I am too busy to post much today…but I came across this Science Daily article titled “New gateway to treat leukemia and other cancers,” which I thought you might find interesting: http://tinyurl.com/ybwcors Zooooooming off…ciao!

In mid February I received a Google Alert that took me to a study published in January 2010: http://tinyurl.com/ygl775x The full text is available for free online…just click on the “Download PDF” button. At first, I admit, I was concerned (I mean, heckaroni, I don’t want to be taking anything that could possibly hurt me…or, horror!, hurt anyone else, for that matter!)…then I read the study again (and again…and again), did a bit of research, and my concern was put to rest.

Back then, I wrote a draft that I didn’t publish immediately but set aside, intending to return to it in a less “heated” moment. Well, I then got caught up in other things—my father-in-law’s health condition and so on—so I forgot about my draft…and many other things, come to think of it!…until a few days ago, when a blog reader left me a comment that included a link to a study written by three of the same authors who wrote the above-mentioned January paper and published this month (see: http://tinyurl.com/y8k73g4). Other blog readers have since brought that March study to my attention. Judging from the abstract, the content of the March study appears to be much the same as that of the January one, which I shall be discussing in this post (and at least one more). The study is fully available online, so you can read it, too.

Note: the January 2010 study mentions the Australian MGUS-curcumin pilot study that I posted about on my blog last year…here is a reminder of what that is all about: http://margaret.healthblogs.org/life-with-myeloma/discovery-of-curcumin/md-anderson-curcumin-myeloma-clinical-trial-results/another-curcumin-mm-clinical-trial/.

Before I begin, I would like to make it clear that I always enjoy reading serious, well-presented and well-argued studies, even if they are critical of something near and dear to me (in this case, curcumin). This particular study, however, does not fall into that category…no, I was not impressed with it. In Part 1, therefore, I would like to make a few points that I will develop further in Part 2…:

1. if you look at the “References” section (p. 268), you will notice that the authors don’t list any of the curcumin studies co-authored by Prof. Aggarwal. Not one. Now, I am always interested in a study’s bibliography, and I must say that I was quite surprised and also puzzled not to find an Aggarwal study among the 12 curcumin studies listed here. Out of curiosity, I did a search for “Prof. Aggarwal” in PubMed, where I found that he has co-authored 495 studies, 69 of which are on curcumin. Now, in my opinion, writing a study on curcumin without referencing Aggarwal, the world’s authority on curcumin and cancer, is like writing an essay criticizing the theory of relativity without quoting Einstein…or writing about Harry Potter without mentioning J.K. Rowling. It just makes no sense…or…could there be more to this than just…forgetfulness? (Oh dear, perhaps I have watched too many seasons of “CSI Crime Scene” and have developed an overly suspicious nature…)
2. here and there, the authors seem to use the words “turmeric” and “curcumin” interchangeably. But wait, there is a HUGE difference between the two. Turmeric is the spice…whereas curcumin is its active ingredient. Are the authors confused on this crucial point? We will discuss this more in depth, but not today…
3. the choice of “case study” was a bit peculiar, and you can bet your purple socks that I have loads to say about it! Not now, though. I would like for you to read this study without too much interference on my part.

Oh phooey, I can’t resist. I will interfere…but just on one more point. It is hard not to be struck by a sentence written at the very beginning of the study (my emphasis): A recent pilot study found that curcumin, in certain patients with monoclonal gammopathy of undetermined significance (MGUS), decreases the paraprotein load and the urinary N-telopeptide of type 1 collagen bone turnover marker. While this result is encouraging, the easy availability of the food component turmeric, containing curcumin, may lead to intake by MGUS patients without medical supervision.

Now wait a sec…does this mean that—based only on ONE case study (as we will soon find out)—all MGUS folks and, even more so, SMM patients, should avoid cooking with a bit of turmeric without our doctor’s approval??? Even if we are not doing any chemo? Even if we do not have another health condition that requires us to take prescription medicine? Even if we don’t have a medical history similar to the case study discussed in this report? After a moment of surprise, then of irritation, this sentence almost made me laugh. Ridikkulus.

Sure, I agree with the authors that we should always inform and update our doctors on the supplements that we are taking…I have stated that over and over again in blog posts and private messages…that just boils down to common sense.

I am certain, however, that my haematologist would not be overly pleased, to put it mildly, if I phoned her every time I decided to cook something, asking her to check my list of ingredients. “Hello, Prof. S, may I add a bit of grated ginger to my vegetable soup?” C’mon, this is really going a bit too far…

Okay, that’s it for today. As I mentioned, I don’t want to make too many comments right now, but you can be sure that I have plenty to say…ah yes, plenty…stay tuned…

I apologize for not having posted anything here in the past few days. I’ve been quite busy with work (students, translations, more students, more…) AND, most importantly!, planning our upcoming Easter trip to Rome. Yes, ROME! We decided that we needed a break (…), so…acting on an impulse last night, we got online and made a reservation at a really nice (we hope!) B&B that is a mere five-minute walk from the Vatican Museums. Perfect.

Stefano and I immediately made reservations (online, so as to skip the long queues, yaaay!) to visit the Vatican Museums and the Sistine Chapel, which we haven’t seen yet…shocking, eh? I mean, we live so close to Rome…well, better late than never. Of course, we have both been to Rome before…in fact, a few years ago we walked around the center of Rome nonstop for hours and hours and hours (by the late afternoon, my aching legs went on strike, so we got on one of those nifty “hop on, hop off” tourist buses that take you around to all the major attractions). We saw a lot, but obviously not everything…

Another thing I would really like to visit is the Caravaggio 400th anniversary exhibition, see: http://tinyurl.com/yetxqd8 and http://tinyurl.com/yd7g7ye Wow.

Anyway, back to us…I have a bunch of unfinished drafts sitting on my desktop but just don’t know when I will have the time to get to them. Plus, it’s the weekend, and we have some fun planned!

Okay, I had better get back to the garden now and help my indefatigable sweetie with our annual spring yard cleaning/pruning etc (oh, in case you were wondering, yard work is NOT part of the fun we have planned for the weekend…! Ah, if only we had a garden that would take care of itself…dream on…).

Have a great weekend, everyone! And don’t forget to laugh…ah wait a sec, speaking of which…here is something that a blog reader (thanks, D.!) sent to me…some Happy Easter wishes…but I warn you: click on this link ONLY if you have a wacky sense of humor: http://terrisfp1.com/holidays/chick.swf Hehe.

If you live in Italy, you can order your curcumin (or whatever) from a very friendly pharmacy (with a galenic lab) located in Calenzano, right outside of Florence: www.farmaciabalducci.it

And it gets better: if you live in Tuscany (well, unless you live too far from Florence), the pharmacy staff will deliver your order right to your door, otherwise they will mail it to you. Very highly recommended by yours truly…okay, now in Italian.

Per chi vive in Italia: potete ordinare la curcumina (e tante altre cose!) presso la Farmacia Balducci di Calenzano (provincia di Firenze) che ha al suo interno anche un laboratorio galenico (cliccate sul link di cui sopra). Se abitate nei dintorni di FI, il vostro ordine vi verrà recapitato direttamente a casa…altrimenti, verrà spedito per posta.

Nota bene 1: 1. il gentilissimo Dr. Balducci usa la curcumina C3 Complex, la stessa che è stata usata nello studio clinico mieloma-curcumina svoltosi alla MD Anderson Cancer Research Center, università del Texas. Meglio di così…! 🙂

Nota bene 2: Se volete arrivare a 8 grammi di curcumina al giorno, vi consiglio di non superare la dose di 15-20 mg di piperina (= di solito questa viene abbinata alla curcumina per favorirne l’assorbimento), per cui vi consiglio di parlate direttamente col Dr. Balducci per decidere la dose di piperina e curcumina per ogni capsula. Sono certa che vi saprà consigliare bene, anzi benissimo!

Yesterday I received a message from a blog reader/curcumin-taker who was recently diagnosed with smoldering myeloma (SMM). She also has Addison’s Disease*. She asked me a very good question: do any of your blog readers have smoldering myeloma in addition to having Addison’s Disease or diabetes? I have no idea, and that is why I am asking this question today…

*A mini-quote from her message: “my adrenals have worn away and I take steroids (hydrocortisone) 3 times a day to replace the natural steroids my glands ought to be producing (very similar to a diabetic who takes insulin).”

*For more info on Addison’s Disease, a disorder of the adrenal glands, please see this Mayo Clinic overview: http://tinyurl.com/ynolcr 

If you would like to get in touch with her, please leave a comment here or fill out my blog’s Contact form (on the right)…or send me an e-mail. Thank you!

A blog reader (thanks!) sent me most of these…I added a few…enjoy! 😀

Apartment laundry room sign: “Please be courteous and remove your clothes promptly.”

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Photographer’s studio: “Out to lunch: If not back by five, out for dinner also.”

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High school wall: “Fite Illiteracy.”

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Podiatrist’s office wall: “Time wounds all heels.”

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Proctologist’s  office door: “To expedite your visit, please back in.”

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Plumber’s truck: “We repair what your husband fixed.”

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Another plumber’s truck:”Don’t sleep with a drip. Call your plumber.”

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Pizza shop: “We offer pizza and quiet.”

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Repair shop door: “We can repair anything. (Please knock hard on the door – the bell doesn’t work)”

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Gynecologist’s office: “Dr. Jones, at your cervix.”

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Auto repair service station: “Try us once – you’ll never go anywhere else again.”

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Towing company: “We don’t charge an arm and a leg. We want tows.”

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Electrician’s truck: “Let us remove your shorts.”

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In a non-smoking area: “If we see smoke, we will assume you are on fire and take appropriate action.”

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Maternity room door: “Push. Push. Push.”

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Maternity ward (Florida): “No children allowed.”

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Optometrist’s office: “If you don’t see what you’re looking for, you’ve come to the right place.”

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Outside a muffler shop: “No appointment necessary. We hear you coming.”

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Package label: “Please notify us at once if this label fell off in transit.”

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Veterinarian’s waiting room: “Be back in 5 minutes. Sit! Stay!”

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Music teacher’s door: “OUT CHOPIN”

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Men’s restroom: “Toilet out of order. Please use floor below.”

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New British Town Hall (which was to be opened by the Queen): “The Town Hall is closed until opening. It will remain closed after being opened. Open tomorrow.”

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Restaurant window: “Don’t stand there and be hungry; come on in and get fed up.”

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Front yard of a funeral home: “Drive carefully. We’ll wait.”

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Chicago radiator shop: “Best place in town to take a leak.”

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Dry cleaner’s shop: “Anyone leaving their garments here for more than 30 days will be disposed of.”

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Billboard: “Keep your eyes on the road and stop reading these signs.”

If you have been following my blog for at least a month, you will know that my father-in-law was recently diagnosed with invasive melanoma (for a reminder, please see my Feb 6 and Feb 16 posts). In early February, we were told that the cancer had spread to his lungs (the nodules are small, which is positive…but they are there, which is not positive…).

Update: yesterday we received the results of the biopsy done on his cheek on Feb 11: no cancer cells…not even the shadow of a cancer cell. A bit of good news…

As you may remember, on Feb 16 Stefano and I accompanied my father-in-law to see his oncologist, Dr. P, who spoke with me very openly and amicably about curcumin (my Feb 16 post provides more details). Dr. P told my father-in-law to take at least three grams of curcumin per day. He also explained that the chemo “program” consisted of at least two cycles and then, provided that my father-in-law’s red/white cells and platelets didn’t decrease too much, perhaps a third one. This particular chemo drug tends to depress red and white cells and platelets, you see, so many patients are forced to stop at cycle number two (according to Dr. P).

Well, I am happy to report that my father-in-law was able to finish all three chemo cycles. His platelet and complete blood count remained stable during the first two cycles…indeed, they were “perfect,” according to a very pleased Dr. P.

I would also like to mention that my father-in-law did not experience any side effects from the chemo. None. On the contrary, he always reported that he felt as strong as a horse…

As you can imagine, I have been asking myself if such a positive reaction could have been a consequence of his curcumin intake…? Nobody can answer that question, obviously. But one thing I can and will say: every time he went to the hospital on “blood test day” or “chemo day,” my father-in-law reminded Dr. P that he was still taking curcumin. Dr. P always replied: “excellent, excellent, please continue to take it.”

I hope things continue to go well, of course. We should know a bit more next month, when my father-in-law undergoes more tests, another MRI and so on…

Is this a little white kitty hanging out of a cat tree

OR a rare sighting (in Italy, anyway!) of a Hairy-legged or White-winged vampire bat…? I can’t decide…

…It began with my reading a message from a MGUS blog reader who had contacted me last fall, after noticing that her markers, especially the freelite ones, were steadily worsening. After receiving my reply, she began the curcumin protocol. Today she received her test results: normal. No, I am not kidding: NORMAL. And her freelite chains are too small to be quantified. She is ecstatic, of course, and so am I! Ah yes!

I also had a very good day at work…and, when I got home, I found a message on Facebook from a childhood friend whom I had looked up and contacted yesterday evening. Enough to put a big grin on my face…but there is more. Another blog reader, who takes six grams of curcumin, informed me that he found out today that he is still stable. Stable…one of my favorite words in the dictionary…fantastico!

This evening I am having dinner with my girlfriends (we are playing cards after dinner, naturellement…)…which reminds me…oh no, where did the time go? It’s late, and I still have to ice my carrot cake…off I go! Well, I hope everyone has a great evening, wherever you are…!

I looked up the three small melphalan-prednisone studies on SMM patients mentioned in the abstract. Here are the links: 2009 abstract: http://tinyurl.com/ygnlwr5; 2000 full study: http://tinyurl.com/yjfneba, and 1996 full study: http://tinyurl.com/yhogw2y). A cursory glance shows that there was no difference in survival…indeed, a couple of patients in the first study developed acute leukemia during treatment. Unfortunately, I don’t have time now to read the studies in great detail, but the upshot seems clear: there is absolutely no benefit in administering early treatment to SMM patients. Case closed…as far as I am concerned, anyway.

The study goes on to discuss the administration of thalidomide to SMM patients and concludes that this drug cannot be recommended for the treatment of SMM until a benefit is shown in prospective randomized trials. Caution happens to be my middle name (well, okay…not really! ;-)). Personal note: in 2007, when my hematologist suggested that I take some thalidomide to zap the cancer cells lurking in my bone marrow (=50% at the end of 2005…down to less than 40% at the beginning of 2007 after one year on curcumin), I said no. She tried to insist, but I was adamant. I want my “tiger” to remain dormant for as long as possible…so, no CRAB, no treatment. Period.

As for bisphosphonates, the study states that data from a few SMM trials shows that they might be beneficial for those who have early bone disease, but the potential toxicities of bisphosphonates, such as renal injury and osteonecrosis of the jaw, should be taken into account […]. Wait a sec. I read something recently about bisphosphonates, but can’t recall what, exactly…hmmm…was it good or bad? Oh I know, I read about it on the MMA patient list. I don’t think list members will mind if I post the link, provided by a list friend (thanks!), to this “USA Today” article: http://tinyurl.com/ykguaxm If you are currently taking bisphosphonates, please read this article and ask your doctor about it…

Another thing that we should all keep in mind if some day we face the choice of undergoing conventional treatment: In patients with SMM who then evolve into symptomatic MM the response rate to chemotherapy has ranged from 52% to 64%. I was actually surprised to read that there was such a low response…

Well, okay, so what do we, SMM folks, need to do? The study offers a useful Table outlining the tests that should be done right after we have been diagnosed with smoldering myeloma:

• Medical history and physical examination
• Complete blood count
• Serum calcium and creatinine
• Protein studies
• Total serum protein and serum electrophoresis (serum M-protein quantitation)
• 24-h urine protein electrophoresis (urine M-protein quantitation)
• Serum and urine immunofixation
• Serum free light chain measurement (FLC ratio)
• Beta-2 microglobulin
• Bone marrow aspirate
• Skeletal survey
• MRI of thoracic-lumbar spine and pelvis

After three months, we should have our blood and urine tests repeated…then, if our markers remain stable, we should continue to be checked every 3 months for the first year in order to establish the pattern of evolution (evolving vs nonevolving). If the markers do not remain stable, however, then a full evaluation should be done again, including a bone marrow biopsy. However, SMM folks should not be treated, the authors repeat, until progressive disease with end-organ damage is evident. Especially those who are in the nonevolving category! I couldn’t agree more…

IMPORTANT: A progressive decrease in the Hb level is the most frequent and reliable indicator of progression. Other indicators of progression that mandate treatment are the development of soft-tissue plasmactyotmas or significant skeletal involvement as well as increased serum calcium or a rise in the serum creatinine level.

So please keep an eye on your hemoglobin, in particular…and take action immediately if that number shows any signs of decreasing!