I grew up in Italy, where patriotism is not overtly expressed. The only time you will see lots of Italian flags waving about is when Italy wins the World Soccer Cup. And perhaps on a few other occasions.

The opposite is true here in the U.S. There are flags everywhere. I don’t mean that in a negative sense, eh, please don’t get me wrong. It’s just different, that’s all.

But…a flag stuck on top of a…beach umbrella?

Fabulous long walk on the beach this morning. We happened upon a laughing group of friends playing bocce and having a great time…further down the beach, a few brave folks who must have been related to polar bears were in the chilly water…but what kept my attention was…this (see photo). Hmmm, not something that I would personally choose to do…but today was certainly a glorious windy day, perfect for flitting about over the water…I guess!

This morning, while waiting for Stefano to wake up so we could go for a walk on the beach before the crowds took over, I came upon a bit of online news that explains something that happened to me a few years ago: http://tinyurl.com/m2xf24

Now I know why I screeched a few, er, unladylike words during my second bone marrow biopsy (I have had three in all, and the first two were excruciatingly painful)…in my defense, the person performing the procedure was a medical intern…and I was her guinea pig, though nobody told me that until it was too late to say NO! There was an overseeing doctor, of course, also a woman, who began guiding the intern through the procedure: “do this, do that…no, don’t do it that way.”

As the intern pierced my hip bone with the needle, though, instead of continuing in a calm and reassuring manner, Dr. Nutcase began yelling bloody murder at the trembling intern. Right over my head. Things that a patient should never have to hear: “no, don’t hold the needle like that! Can’t you tell that it’s shaking??? Hold it steady, for crying out loud. And push, darn it, push, no push harder, puuuuuushhhhh!!! Harderrrrr!” (=the equivalent in Italian.)

I remember an initial attempt at humor on my part, something like “oh yeah, please do be steady with that needle, will ya???” As my pain increased, though, I remember moaning: “sorry, guys, but I have to do this…” And then I let out a couple of Italian swear words…similar to “darn it,” nothing too strong, mind you (“ma porca miseriaaaaa!!!”). And I really did feel better. Now I know why…

This morning I woke up thinking how easy it is to forget that I have cancer cells inside of me…I haven’t given cancer half a thought since I’ve been on holiday (until now, that is!). Even my daily dose of curcumin and fish oil doesn’t remind me…

It’s easy to forget about the evil cells when you are walking along a nature trail in Nickerson State Park and practically stumble upon a couple of red squirrels at play…chasing  each other around and on top of a pile of dead branches, putting on a real show for Stefano and me.  What a fantastic moment that was…

It’s easy to forget…while on a Cape Cod beach at sunset, watching children fly kites or try to save their elaborate turreted sand castles from the advancing high tide. Ah yes, it’s easy.

Sherlock sent me a study that I mentioned in a recent post…but I am in no mood for research right now…and even though I am and will be answering e-mails and posting a few photos on my blog, the serious stuff will just have to wait for another couple of weeks…

Stefano and I arrived safe and sound last night at my parents’ home on Cape Cod, Massachusetts (U.S.A.)…our Florence-Paris-Boston trip was uneventful…hmmm, well, okay, except for a bit of turbulence toward the end…oh, and having to sprint like cheetahs through the Charles de Gaulle airport, pant pant sweat sweat…now why the heck were we not allotted more time to catch our connecting flight to Boston? We ended up having only a half hour or less to change terminals and go through security checks again, hello???…Afterwards I thought that if we’d caught the wrong bus to the wrong terminal (an entirely possible scenario), we would have missed our flight for sure (not that being stuck in Paris for a night would have bothered me that much, eh!)… 

This morning, after five hours’ sleep, we went out for breakfast (if you visit Cape Cod, you have to have breakfast at the “Red Cottage” in South Dennis, yum yum!)…then we stopped by the supermarket to buy some food (y’know, I could spend an entire week wandering around a U.S. supermarket…an entirely fascinating experience!)…and late this afternoon we went for a walk on the beach. It’s so lovely here. I feel fabulous…so relaxed…hmmm, could be the jet lag…zzz…in fact, I think I need a nap right about now 😉 

I’d like to leave you with a link that my cousin sent to me…an adorable UK cat story that made the Italian news, too: http://tinyurl.com/l3xzpz Enjoy!

I found a verrry interesting item while reading “Jaymun’s Journey” (see: http://tinyurl.com/l5te4c Thanks, Dave! Incidentally, I am so thankful and happy that Jaymun is home now, what a relief!), which then led me to the following abstract: http://tinyurl.com/klxuvf Wowiezeewie!

In September, I will ask Sherlock if she can get me the full study…in the meantime, we will have to be content with what can be gleaned from the abstract, such as this glorious titbit: Ganoderma lucidum extract has a profound activity against leukemia, lymphoma and multiple myeloma cells and may be a novel adjunctive therapy for the treatment of hematologic malignancies. Profound effect??? That sounds super…but what is this stuff?

Well, ganoderma lucidum is a mushroom species…a fungus that has been used in traditional Chinese medicine for more than 4,000 years, making it one of the oldest mushrooms known to have been used in medicine, as we can read in its write-up in Wikipedia: http://tinyurl.com/n5szkn Perhaps many of you will recognize, as I did!, the Japanese word for this mushroom: Reishi. Ah yes. It seems to be another one of those fix-all-and-more remedies…it is used to treat conditions as diverse as rheumatism, heart problems, asthma, fatigue, psoriasis, high blood pressure, HIV and…cancer. And more…

I urge you to have a look at the above Wikipedia link. The “History” section is absolutely fascinating. For instance, the oldest book in oriental herbal medicine (2,000 years old!) states the following: “The taste is bitter, its energy neutral, it has no toxicity. It cures the accumulation of pathogenic factors in the chest. It is good for the Qi of the head, including mental activities… Long term consumption will lighten the body; you will never become old. It lengthens years.” Uhm…never become OLD?!!! Words escape me at the moment…

In Chinese, by the way, it is called “lingzhi,” which means “herb of spiritual potency” and my personal favourite: “mushroom of immortality.” 🙂

Wikipedia also provides suggestions on how to cook this mushroom as well as a list of scientific studies backing its rather impressive anti-this and anti-that properties. Can you tell that I am excited? 🙂 There are also heaps of studies on the mushroom of immortality in PubMed…I have already found a reliable source and will buy some of the, er, immortal extract, even though I don’t have the time now to go through any of these studies (but what I have read is enough to convince me to give it a whirl…)…

Finally, I would like to add that 24 hours from now Stefano and I will be on a flight for the U.S. We are spending our three-week summer holiday in my home state of Massachusetts. Yaaay! I can’t wait!

I will have access to my blog and e-mail account during this period (we are staying at my parents’ house, mostly), so I won’t “disappear” as I was forced to do last summer, when we went to France. But hey, after all, we will be on holiday, so I doubt I will be doing much research! A more likely scenario: Margaret (and Stefano, of course!) on a whale-watching boat or wandering through one of the Mass Audubon wildlife sanctuaries. But I will certainly stop by the blog now and again to say “hi there!” and post a few of the glorious photos that I plan to take…well, I have some packing to do, sooo…ciao for now!

Cat lovers should be familiar with Nora, the piano-playing cat (if not, have a look on YouTube)…well, yesterday my cousin sent me the link to a wonderful piece featuring Nora and a symphony orchestra. I enjoyed it very much and hope you do, too! See: http://tinyurl.com/nolmn4

This morning I took on the task of going through some of my still unread (=for lack of time) e-mails, in particular, my “Science Daily” messages. So glad I did! I found one very interesting item (see http://tinyurl.com/mcac5k): a new study shows that women treating their symptoms of menopause with hormone replacement therapy could reduce their risk of developing breast cancer by taking, tadaaa!, curcumin.

The researchers found that curcumin delayed the first appearance, decreased incidence and reduced multiplicity of progestin-accelerated tumors in an animal model. Curcumin also prevented the appearance of gross morphological abnormalities in the mammary glands. It did this by blocking progestin’s increased production of VEGF (aha, an old nemesis of ours pops up…). The researchers believe that curcumin and other antiangiogenic substances could decrease or delay the risk of breast cancer associated with combined hormone replacement therapy. Holy puffins!

Menopause is a very complicated process…I admit to knowing very little about it, except the basics that I suppose every woman knows…but I realize that I must look more closely into this process at some point soon because I seem to have entered a premenopausal stage…even though I have had no unwelcome symptoms yet (hot flashes, e.g.). I must say, though, after reading this article, I feel much encouraged that perhaps my daily intake of curcumin will protect me in yet another way…a peachy thought!

A couple of myeloma list friends/blog readers have sent me links to the same article on how cats control us humans. Very true. Those interested can click here: http://tinyurl.com/nwc4ax

And, if you are in need of a smile (even if you aren’t!), have a look at the most recent “Simon’s Cat” video: http://tinyurl.com/m9bdzs Hehe! I am a huge fan of this brilliant cartoonist, who, by the way, has three cats of his own…

Premise: in my blog, my intention has always been to report on my own experience concerning both health issues and life in general, with some funny stuff thrown in here and there. I have always intended to do this in a straightforward and humorous manner…that’s how I am in real life, after all! And if I make a mistake, or base a post on incorrect information that I found on my own or that I received from someone else, I try to set things right as soon as possible. Well, I made a mistake in my April 16 2009 post. I meant to write a “correction” post earlier, but other things (life!) got in the way…then a blog reader reminded me of my duty just this morning. OOPS!

I owe a huge debt of thanks to that same blog reader who wrote me a message back in early May (!) concerning my above-mentioned post, the one about the risk of progression from SMM to MM. After reading it, in fact, he wrote directly to one of the authors of the NEJM study. He then sent me their exchange, which I, without naming names for reasons of privacy, will post about today, with his prior permission, of course. Since numbers, as those of you who know me well, are not at all my forte, sigh, I will simply post the examples that my blog reader and the expert used:

Blog reader: I have a friend who currently has Smoldering Multiple Myeloma and has had that diagnosis for 10 years. She has been advised that according to your graph – “Figure 2. Probability of Progression to Active Multiple Myeloma…” she has a 66%  probability of developing MM sometime in the future. Further, that as time passes, since the cumulative probabilities are increasing, if she makes it to 15 years, she will then have a 73% probability of progressing to MM and eventually she will have a virtually 100% chance of progression.

I see the data as retrospective rather than prospective. That is, on average, 66% of people with smoldering MM already have progressed to MM after 10 years. As for those who have not progressed at 10 years (about 34% of the original group), an additional 7% in absolute terms or about 21% in relative terms (21% of 34% = 7%)  will progress  – thus arriving at the 73% cumulative probability at 15 years.

I realize the 21% is a theoretical and imperfect estimate since it does not take into consideration many factors such as death from unrelated causes etc. However, would you say that the 66% value in your graph refers to the proportion of people who have progressed to MM at 10 years and is not an estimate of the proportion of people who will progress after 10 years?

The expert: You are correct in your assumption that the 66% value refers to the proportion of people who have progressed to MM or AL amyloidosis at 10 years and is not an estimate of the proportion of patients who will progress after 10 years.  As a matter of fact, the risk of progression after 10 years is approximately 1% to 2% per year.

Our data indicates that the patient is at greatest risk during the first five years and then the risk decreases.  As you pointed out, we are all at risk of succumbing to something as times goes on.

So, the rather dismal statistics in the NEJM study refer only to those who HAVE PROGRESSED from a smoldering state to active myeloma after 10 years. It does not take into consideration those who HAVE NOT PROGRESSED. Indeed, if you have NOT progressed, your risk factor decreases with each passing year, which, by the way, coincides with my original interpretation of the study. In the study author’s own words, As a matter of fact, the risk of progression after 10 years is approximately 1% to 2% per year. Hah.

By the way, another myeloma list member recently left a comment on my April 16 post. Here is her take on the study (my emphasis): 

“The overall risk of progression was 10% per year for the first 5 years, approximately 3% per year for the next 5 years, and 1% per year for the last 10 years.” What this means is that in year 1, 10% of the group of smolderers progressed to full MM, same in each of years 2-5. Then, after that, of those who were left in the group, in each of years 6-10, 3% of the group progressed. Next, again out of those who were left, only 1% of them progressed each year thereafter. So basically, the rule is “the longer you have been smoldering, the more successful you will be at staying in the smoldering state”, statistically speaking and in layman’s terms. You don’t accumulate [ ie. add ] the percentages as you go along. For example, if you make it as far as year 6, then your chances of progressing during year 7 are 3%.

Okay, so, having SMM does not mean that some day you will inevitably progress to active myeloma. Some of us will, some of us won’t.

I hope this is reassuring to those of you who, like me, have been in a stable smoldering state for a while (2010 will be my fifth year as a…smolderer). And, once again, I deeply apologize for having waited so long to post about all this…ah, what can I say in my defence? I must be super allergic to numbers…in fact, here it comes…ahhh…ahhh…atchooooo! (etciù! in Italian…)