For some time, I have been reading about how close a number of multiple myeloma experts feel they are to turning multiple myeloma into a chronic disease.

This should be good news, right?  Novel therapy agents are delaying disease progression for years in a large majority of patients.  Median life expectancy has also jumped up, and these same experts expect that this number should continue to rise quickly.

But a number of multiple myeloma patients are saying “NOT SO FAST!”

One fellow patient hates when doctors speak proudly about multiple myeloma soon becoming a “chronic disease.”  He feels (and I agree!) that myeloma is catastrophic, and the drugs used to combat it are highly toxic.  “Where is the urgency?” he asks.  “Shouldn’t there be a call to activism?”

A son, whose father passed-away last year after a 10-year fight against myeloma, also contacted me recently and asked, “Where is the cure?”

These frustrated and anxious people affected by myeloma have a point.

At the same time, I listened last week to an enthusiastic hematologist in Atlanta describe the positive progress that has been made over the last five or six years.  A 23-year veteran of the myeloma wars, this physician was clearly pleased he could offer multiple myeloma patients effective treatment options.  In previous years, he only had a few options that only worked for a few short months or maybe a year or two.

I can see both points of view.  Yes, clearly improvements have been made, and lots of patients are living longer.  But if it’s your mother, father, spouse, son, daughter, or friend who is dying, a few extra years just isn’t good enough.

The comments I shared above aren’t the first I have heard criticize the current approach by hematologists, oncologists, and researchers to “settle” for buying patients a few more months or years of life.

Which begs the question:  Why is the emphasis on turning multiple myeloma into a chronic disease?

One answer is simple enough:  Because they can!

Multiple myeloma tends to be responsive to a number of different types of treatment.  But they rarely work forever.

No matter how many different combinations of drugs researchers try, and no matter how many new drugs they develop, none of them seem to work for long.

So common sense tells them:  Theoretically, if they can develop enough new, different therapy options, then chances are a patient can use them one after another—or in combination—indefinitely.

But challenges to this approach include the wear and tear on one’s body from taking poisonous chemotherapy month after month, as well as the risk that one may develop a secondary cancer or serious complications as a result of never-ending treatment.

And let’s not forget about the cost.  To remind you that multiple myeloma therapy isn’t cheap is an understatement.

Which leads us into considering another, more cynical, insidious explanation:  The vast majority of research studies are funded by drug companies.  If you were developing a business model for a pharmaceutical company, which would you prefer:  Find a cure, or treat patients for decades?

I’m not implying there are master planners sitting in a secret room somewhere, plotting a way to make cancer patients rely on or become addicted to novel therapy agents.  Corporations would never do that, would they? (Mmm…  Why was that elderly cancer patient sitting, slumped over, smoking outside our cancer clinic this afternoon?)

No, I believe the vast majority of researchers, doctors, and even business executives have the patients’ best interests at heart.  But you must admit that the system is set up to encourage the development of drugs that don’t cure cancer—but instead just help a little.

I believe the real reason this happens is it’s easier.  It’s easier to develop a drug that is similar to another drug that works.  Let’s face it.  Truly unique ideas are rare—that’s what makes them unique.

So instead of a cure, we get lots of similar, copycat drugs.  Plus, making a commitment to find a cure may take decades.  It would be prohibitively expensive.  I’m not sure stockholders would be that patient.

What do you think?  What can we do?

Keep pushing for a cure, while we appreciate every extra day the new drugs buy us.  (Pun intended!)

Feel good and keep smiling!  Pat