Kidney Cancer May Be Linked To Multiple Myeloma

NEW YORK (Reuters Health) - For the first time, researchers have evidence of an association between renal cell carcinoma and multiple myeloma, a type of blood cancer, one that "cannot be explained by random incidence alone," they say.

"I think general oncologists as well as myeloma and renal cancer physicians should be aware of this association," Dr. Mohamad A. Hussein of the H. Lee Moffitt Cancer and Research Institute in Tampa, Florida, noted in comments to Reuters Health.

Renal cell carcinoma begins in the kidney cells and although it may progress slowly, it is very resistance to chemotherapy. Multiple myeloma, which may also progress slowly, is likewise resistant to treatment. It begins in the blood's plasma cells, a type of white blood cell that is part of the immune system. Over time, myeloma cells build up in bone marrow and then in the solid parts of bone.

In a review of data from patients referred to the Cleveland Clinic between 1990 and 2005, Hussein and colleagues identified 1,100 patients with multiple myeloma, 2,704 with renal cell carcinoma, and 8 with both types of cancer.

In 4 of the 8 patients, renal cell carcinoma was diagnosed 3 to 46 months after the multiple myeloma diagnosis. In the remaining 4, renal cell carcinoma was diagnosed 1 to 108 months before the multiple myeloma. Seven of the 8 patients were first diagnosed with renal cell carcinoma on the right side.

"The probability of this association was much higher than that expected in the general population," the researchers note in the medical journal BJU International. "No clear treatment-related, environmental, genetic or immune-mediated common factors can fully explain this association."

The investigators point out that interleukin-6 supports the growth and expansion of both types of cancer. Interleukin-6 is a "cytokine" that normally enhances the body's immune response to disease and infection.

"I think the take-home message," Hussein said, "is that after active therapy for myeloma, if the kidney lesion does not clear -- especially if it is affecting the right kidney -- renal cell cancer should be considered."

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Craig 

Thanks so much Craig!  You are a fantastic researcher!  I'm taking a copy of this to show my GP tomorrow and will send a copy on to my oncologist and urologist.  Many thanks once again,  Cath

Hey Craig, get this!  My urologist just sent me a letter to say that the analysis of my 'stones' shows that they are composed of clacium and oxalate, not uric acid as he had assumed before the analysis.  Therefore I have to immediately stop taking the Ural sachets and the Progout- Allopurinol tablets!  He told me that it was the 'chemo' that I had taken that had caused the stones and would continue to do so, however there is no way I'm going off Revlimid as long as it is still working for me!  It just goes to show that although a person can be a specialist in one area it doesn't necessarily mean that they have any understanding of cancer - speciffically myeloma - and its impact on their area of speciality.  Another oncologist told a myeloma seminar that I attended last week that it is very important for people to choose an oncologist who has specialised in myeloma, not just a generalist oncologist, because most of the generalised doctors do not have an understanding of the latest innovations in myeloma treatment.  This is so true -- we have heard of several myeloma patients who are 'stuck' in treatments used 15 years ago, simply because their oncologists have not been able to keep abreast of the latest novel treatments.  Mind you, Cancer is so individual and there is so much happening that it would be impossible that any generalist oncologist could never hope to be up to date on the latest treatments and drugs for each and every type -- especially given that everyone seems to have an individual response to every treatment and requires even more specialised treatment to handle the wide variety of side effects.

Anyhow, I'm now going to have to learn more about just what a calcium/oxalate combination means to me!!  Take good care and thanks again for your info.  Cath

I am very sorry to hear that the medication is involved with your kidney stones ... but on the other hand now you know what type of stones they are and can possibly take some steps to decrease the odds. I know there is quite a bit of information out there to absorb on the subject. The very best and keep us informed.

Regards,

Craig 

Hi Craig!  I just wrote a long reply and then 'lost' it -- don't know why but it is very frustrating!  I was telling you that the urologist prescribed 300mg of Progout to stop me from making kidney stones without telling me that I might actually get GOUT by taking the medication!  And low and behold I now have two highly inflamed big toes -- my GP was amazed that I hadn't been told that this might happen.  So now I have to take medication - Indocid- to reduce the gout!  I feel like a patchwork quilt -- a bit of myeloma, a bit of kidney stones, a bit of gout, a bit of flu and pneumonia injections -- and none of the doctors know the whole story.  I really need some sort of health care notebook that each of the doctors can write in when I visit so that I can show it to each of the others and everyone would know what is happening to me medically -- and hopefully a mis medication incident would not happen!  Right now its all piecemeal.  You'd think that the GP could access my records held at the hospital and that the other specialists could give information to the GP within less than two months -- it would make for a much higher quality of care.  But people go on and on about privacy laws etc -- I'd be happy for them all to access everything and I'm sure many others would too. Its just so frustrating -- and painful, gout is not pleasant -- for what??  Again, the system frustrates me even though my doctors are the very best!  So my message for today is: take care when prescribed gout medication -- make sure its not going to give you gout before it starts to work on kidney stones!!   I mentioned the renal cancer/myeloma connection to my GP and he'd never heard of it so I've left the print out with him.  Many thanks again, Cath