Treatment for Multiple Myeloma Linked to Nuclear Testing

Iconic American news reporter Tom Brokaw announced his bout of multiple myeloma only after approximately six months of successful treatment. When he did this, the public became more interested in this rare type of blood and bone cancer.

Brokaw received his diagnosis in August 2013 by medical staff at the Mayo Clinic, which is only of the many educational facilities that has awarded him an honorary degree. This medical center is progressing rapidly in the pursuit of a cure for multiple myeloma and researchers and treatment staff are optimistic.

Accessing Cancer Research

Through my studies in preventive medicine and public health, I found that the Mayo Clinic provides the most up-to-the-minute progress reports in medical research surrounding a number of conditions and diseases.

The clinic professionals conduct ongoing research into a number of health conditions and diseases as well, including multiple myeloma. Their website pages offer etiology, risk factors, symptoms, complications, treatments, and impact for future research and treatment, making these pages tops for research by the public.

When I want further details about health matters, I consult the Mayo Clinic, The Ohio State University Medical Center and its James Cancer Clinic/Solove Cancer Research Institute, and other well known research centers, teaching hospitals, and US Medical Centers of Excellence around the United States. From there, I consult the latest research published in journals and can sometimes find preliminary results of studies not yet published.

This article will look at Tom Brokaw's case, possible risk and causation factors, and the role that US nuclear testing in the American West may have had in the development of multiple myeloma.

At this writing, multiple myeloma is classified as an incurable cancer. However, professionals at the James Cancer Clinic in Columbus, Ohio are researching treatments so aggressively, that their belief is that they will find a cure. Dr. Craig Hofmeister of The Ohio State University and Dr. Sagar Lonial of Emory (see link below) explain their hopefulness in the video below.

OSU's Craig Hofmeister, MD also holds a Masters of Public Health and has been active in researching and treating multiple myeloma and bone marrow transplantation for many years. From 2007 - 2014, his department has become one of the largest in the USA to treat multiple myeloma.

Some related clinical trials handle more patients than any other in the country. He and his research partners are finding new treatments, new ways of studying the origins and cycle of the condition, and had discovered cell therapies that work. His colleagues are Drs. Benson, Efebera, Pichiorri, Rosko, and collaborator Dr. Jinahua Yu.

A oversimplified shorthand description of the action of this cancer is this one:

Calcium is pulled from the bones of the body, forming depressions and even holes in the bones. Some accounts describe the bones in advanced cases of being "like Swiss cheese." Calcium deposits are left in the blood stream, which cause other symptoms, such as cardiac and neurological involvement.

A little more fully, yet still understandable:

The disease is a blood cancer that affects a specific type of white blood cell that produce antibodies. The specific white blood cells are the plasma cells in the bone marrow. The antibodies are proteins that are made by these plasma cells to aide the body in fighting and conquering infections.

As the plasma cells are adversely affected by multiple myeloma, the plasma cells replicate too fast and form clumps that are not useful.

Because of clumping, the body succumbs to increasing numbers of infections and/or longer-term infections, if treatment is not sought or does not prove successful.

Additional Effects of Multiple Myeloma

The Mayo Clinic reports that multiple myeloma may affect the bones, kidneys, immune system, and red blood cell count.

Symptoms, although the disease can be present without symptoms (called "smoldering multiple myeloma"), can include:

• Increased blood levels of calcium.
• Bone pain. Often this pain is experienced in the spinal column and ribs, pelvis and even the skull. Broken bones can occur.
• Severe tiredness and fatigue arising from anemia.
• Kidney failure (end stage renal failure)
• Repeated infections of various types, even recurring sinus infections that we might be tempted to ignore. Shingles can be recurring in these cases, but a number of infections may repeat. Keep of log of infections if you begin to have them again over time.
• Weight loss.
• Weak or numb feelings in the legs. (I suspect that these sensations would cause difficulties in standing for long periods of time, such as in some jobs or standing in a line at the store or theater.)

The prominent effects of multiple myeloma are remembered by CRAB:

• Raised Calcium levels
• Renal failure
• Anemia
• Bone pain

The symptoms that send patients to the doctor are often fatigue, weak feelings, and bone pain.

In August 2013, the month that Tom Brokaw learned of his own diagnosis, Dr. Shaji Kumar spoke about new treatments that are prolonging the lifespan and increasing a good prognosis in patients with multiple myeloma.

Mayo Clinic findings in cancer research cast a very bright light of hope into the lives of these patients - so much so, that Brokaw calls himself "lucky."

Additional successful treatments have been shown by the programs of Dr. Sagar Lonial at the Multiple Myeloma Research Foundation.

Risk Factors

Medical scientists and doctors largely agree that the risk factors for for multiple myeloma include:

• Advancing age. For example, the Mayo Clinic reports that most cases of the disease occur after the finding of the benign (harmless) condition called monoclonal gammopathy of undetermined significance or MGUS. In America, 3% of all adults ages 50+ have this condition and 1% of those cases develop 1) multiple myeloma, 2) a similar blood cancer, or 3) show a marker for what are known as M proteins made by abnormal plasma cells.
• Male gender.
• African American ethnicity.
• Obesity.
• Employment in petroleum related work.
• Exposure to nuclear radiation.

The Case of Tom Brokaw

In Tom Brokaw's case, he is male, is over 50 years old, and is one who lived under exposure to nuclear radiation to varying degrees from birth through high school, the radiation dose likely heavier during high school years. The dose was likely heavier, because the county in South Dakota in which he lived was irradiated more heavily than many other counties by nuclear testing. The symptoms he suffered before diagnosis at age 73, if any, are not known at this writing.

Nuclear testing was performed in the United States on land, under the sea, and underground at least from 1945 through 1992, reportedly all underground as of 1962 or 1963. South Dakota, Tom Brokaw's home state is one of the states that experienced nuclear testing ad nuclear fallout. According to the CTBTO nuclear test-ban organization:

• "Detonated on 6 July 1962, Sedan [a nuclear test] released roughly 880,000 curies of Iodine 131 into the atmosphere. Detected radioactivity was especially high in parts of Iowa, Nebraska, South Dakota and Illinois, exposing millions of people to radioactive fallout. "
• States affected by the Sedan fallout appear in Table I.

Evidence suggests also that the Nevada Test site explosions sent fallout into South Dakota from 1951 - 1970.

The southeastern South Dakota county (Yankton) in which Brokaw attended high school from approximately 1954 - 1958 was more heavily affected by nuclear testing and fallout than many other SD counties. However, the fallout may be attributed to global fallout, meaning that it came into the USA from foreign nations.

Regardless of fallout origins, Tom Brokaw was likely exposed to radioactive fallout as a teenager and in college at the University of Iowa and the University of South Dakota in Vermillion, which is also in the southeastern corner of SD, an area of greater fallout exposure in the state.

Additional exposure threats in South Dakota today involve uranium and radon gas.

Advice from the US Government and private doctors to people living in nuclear fallout areas was that children could develop leukemia and thyroid cancers. However, multiple myeloma occurs more often in people ages 50+, although younger people may develop it as well.

It is easy to jump to the conclusion that nuclear fallout caused multiple myeloma in Tom Brokaw and others of his age group, but the evidence is not strong enough in light of the other risk factors. In fact, advancing age is a major risk factor for many disease. For example, if one lives long enough, one is increasingly at risk for a number of cancers and Alzheimer's Disease. Confoundingly, individual differences keep some of our "oldest old" population segment from contracting either. Did fallout hurt Mr. Brokaw? Maybe.

• Plan to pay attention to your health.
• Note any symptoms of multiple myeloma that you may have.
• If you are 50 or older, ask your doctor about the condition and your other risk factors. Several tests available can confirm or rule out its presence.
• If you have unexplained or excessive fatigue, weakness, or weight loss, see your doctor.

Recognizing Tom Brokaw, thousands of Americans and global citizens will likely become interested in multiple myeloma and consider the condition as they maintain their individual plans for health and long life.

Social psychology tells us that the attention a famous person brings to a disease, condition, or public cause, the more likely are the members of the public to respond. In early 2014, Star Trek®s Leonard Nimoy revealed that he suffered from Chronic Obstructive Pulmonary Disease, (COPD), the same condition that led to the death of famous writer Lilian Jackson Braun. Both of these people have brought increasing interest from the public in COPD. Jerry Lewis brought enormous attention and private funding to muscular dystrophy research and cures for 59 years.

The cause of curing multiple myeloma could not have a better spokesman than Tom Brokaw.

Sources

• WCNC.com. Blood cancer treatment called 'revolutionary' after all study patients responded. June 7, 2017. www.wcnc.com/news/health/blood-cancer-treatment-called-revolutionary-after-all-study-patients-responded/446519621 Retrieved October 31, 2017.
• Mayo Clinic Staff. Multiple Myeloma. http://www.mayoclinic.org/diseases-conditions/multiple-myeloma/basics/definition/con-20026607 Retrieved February 16, 2014.
• Multiple Myeloma Research Foundation. http://www.themmrf.org/living-with-multiple-myeloma/patients-starting-treatment/symptoms-and-side-effects/ Retrieved February 17, 2014.
• The Ohio State University/James Cancer Clinic. http://internalmedicine.osu.edu/hematology/directory/faculty/hofmeistercraig/hofmeister-cv/ Retreived February 17, 2014.