After outliving his predicted survival from terminal cancer, Professor of Neuroscience David J. Linden (Johns Hopkins University School of Medicine—Baltimore, MD) wondered if what he calls his “extra innings” were linked to his “hopefulness and curiosity.”
In an opinion article he wrote for the NY Times, Dr. Linden recounts how his oncologist told him that even with radiation and therapy, he could only expect to live an additional 6 to 18 months after he was diagnosed with a malignant form of soft-tissue cancer.
Yet, Dr. Linden’s last CT scan showed that “the remnant tumor has not grown, and no metastases have developed.”
Dr. Linden’s theory stems from his knowledge that there are nerve fibers in tumors, and that blood chemical messengers can also affect cancer cell growth.
“One potential biological explanation is that some type of signal must be sent from the brain to the cancer cells in the body. The main way the brain communicates with the body is through nerve fibers that form paths from the brain to the body to conduct electrical signals, which in turn release neurotransmitter molecules at their endings. (The brain can also communicate with the body through molecules that are secreted into the bloodstream.)”
“In recent years, we have learned that certain types of cancer in the body receive nerve fibers, which originate in the brain and are passed to the body via electrochemical signals that travel in a chain from neuron to neuron. These include tumors of the lung, prostate, skin, breast and pancreas and the gastrointestinal system. This innervation of tumors often contributes to the growth and spread of cancer. In most cases, if you are a cancer patient and your tumor is innervated, then your prognosis is worse. However, nerve fibers come in several types and there are others that may slow cancer progression and yet others that have no effect,” Dr. Linden notes.
Related to myeloma, there is knowledge that the bone marrow (where myeloma builds up) also has nerve fibers and that many hormones and chemical messengers are in the immediate microenvironment as well as in the blood stream and can influence cell growth.
I have often observed that myeloma patients doing unusually well have not only had excellent treatment, but also possess an optimistic attitude—they expect that they can and will do well.
It seems now that science is catching up and may be able to provide explanations for unusually good outcomes.
Dr. Linden references recent research made by Sebastien Talbot, PhD, a tenured associate professor at the Department of Biomedical and Molecular Sciences in Queen’s University in Kingston, Ontario. Dr. Talbot’s laboratory noted that a chemical called calcitonin gene-related peptide (CGRP), which comes from nerve fibers, prevents immune cells from killing cancer.
“When these nerve fibers were silenced in melanoma-bearing mice, which stopped the secretion of CGRP, the spread and growth of melanoma was greatly reduced, leading up to a tripling of the mice’s survival rate. This means that blocking the electrical activity of these nerve fibers allowed the immune cells to help subdue the cancer,” writes Dr. Linden.
We certainly know that immune cells are very important in killing myeloma cells, as evidenced by the recent results of CAR T-cell therapy in which engineered T cells produced dramatic responses even in patients with progressive myeloma after multiple prior therapies.
However, it is still a bit of a stretch to conclude that positive thoughts can have an impact on this type of immune cell killing. Basically, Dr. Linden believes further studies are needed.
A new book, We Are Electric by Sally Adee, provides further support on the notion that nerves or electrical factors can have an impact.
She delves into the field of bioelectricity and introduces the body’s electrome. In a review by Simon Winchester of NY Times, he explains how an electrome is different from the genome, biome, and proteome (on a side note, proteomics is used to study myeloma proteins).
“The others all have mass—you can measure the mass of a cell’s nucleus or, if you must, you can weigh the minute menagerie that lives in your colon. But the electrome has no mass at all, nor any weight; it is simply the electricity that courses through your body and its 40 trillion cells, and which transmits encoded signals through and between everything, head to toe,” says Winchester.
Adee supports her emphasis on the importance of these electric signals by noting the fact that the U.S. government has funded considerable research to understand these electrical messages, and how to enhance or change them. It seems that much can be achieved by tinkering with the extraordinary electrome , but safe and useful medical interventions will take time (probably several years) to develop beyond current proposed uses.
However, some electrical stimulation devices—such as the transcutaneous electrical nerve stimulator (TENS)—are already being used as treatment for neuropathic pain, with other devices already in development. Moving to much more sophisticated devices will take some time.
While we are on the discussion of positive thinking and its probable role in helping recover immune functions, it would be good to mention stress because it does the exact opposite—hampering immune response.
What are the main stressors that myeloma patients face? And how do they deal with it?
It is worth emphasizing that having a true and realistic positive attitude typically requires resilience in order to identify what the main problems are and to be able to find solutions. Obviously, adjusting to the initial diagnosis of myeloma is the key first step.
Even though outcomes have improved dramatically, getting a myeloma diagnosis is still life-changing, not just for the patient but for family members, friends, even workmates who need to adapt to this new reality.
Additionally, learning the myeloma lexicon takes time (those words you never heard of) as well as options and potential pitfalls along the way, as you embark on a hopeful journey to remission and the longest survival possible with the best quality of life.
Apart from which, you have to cope with the day-to-day logistics of juggling altered schedules and trips to the clinic, the expense of getting much-needed medicines, and then dealing with possible side effects—so many issues!
According to the NY Times, some patients even have to deal with “unaffordable miracles.”
“For many people using private insurance, innovative medicines are dangling just out of reach. Even when Medicare’s 2025 cap comes into play — or the $9,100 cap that already existed for those receiving insurance under the Affordable Care Act — many will still find drugs unaffordable. Research suggests large numbers of patients abandon their prescriptions when faced with $2,000 in payments,” reported NY Times.
An opinion article written by Daniel J. Stone for LA Times on “how American healthcare has gone so wrong” reiterates “the sad but undeniable fact”—the way U.S. healthcare system “distributes and pays for healthcare makes it the most expensive failed enterprise in the history of human civilization.”
Stone cites “the latest obstacles to drug therapy” where “the costs are so high for so many medicines that even insured patients struggle.”
If you’re facing the same difficulties, the International Myeloma Foundation is always here to help.
As I have stated previously, these are potential stressors for myeloma patients and dealing with them makes it difficult to face a myeloma diagnosis with a calm and positive attitude. However, with excellent response, resilience and the wonderful support of family and friends, a new balance can be achieved—allowing time for self-care and a positive attitude which, in turn, can work wonders in helping the immune system do its job.
An important part of the recipe for improved health is an improved diet. I have discussed the Blue Zone diets similar to the Mediterranean diet which I absolutely recommend.
Dani Blum of NY Times mentions a new twist: adding healthy olive oil to coffee as a substitute or in addition to cream or milk.
“Olive oil is rich in antioxidant compounds called polyphenols, which can help protect your cells from damage,” said Dr. Selvi Rajagopal from Johns Hopkins University, adding that “no matter what kind of olive oil you choose, it will still have some health perks” and that “you don’t have to get the most cold-pressed, pure, expensive kind.”
Definitely, something to think about!
Even though more research is needed to understand how a positive attitude may possibly bring improved outcomes, I would still say that being optimistic is very important for myeloma patients.
It is definitely worth the effort to overcome as many day-to-day stressors as possible in order to achieve balance that will allow for a truly positive mental state of mind.
Always keep in mind that the IMF is here to help and support you, in every possible way.
Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is the Chairman of the Board and Chief Scientific Officer of the IMF. Dr. Durie is also the Chairman of the International Myeloma Working Group (IMWG)—a consortium of more than 250 myeloma experts from around the world—and leads the IMF’s Black Swan Research Initiative® (BSRI).
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