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It's The 4Th Treatment Already. Any More Options?

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Subject: It's the 4th treatment already. Any more options?
Date: 01/19/2008

Hi all,

This is a very informative site, and I would like to see if I could get some ideas for the next visit my mom has with her oncologist. 

My mom is 82.  She was diagnosed with MM in March of 2006. We were told she had the most aggresive form of MM (IgA). They started her on Thalidomide 50 mg because of her age, but it was still too much for her, so they switched her to Melphalan and Predinosa. She was on this combination for 6 weeks, from August 2006 until October 2006. The results were not as expected, so her doctor in Texas decided to try a more aggresive treatment (Velcade and Doxorubicin, with Dexametasone). She started with this treatment in October 2006. 

In January 2007 she came to live with me in Sacramento, CA. Her doctor here continued with the Velcade, Doxoribicin, Desametasone combination.  And my mom seemed to be responding to this treatment. The protein of the Myeloma decreased and by May, the doctor gave her 3 months of a break from treatment.  Unfortunately, by August 2007 the numbers had increased again so they started her with Revlimid. Her initial response to this treatment seemed good, but it didn't last. By December the MM numbers had gone up again, so she was switched to Cyclophosphamide 500 mg once per week. This treatment has been too strong for her; and she has had a transfusion every two weeks; so her doctor decided to reduced the dose to 250 mg.

I'm not sure this treatment is working.  The little lumps she has in her legs (an now also in one of her eye lids) are still there, and it seems she is getting more. 

 So, she is already on her 4th treatment. Unfortunately, so far none of the treatments seemed to have worked as expected. Or, when they worked, they do for a few months.  We know that there is not cure for this illness, but we had hoped that the benefits of one of the treatments would last a little longer.

That has not happened, and she has been getting weaker and weaker. After using the  (Velcade and Doxorubicin, with Dexametasone) she became very weak and the neuropathy was bad in in her legs; but she seemed to recover a lot with some therapy and Gabapentin. However, the improvement stopped, and although she is not doing as bad as then, her legs never recovered completely and seem to be losing strength again.

Does any one have any ideas as to what other options of treatment are out there?  We know she has had almost all of the most recently approved treatments. But, do you know if it's possible to retry any of them or in a new combination?

I don't want to think that we are out of choices.

I would appreciate any information or suggestions.

 Maria

 

 

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