My husband has his first oncologist visit Thursday and I was just wondering if he might be put on steroids at this time before his bone marrow biopsy has been done.
He has a positive SPEP, IgA 1802, and positive Bence Jones protein. His appetite is very poor, and I know he will not be put on anything else until full testing is completed, but I see where most myeloma patients take dexamethasone as part of their treatment, and I thought this might help his appetite and I know myeloma hates it.
Thoughts?
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dogmom - Who do you know with myeloma?: husband
- When were you/they diagnosed?: December 2015
- Age at diagnosis: 58
Re: Treatment with dexamethasone before final diagnosis?
Dogmom:
You ask a very very interesting question. Dex, I understand, is a concentrated form of prednisone. There are many many reasons why prednisone would be prescribed. If he needs it for another reason, it seems to me it should be prescribed without hesitation.
The literature shows that dex actually has single-agent activity. That is from very old studies. Say your doctor wants to see the result of the FISH test before making the final selection of the induction regimen. That might take a month, two weeks to schedule the test, and about 10 days to get the result.
First point is that if you are in the States, it's a 95% + chance that it will be Revlimid, Velcade, and dexamethasone (RVD) (for non-frail).
Secondly, it actually sounds to me like a great idea to start the dex while you are waiting. I think the doctor might look at that differently, however, as off the normal standard of care protocol. Secondly, dex is the med that causes most patients the most noticeably and acute side effects. Like I said, very interesting point, and I would definitely ask that question to your doctor.
I will add you one more point along the line of your idea. There is one antibiotic that is actually used in some of the regimens. That is Biaxin. You can google it as the Bird or the CarBird regimen. In my view, if somewhere along the way the myeloma patient needs an antibiotic for, say, a nasal or chest infection, then Biaxin should be the antibiotic of choice, but very few of the doctors seem to even have awareness of that issue. A closely related med in the family would be the Zpack. Other classes of antibiotics (say the penicillin class) have not been shown to have anti-myeloma effect.
Good luck, and thanks for the new idea.
You ask a very very interesting question. Dex, I understand, is a concentrated form of prednisone. There are many many reasons why prednisone would be prescribed. If he needs it for another reason, it seems to me it should be prescribed without hesitation.
The literature shows that dex actually has single-agent activity. That is from very old studies. Say your doctor wants to see the result of the FISH test before making the final selection of the induction regimen. That might take a month, two weeks to schedule the test, and about 10 days to get the result.
First point is that if you are in the States, it's a 95% + chance that it will be Revlimid, Velcade, and dexamethasone (RVD) (for non-frail).
Secondly, it actually sounds to me like a great idea to start the dex while you are waiting. I think the doctor might look at that differently, however, as off the normal standard of care protocol. Secondly, dex is the med that causes most patients the most noticeably and acute side effects. Like I said, very interesting point, and I would definitely ask that question to your doctor.
I will add you one more point along the line of your idea. There is one antibiotic that is actually used in some of the regimens. That is Biaxin. You can google it as the Bird or the CarBird regimen. In my view, if somewhere along the way the myeloma patient needs an antibiotic for, say, a nasal or chest infection, then Biaxin should be the antibiotic of choice, but very few of the doctors seem to even have awareness of that issue. A closely related med in the family would be the Zpack. Other classes of antibiotics (say the penicillin class) have not been shown to have anti-myeloma effect.
Good luck, and thanks for the new idea.
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JPC - Name: JPC
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