 or 26 MGUSers, as I recall…), it was perfectly okay for them to make pronouncements on the dangers of turmeric based on ONE SINGLE patient (= a guy with a long list/history of ailments, to boot…Just check out the 2010 case report…). So in the end we have, ah, let’s see: 26 cases versus…ONE?

Grump…

So, let’s recapitulate: Vermorken et al use the same patient as an example in two separate studies written two years apart. I find that absurdly astonishing…beyond comprehension, really. So I’m going to repeat my question: is that the best they could do? In two years’ time, could they not find another patient or, better still, a group of curcumin-taking patients who developed some side effects that would prove their points on the dangers of this spice? 

I guess not. 

And that takes me to my next point. If we were to worry about everything that inhibits our T cells, thus depressing the immune system, we would have to stop aging, for one thing. Oh yeah, as we get older, our T cells decrease and are also not as effective as they used to be.

But, a bit more seriously now, we’d also have to avoid taking a lot of helpful medicines, including glucocorticoids. ”Oh yes, m’am, that’s really too bad about your pesky allergies and asthma, but you see, based on the perhaps-totally-unrelated experience of one single patient in the Vermorken study,  you should really avoid taking glucocorticoids because they might depress your immune system. And yes, you’ll just have to put up with the itchy hives and the wheezing, sorry!”

I mean, c’mon…

And another thought just popped into my mind. How come Vermorken isn’t worried about the clinical trials that are already testing or are about to test drugs such as lenalidomide (Revlimid) and dexamethasone, just to name a few, on smoldering myeloma patients? These are immunosuppressant drugs…tested on SMM folks. Now why isn’t Vermorken concerned about these drugs’ immunosuppressant effects, which I imagine would be far stronger than those of curcumin??? (See my April 1 2010 rant and rave on this topic.)

One of these trials, as you may recall, is the Spanish SMM chemo study (grrrrrr!!!). Well, I recently found an interesting bit of info that I want to share with you: the Mayo Clinic and the Spanish PETHEMA can’t even agree on which SMM folks are considered to be high-risk. No kidding. Check this out: http://goo.gl/2D7S3 Oh yeah, I’m angry. You can bet your favorite polka dot mittens on that. It’s a bloody disgrace…

And I say this with much regret, believe me. I wish it weren’t so. I really do. But what else can we conclude?

Okay, I’ll stop ranting for a second and get back to our topic at hand.

If you’re curious to know which conditions are treated by glucocorticoids, this page at Drugs.com will give you an exhaustive list: http://goo.gl/1f8Tx…from Acute Lymphocytic Leukemia to allergic reactions all the way to uveitis…oh, all sorts of ailments… 

In a comment on my March 25 2013 post, Joao (thank you!) reminded us of the CAMP protein, which is vital to our innate immune system and, well well well quelle surprise (not!), is stimulated by…drum roll!!!…yes, you guessed it!, is stimulated by curcumin: http://goo.gl/ZjhLH Vitamin D stimulates CAMP, too, by the way. In fact, my intake of both (plus Nigella sativa) might explain why I am so healthy (knocking on wood, here!)…

So much for the issue of immunosuppression. I think I’ve said more than enough. 😉

CHAPTER SIX. On to paragraph 5.5. “Could curcumin induce a more malignant phenotype?” Wow, that’s a real eye-grabber. Let’s take a closer look.

Here the authors briefly discuss VEGF, which is a close friend and “feeder” of Mr. Myeloma. That’s precisely why VEGF is a target in conventional myeloma treatment. Unfortunately, though, at some point, myeloma cells become resistant to these anti-VEGF drugs. And these resistant buggers are more invasive. Okay, that’s clear. 

But the authors imply that, since curcumin also inhibits VEGF, it might create resistant cells and a more malignant phenotype…just like those potent toxic conventional drugs. Huh? That’s all the “proof” they provide??? Just a hypothesis???

I have two observations to make:

1. if the conventional anti-VEGF (= anti-angiogenesis) drugs create more resistant and aggressive myeloma cells, then they should certainly not be used to treat myeloma…Translated, that means: no more thalidomide and analogues (the recently-approved-by-the-FDA pomalidomide/Pomalyst, lenalidomide…). No more bortezomib (Velcade) or other proteasome inhibitors. No more cyclophosphamide. No more zoledronic acid (Zometa)…ah, yep…Zometa inhibits the myeloma-feeding process of angiogenesis, too. Well, I’ll stop here. You get the gist. 

2. now, if a hypothesis doesn’t need to be backed up by any tangible evidence (and in this particular case, as they did in paragraph 5.4 sigh, the authors bring forth no proof whatsoever that curcumin might induce a more malignant phenotype), does that mean that I can just blurt out any kind of crazy or random hypothesis about, well, about anything? What if I were to state that curcumin cures myeloma? Based on Vermorken et al, I don’t need to back up my statement with any proof. All I have to do is write a study about it. 

Yes, of course it’s absurd. That’s precisely my point. 

Sheesh. 

Let’s keep going. I have a final clincher… 🙂

Conclusions. Vermorken et al continue to insist that there is a “dark side” to curcumin. There may well be, but it isn’t immunosuppression. And here we do have proof. 

As for so-called “controlled clinical trials,” well, in a perfect world, I’d agree that these would be of the utmost importance. But we don’t live in a perfect world, to say the least. If you haven’t done so already, please have a look at my March 11 2013 post on “Publication bias.” The TED talk to which I link in that post is a real eye-opener…Obviously, this doesn’t mean that we should start testing potentially dangerous stuff on ourselves. It just means that we shouldn’t live with blindfolds over our eyes. We should be aware that negative data frequently doesn’t get published. That’s all I’m sayin’… 

MY FINAL CONSIDERATIONS. I always find the “Conflict of Interest” part of a study most illuminating. Remember all the raging posts I’ve written about the Spanish SMM trial…remember how many of the physicians/researchers involved in that trial had incredibly obvious ties to Celgene, the maker of one of the drugs used in the trial (one of them, as I recall, was a Celgene employee, not even an MD!)? Yeah. My blood still boils when I see a reference to that trial, grrrr. 

Well, as for this study, in addition to looking at the Acknowledgements, please don’t neglect to check out Prof. Andrès’ associations: “He has received several grants for lectures, studies or expertise from laboratories.” Hmmm, which laboratories? It’s worth it to list them all, methinks: 

GlaxoSmithKline (that’s what GSK stands for), Amgen, Roche, Chugai, Vifor, Ferring, Sherring, Genzyme and Actelion…

Hey hey hey, lots of Big Pharma, here. Gee wiz. Is there anyone out there who has NOT been “contaminated” by big pharma money? 

But, of course, “this work is free of any such association.” Of course it is. That malicious thought didn’t even pop into my mind. Or…

Did it?

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