By Adele Slaughter, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

In 1984, Geraldine Ferraro made history as the first woman vice-presidential candidate. What history could not have foretold was that 14 years later Ferraro was going to run the race of her life against a deadly disease.

In 1998 Ferraro was diagnosed with multiple myeloma.

"I went for my annual check-up after running for the Senate in '98," Ferraro says. "My doctor said to me, 'Unless you hear from me, everything is fine.' That was how we ended every conversation. I got a call from his office and he said, 'You have either leukemia, lymphoma or multiple myeloma." I asked him 'What is multiple myeloma?' He said, 'It's also a blood cancer.'"

Ferraro and her husband made an appointment to learn details of the disease.

"I asked what was my prognosis," says Ferraro. "He said, 'They say three to five years, but I've got patients who've had this thing for 15 years.'"

"When he described this thing I thought, 'Oh my God, thank you it's not one of my kids,'" Ferraro says. "Because 63 is not old, old. I certainly didn't want to die at 63, but it is a heck of a lot older than 33 or 35. I have lived my life and I've had a very strong life. I have had a blast."

Five years later, Ferraro is still in the running.

"I'm lucky. Not everybody reacts to the medication as I did, and not everyone is diagnosed as early as I was," Ferraro adds.

Multiple myeloma is a cancer of the plasma cells, antibody-forming cells in the immune system. These cancerous plasma cells proliferate and accumulate in the bone marrow, causing reduced numbers of normal blood cells and bone destruction.

Beating the odds

According to the American Cancer Society, approximately 14,600 newly-diagnosed cases of multiple myeloma occur each year in the United States. Over 10,000 people are expected to have died from the disease in 2002. Today, there are almost 50,000 people living with multiple myeloma, the second most common blood cancer, representing one to two percent of all cancers.

"It is not known what causes myeloma," says Ken Anderson, professor of medicine, Harvard Medical School. "There appear to be factors that put people at a greater risk for developing myeloma such as radiation or pesticide exposure, but we do not know what causes it and most people who get it do not have any known risk factors."

In early stages of the disease there may be no symptoms.

"I spoke to a man who found out he had it when he got these terrific pains in his chest," Ferraro says. "I didn't have that. When I ran in that senate campaign, you know, it is a lot of running around. It's a big state, and I was tired. I thought it was a matter of age. But my doctor says I was very anemic and I had blood cancer."

In early stages, bone pain and fatigue characterize multiple myeloma, as well as broken bones, weight loss, or repeated infections. At advanced stages symptoms include:

• Nausea
• Vomiting
• Constipation
• Problems urinating
• Weakness or numbness in the legs

"When I was first diagnosed there was no real treatment. They ran a series of tests," Ferraro says. "Immediately they put me on a bone-strengthening regimen. I would go once a month for two and a half-hours to get an infusion of this stuff to keep my bones strong."

Now, two and a half years later, researchers say the newly developed treatments take only 15 minutes.

"I had indolent myeloma for the first 18 months," Ferraro notes, meaning she was symptom free. "No protein showed up in my blood. Then in June of 2000 it showed up in my urine, and they started medicating me with thalidomide."

"The tough part of this disease is the five-year survival rate is only 28% while the average survival rate for cancer is 68%," Kathy Giusti says, president of the Multiple Myeloma Research Foundation, who was diagnosed with MM in 1996 when she was 36 years old. "For decades nothing had been done. The treatments they were offering me were the same treatments they had offered my grandfather decades before. There was a real lack of support financially."

Now, thanks to Giusti and her twin sister, MMRF spends 95 cents of every dollar on research, and research has made all the difference.

Changing history

"They actually did a lot of gene array testing looking at my sister and me," Giusti says. "At first I thought that was no big deal. But by looking at identical twins you can move the field along a lot faster, because you can look at the targets and see what genes are turned on in me that are not turned on in her. It is just so amazing that we fund the research and we are the research."

Over the past decade treatments have advanced in many areas, including stem cell transplantation, immune treatments, and supportive therapies.

"Perhaps the most exciting new treatment area is the drugs that not only target the myeloma cell but also the myeloma bone interaction and factors in the bone marrow that the myeloma needs to grow and survive," says Anderson, who is also chairman of the Multiple Myeloma Research Foundation Scientific Advisory Board. "Examples of these last targeted drug therapies include thalidomide and Revimid, which are immunomodulatory drugs; and the third drug, Velcade, which is a proteasome inhibitor." Proteasomes are enzymes present in all cells that help regulate cell division. Although thalidomide is FDA approved, Revimid and Velcade are still in the clinical trials phase of development.

"In the lab these drugs can overcome drug resistance and demonstrate activity against human myeloma cells," Anderson adds. "In clinical trials people are living longer and living in remission using these drugs."

In fact, thalidomide put Ferraro into remission for five months.

"I think people who are newly diagnosed need to become cognizant of the recent advances in the understanding of the biology that have translated into new treatments for myeloma," Giusti says. "They should seek out centers where the treatments are being developed pre-clinically. Clearly this has been considered a uniformly fatal illness, and what we are hoping is to make it a chronic illness. We are also trying to develop a cure."

"Myeloma doesn't have to be a death sentence," Ferraro says. "Dr. Anderson told me I will live to see my grandchildren go to college. I talk to so many people who are so afraid and sound as if they are ready to go to the grave. I know that there's a report out that says that a positive attitude doesn't mean anything, but I don't believe that. To me a positive attitude is essential. Plus, I cheat a little bit. I have a whole bunch of people praying for me. I am a big believer in prayer."

For more information on multiple myeloma, click here. (Multiple Myeloma Research Foundation)

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 2/22/2003  -  Adele Slaughter & Stephen A. Shoop, M.D.