Myeloma

Multiple supplements and dietary compounds are linked to better outcomes, often from studies of myeloma case data. Frequently, the underlying mechanisms involve protecting and improving immune system behavior, balancing crucial micronutrients including iron as well as dampening systemic inflammatory responses that tend to fuel cancer activity and increase its resistance.

A diverse healthy gut microbiota is reported to improve treatment results, and in myeloma it plays a crucial role in stem cell therapy impact. Even certain bacteria strains are tied to response rates and impacts, some of which might be supplemented and certainly indicate a functional food regime. This is becoming a common finding in cancer research and akkermansia is an example of such a key bacteria.

Also commonly reported at diagnosis of myeloma are low levels of vitamin D3. A key for immune and vascular system health, this deficiency is common and depletion increases with advancing cancer activity and resulting inflammation. Studies show relatively higher levels are needed for better treatment outcomes.

Another important factor in stabilizing and resisting myeloma is iron and copper balance. Lactoferrin can help bring up iron levels but also potentially counter myeloma related dysfuntional activity related to enzyme-like proteins, ferritin, that can be utilized for progression. Likewise unusually high copper utilization by cancer cells might be reduced by reaching lower natural levels. High copper and low zinc are frequently reported in cancer patients including myeloma. Here, use of citrus pectin especially with alginates (kelp) extract, which also brings other actions that may limit myelomas upregulated galectin-3 activity for glucose.

Both statins and low dose aspirin feature prominently in ongoing ctrials for various cancers. These each are shown in patient data to have some significant risk reducing actions in myeloma progression rates. Where a prescription statin is not available, red yeast rice is the source of lovastatin and is a widely available supplement.

Well proven highly available herbal extracts such as danshen have evidence in several cancers based on national patient records in Tiawan. For myeloma this research reports much slower progression rates in thoser who added danshen prescriptions to their oncology treatment. The exact reasons are not always mapped out, but overall evidence across cancers shows enhanced immune system activity and reduced side effects from oncology. A low immune inflammation level , the neutrophil-to-lymphocyte ratio is a risk factor during and after chemotherapy, especially in advanced stages and in patients over 65. Another well proven herbal supplement, astragalus, has clear evidence for helping re-balance the immune response (and reduce NLR). Meaning it is indirectly implicated to support both myeloma treatment impacts and its side effects.

With its metabolic health impacts, berberine has good evidence in reducing fasting blood glucose, insulin and even improving metabolism of fatty acids all of which are associated with increased myeloma activity. Similaraly, urolithin A , often derived from walnuts or pomegranate, also has evidence from anti-aging research to improve fatty acid metabolism and fundamental, mitchondrial, cellular health. Meanwhile quercetin a flavanoid from vegetables is able to act on specific mechanisms , clearly linked to myeloma progression as seen in patient records. Whilst the evidence so far is in lab only, its compelling enough to make all of these an interesting part of a functional food and supplement program.

The so called Th1/Th2 immune system balance is strongly linked to the progression in myeloma and to treatment resistance. Molecular iodine solutions are emerging in this area in breast cancer management, seen boosting Th1 anti tumor activity and helping suppress over active Th2 used in resistance. This has improved results in surgery plus chemotherapy and may support increased responses during immunotherapy (see Supplement Library). For immunotherapy the presence of high sodium levels is now identfied as a key marker for success in other cancers. Also in other cancers, AM treatment programs are substantially more effective that PM/evening sessions

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Akkermansia continues to emerge as a key bacteria strain especially with immunotherapy

Low or no akkermansia and blautia gut bacteria level linked with treatment failure
Necessary oncology treatments an antibiotics seen to reduce levels
Diversity of gut microbiota has extensive research showing improved outcomes

Lower microbial gene richness, a lower abundance of the genus Blautia, and a lower abundance of Akkermansia muciniphila, early post-aHSCT was observed in those who developed aGVHD. Myeloablative conditioning was associated with aGVHD along with a reduction in gene richness and abundance of Blautia and A.muciniphila. These results confirm low diversity and Blautia being associated with aGVHD. Crucially, we add that pretransplant conditioning [chemo/radiotherapy] is associated with changes in gut microbiota. Investigations are warranted to determine the interplay of gut microbiota and conditi...

Lactoferrin increases iron balance and reduces anemia rates, countering cancers use of iron

Relatively lower circluating iron, ferritin, indicate much lower risks
The group with below average ferritin had half the progression risk
All cause risk is not reported but is also more than halved

Our data provide evidence of the importance of ferritin evaluation in the work-up of MM patients’ assessment and follow-up. Therefore, we identified ferritin as a potential new target for MM treatment, laying the groundwork for future combinatory studies that should include iron chelation as a backbone to enhance immunomodulatory agents or mAbs. Some preclinical evidence already supports this point. Finally, further evidence is needed to fully validate ferritin as a new prognostic factor for MM, and to determine its role as a new potential target to improve patient outcome.

Red Yeast Rice or a statin have multiple beneficial actions including all-cause risks

Statin use shows a 27% reduced risk for progression
Importantly, almost a fifth lower risk for all cause mortality
Trends towards higher effect with increase dose in this study

In summary, our results concur with earlier observational, clinical and in vitro studies, adding further evidence that statin use may improve MM-specific survival. Additional investigations in randomized prospective settings are needed to establish whether statins should have a role as adjuvant treatment in MM. An improved MM survival with statin use would provide an option for adjuvant MM treatment at a low cost and with few side effects and would be an appealing addition to the current treatment options, especially in the presence of disparities.

Vitamin D3 and its immune system health actions are key, higher doses being trialed in oncology

About a third improved odds for even normal levels of Vitamin D3
Importance of correcting deficiency at diagnosis is noted by researchers
Effects were specific to white not african american patients

Our study shows the importance of screening for vitamin D deficiency at diagnosis in MM and highlights the differential effect of vitamin D across race, where white patients with deficiency had much worse outcomes. When studying the effect of vitamin D deficiency on other comorbidities across race, deficiency has been associated with both increased overall mortality and increased cardiovascular-related mortality in AA and non-AA The Health ABC study demonstrated increased overall and cardiovascular mortality among AA and white participants, but only showed increased risk for c...

Aspirin has a majority of analysis in its favor including all-cause mortality

An almost 40% reduced risk level with aspirin across 436 cases
Similar effect for all cause mortality reduction of 37% noted
Reports increased survival for 81mg daily dose vs no aspirin

We previously reported an almost 40% reduction of multiple myeloma risk in individuals with higher average quantity or longer duration of regular aspirin use compared with nonusers in the combined populations of the NHS and HPFS (18). In the current study, we observed that regular aspirin use after a diagnosis of multiple myeloma was associated with an almost 40% reduction in both disease-specific and overall survival, independent of prediagnosis use…Our study provides preliminary support for the hypothesis that regular aspirin use may be associated with extended survival among patien...

Citrus Pectin removes heavy metals such as copper and has its own anti-cancer mechanisms

Significantly reduced progression risks in patients with lower copper levels
Elevated copper is seen in multiple studies on MM
Specific signaling pathways clearly verified here in lab study

Elevated COMMD3 expression was correlated with extramedullary myeloma and poor prognosis in MM patients. COMMD3 promoted MM cell proliferation and migration, modulating intracellular copper levels, likely through the ATOX1-ATP7A-LOX copper-metabolism-related pathway. High ATOX1 expression was correlated with worse outcomes, and ATOX1 inhibition abolished COMMD3’s effects. Conclusions: This study highlights the pivotal role of COMMD3 in MM progression, particularly via the ATOX1-ATP7A-LOX axis.

Berberine is a natural anti-diabetic with multiple other anticancer actions

Even in non diabetics, elevated insulin drives progression
Here, response to treatment is reported to depend on insulin
Multiple studies have reported accelerated disease with diabetes

Patients with higher calculated HOMA-IRIf [insulin resistance marker] values after treatment had a poorer response to therapy. NDMM [non diabetic] patients with a better response to the applied therapy had a lower HOMA-IRIf. It can be said that lower HOMA-IRI values in NDMM patients indicate a higher probability of remission, as well as a lower possibility of no response to therapy or progression under therapy. Such results could certainly be expected, bearing in mind the already detected metabolic vulnerability of multiple myeloma, whose main agent is the IGF (insulin-like growth factor) s...

Urolithin A can improve lipid metabolism and is entering pilot clinical studies in cancer

Data on patients with low ACSL1 fatty acid activity had over 40% risk reduction
Similar reduction in risk for relapse and treatment continuation rate
Lab study here shows interaction with mitochondrial health

Our data support the hypothesis that ACSLs (enzymes) maintain myeloma cell fitness and viability though effects on cellular metabolism, mitochondrial function, survival pathways, proliferation rates, stress responses, and superoxide levels. ACSLs represent promising therapeutic targets for MM and further research and development is needed to translate this preclinically identified target into clinical benefit. Overall, our work demonstrates the importance of cell intrinsic fatty acid metabolism in oncology and demonstrates the potential for novel therapeutics, or other interventions, to int...

Quercetin continues development in anti-aging science and more

Low activity level in so called IRE1 activated unfolded protein response is beneficial
Both a 37% increased time to recurrence, and more than 50% reduced overall risk level
Treatment resistance increased by IRE1/XBP1 action on Unfolded Protein Response

Immunoglobulin production by myeloma plasma cells depends on the unfolded protein response for protein production and folding. Recent studies have highlighted the importance of IRE1α and X box binding protein 1 (XBP1), key members of this pathway, in normal B-plasma cell development..This study provides further data to suggest a role for high XBP1s in myeloma pathogenesis and to show that patients with high XBP1s/u ratios have a significantly poorer survival. Importantly, the XBP1s/u ratio acts as an independent prognostic marker.

Danshen evidence from patient records is compelling in both cancer and vascular health

Analysis of Tiawan national patient records shows 60%+ risk reductions with chinese herbal medicines
Most studies are danshen and astragalus, and prescriptions are usually several months during chemotherapy
Danshen has evidence of supporting better oncology outcomes in several cancers

Currently, clinical doctors are greatly interested in CHM [chinese herbal medicine] treatment for MM because of its popularity as an integrative therapy in Taiwan. The therapeutic results of CHM in MM patients had previously been reported in the form of quality of life. However, whether MM patients have a higher survival rate after CHM therapy has never been explored. Our results showed that the benefit of CHM intervention was independent of sex, age, comorbidities, and standard Western medical treatment, such as bortezomib or HSCT.

Curcumin has evidence for reducing levels of systemic inflammation used by cancers

Overall risk and progression risk less than half with sufficient platelets
Low inflammation seen in c-reactive protein almost halving risk levels too
High CRP or low platelet count is reported as markers of prognosis

The incidence of thrombocytopenia in this study was 17.8%, consistent with previous studies. Thrombocytopenia was associated with poor prognosis in patients with NDMM treated with PI and/or IMiDs, similar to previous studies . Thrombocytopenia was not associated with the NCC but BMPC and high IPF, suggesting that thrombocytopenia might reflect not myelosuppression but the activity of myeloma disease and consumption of platelets. Thrombocytopenia and high CRP [c-reactive protein] independently predicted short OS and TTNT in patients with NDMM, and a new prognostic factor was developed using ...

Astragalus actions include protecting and balancing immune responses often with clear effects reported

Significantly lower risk with lower Neutrophil-to-Lymphocyte ratio
Effects are evidence in patients >65 and also during advanced stage
Astragalus can re-balance immune inflammation and platelet count

In the study, we examined the relationships between the pretreatment NLR, PLR, and various clinical, and further explored the prognostic value of NLR and PLR in MM patients. This retrospective study showed that a lower NLR (<2) at diagnosis experienced superior OS and PFS in patients with MM. Notably, NLR remains a strong independent predictor for the MM patients in multivariate analysis with the known prognostic factors. The choice of NLR (≥2 vs <2) as the cutoff point was consisted with the previous study

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Pathfinder Element	Risk Reduction Factor	Anti-Metastatic	Reduces Side Effects	Research Study
Danshen	>50%	Yes	Yes	Link
Aspirin	26 - 50%	Yes	Maybe	Link
Vitamin D3	26 - 50%	Yes	Maybe	Link
Red yeast rice/ statin	26 - 50%	Probably	Maybe	Link
Astragalus	Indirect - High	Yes	Yes	Link
Gut microbiome / Akkermansia	Indirect - High	Probably	Yes	Link
Lactoferrin	Indirect - High	Probably	Yes	Link
Quercetin	Indirect - High	Maybe		Link
Citrus Pectin	Indirect - Moderate	Probably	Yes	Link
Urolithin A	Indirect - Moderate	Probably	Maybe	Link
Curcumin	Indirect - Moderate	Maybe	Maybe	Link
Berberine	Indirect - Moderate	Maybe	Maybe	Link

Plan Item	Cancers	Background Details	Trial Doses Under Supervision	References
Antihistamines	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Gastric, Ovarian, Cervical, Pancreatic, Melanoma, Lymphoma, Esophageal, Bladder	Research indicates desloratadine for localized cancers or loratadine for metastatic. There are examples of ebastine or other alternatives in certain cases. Growing research evidence indicates improved oncology responses. Taken between meals. Low histamine before and during treatment is beneficial.	Active use in clinical trials is still in early phase, follow the dose recommendation for instance 5mg daily unless under medical supervision where higher 10mg doses are frequent
Aspirin	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Ovarian, Cervical, Endometrial, Pancreatic, Melanoma, Myeloma, Head and Neck, Bladder, Gallbladder, Non Melanoma Skin, Gastric	Use of low dose 75 or 81mg "baby" aspirin is reported to benefit many cancer types across an average study group, and even all cause mortality. There are some indications of specific "responders" for instance those with existing inflammatory conditions or certain gene expressions. With food.	In a colorectal cancer trial responders were tied to the expression of particular genes (PI3KA). Doses were 160mg	LINK
Astragalus	Breast, TNBC, Lung, Colorectal, Liver, Gastric, Cervical, Endometrial, Pancreatic, Prostate, Kidney, Ovarian, Glioblastoma, Non Hodgkin, Lymphoma, Leukemia, Myeloma, Head and Neck, Bladder, Gallbladder, Thyroid	A typical astraglaus membranaceus supplement may have 50mg of astragaloside IV the main active compound. Its possible with meals can reduce any stomach upset. Use of a standard dose to help immune system balance before treatment.	Here, Astragalus is added to standard oncology in lung cancer Doses are 2-3 tablets of 250mg AMe (Solgar, NJ, USA) minimum for 6 months in this example	LINK
Beta Glucans	TNBC, Lung, Liver, Gastric, Cervical, Pancreatic, Melanoma, Non Hodgkin, Lymphoma, Leukemia	There are many options for mushroom or yeast 1,3/1,6 glucan and branded products include California Gold Immune Defense/Wellmune, AHCC, Biogen/ Yestimun, ImmiFlex, IP6 and many more. A pharma grade product, odetiglucan, is continuing in trials. Take on an empty stomach. Use a standard dose to help balance the immune system before starting treatments.	AHCC is used at 3x1g per day over several months during treatment. Beta glucans are used at 1-2g per day and higher.	LINK
Danshen	Breast, Prostate, Lung, Colorectal, Liver, Leukemia, Myeloma, Bladder	The most common chinese herbal medicine in oncology, also known as red sage. Premium brands such as MCS may recommend 1g twice daily as an ongoing dose. Its possible with meals can reduce any stomach upset. Start a standard dose a couple of weeks before treatment to help balance the immune system.	3 x1g daily between meals , over at least 90 days ideally longer to get maximum benefits according to reported patient outcomes, though even shorter dose period reduced risk	LINK
Green Coffee Extract	Glioblastoma	Supplements vary in terms of their chlorogenic acid content, it can be up to 50%. Quality brand might specify this level under their recommended intake. High dose commercial brands may be over 1000mg total, take before meals.	Analysis across trials reports metabolic health benefits start are higher at >500mg or daily. High chlorogenic acid content supplements eg Svetol have been trialed safely for 12 weeks at 200mg x 5 daily dose. As always, be aware of possible drug interactions	LINK
Red Yeast Rice Or statin	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Gastric, Ovarian, Cervical, Endometrial, Melanoma, Leukemia, Myeloma, Head and Neck, Esophageal	Red yeast rice is equivalent to lovastatin. Doses are essentially on the products, and there are many premium brands with guaranteed level of monokolin k around 3mg. A common theme is findings is those with improved cholesterol are "responders". With meals. Start cholesterol and inflammation reducing statins early.	Trial data is often case studies with multiple statins where lovastatin has average effects. Often atorvastatin and sometimes simvastatin come out on top. Research ususally reports intermediate doses ( 10-20mg) are effective but there are examples indicating higher doses under supervision.	LINK
Turkey Tail	Lung, Colorectal, Kidney, Liver, Gastric	A typical premium supplement such as MCS recommend 700mg twice daily with food. Mushroom based glucans can help balance immune response so start them before your treatment.	Pharma grade turkey tail, e.g PSP/ PSK/ Krestin is typically used at 3x 1g daily during oncology, up to 36 months and more. Trials in breast cancer have also used 3,6 and 9g daily regimes in 6 week periods	LINK
Vitamin D3	Breast, TNBC, Prostate, Lung, Colorectal, Gastric, Ovarian, Pancreatic, Glioblastoma, Melanoma, Non Hodgkin, Lymphoma, Leukemia, Myeloma, Head and Neck, Esophageal, Bladder	High dose commercial formulae can be 10,000IU. Which might be achieved by as little as 10 to 20 minutes in sunshine. Vitamin K2 is advised with D3. Take with some food containing fat. Its important to ramp these up before oncology treatments, and sustain the higher levels over time. Add magnesium for best absorption and metabolism.	The VITAL trial used 2000IU and discussed the potential of higher doses to increase responders especially higher BMI/ body weight. Whilst in prostate cancer there are trials demonstrating at least 10,000IU is required to see activity reducing PSA levels	LINK
Melatonin	Breast, TNBC, Prostate, Lung, Kidney, Liver, Ovarian, Cervical, Endometrial, Pancreatic, Glioblastoma	Commonly used in 10 to 40mg daily range no reported side effects, typically an hour before sleep.	Moderate and high dose trials report no significant side effects even at 1000mg daily	LINK
Citrus Pectin	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Ovarian, Cervical, Endometrial, Pancreatic, Non Hodgkin, Leukemia, Myeloma, Head and Neck, Esophageal, Bladder, Gallbladder, Thyroid, Gastric	Trials use a recommended dose up to 5g x3 daily and no significant side effects. Taken 30 minutes before or 90 minutes after food. Ideally, start PectaClear or similar products at least 4 week before treatment to reduce heavy metals. But sustain zinc with supplementation	Even in children age 5 to 12 the daily regime 3 x 5g was safe and effective for heavy metal chelation	LINK
Soy Isoflavones	Breast, Prostate, TNBC	Often dietary sources, tofu and soy based and no evidence of side effects. Supplements generally with food.	In a clinical trial setting up to 900mg with no issues	LINK
Fermented Wheatgerm	Prostate, Colorectal, Melanoma	Trials are with Avemar brand products with no significant safety concerns reported	Typical dose regimes may be aroung 9g daily over longer time periods for instance 12 months	LINK
Iodine	Breast, TNBC	General usage around 1000mcg or 1mg generally with food	Successful pilot studies in breast cancer use 5mg molecular Iodine daily for the duration of therapy	LINK
Lactoferrin	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Gastric, Ovarian, Cervical, Endometrial, Pancreatic, Glioblastoma, Melanoma, Non Hodgkin, Lymphoma, Leukemia, Myeloma, Head and Neck, Bladder, Esophageal, Gallbladder, Thyroid	200mg typical use daily , eg 10ml liposomal formula ideally 30 minutes before meals or 2 hours after. No side effects of note. Start this immediately to achieve and maintain healthy iron absorption, avoid deficiencies and reduce cancer related ferritin levels.	During oncology doses of up to 3g to 9g daily, even higher, have been used with significant side effects	LINK
Selenium	Breast, Lung, Kidney, Ovarian, Cervical, Endometrial, Pancreatic, Melanoma, Head and Neck	Supplements are 200ug doses and similar amounts from about 3 brazil nuts. Start buildin gup your levels immediately and keep them high during oncology. Selenium toxicity is a consideration for high doses over time, so seek medical advice. Ideally taken with meals.	This trial used 2500 to 4000ug 2x daily for 14 days then once daily in kidney cancer with no dose limiting toxicity	LINK
Vitamin B3	Liver, Gastric, Glioblastoma, Non Hodgkin, Lymphoma, Leukemia, Non Melanoma Skin	Typically 500mg for nicotinamide (niacinamide) form of B3 taken ideally with meals	Do not differ from standard doses, here 500mg twice daily related to skin cancer	LINK
Akkermansia	Breast, TNBC, Prostate, Lung, Kidney, Liver, Ovarian, Cervical, Pancreatic, Non Hodgkin, Lymphoma, Leukemia, Myeloma, Head and Neck, Gastric	Commercial products may be at 10B CFU typically 30 minutes before or 2 hours after food. Ramp up levels with diet and moderate supplementation before treatments, especially immunotherapy.	Under development. Results in oncology indicate this is one of many helpful guy bacteria. careful consideration and particularly following use of antibiotics. Diversity is crucial.	LINK
Berberine	Kidney, Liver, Cervical, Pancreatic, Non Hodgkin, Leukemia, Myeloma, Head and Neck, Esophageal, Gallbladder, Thyroid, Non Melanoma Skin, Melanoma, Bladder	A natural anti-diabetic used frequently at 400mg daily and above, shortly before meals	In metabolic health trials frequentlu use up to 500mg at 3 times daily .	LINK
Curcumin	Colorectal, Liver, Non Hodgkin, Myeloma, Bladder, Gallbladder, Non Melanoma Skin, TNBC, Breast, Prostate, Lung, Kidney, Gastric, Ovarian, Cervical, Endometrial, Glioblastoma, Melanoma, Lymphoma, Leukemia, Head and Neck, Thyroid	Doses from 500mg to 2000mg frequently seen. Piperine fron black pepper improves absorption, highly bioavailable formulae are available. Ideally with a meal containing fat.	Higher doses in trials are frequently 2 of 4 g daily (+40 mg piperine) during oncology for instance here at 3 periods of 30 days	LINK
Quercetin	Glioblastoma, Myeloma	Can be found in a healty diet. Supplements often 500 or 1000mg and can be taken with tocotrienols for enhanced absorption, a form of vitamin E . Some evidence that Quercetin should be pulsed on/off.	Clincial trials have safely used up to 5g daily in adults, and 1 to 4g for rare forms of paediatric anemia	LINK
Urolithin A	Prostate, Lung, Colorectal, Kidney, Gastric, Glioblastoma, Melanoma, Myeloma, Gallbladder, Head and Neck	Typical commercial brands run at 500mg once or twice daily, with or without food, some brands suggest with meals	Trials eg in anti-aging science use the same dose range	LINK
Oat and Egg Functional Food	Breast, TNBC, Prostate, Lung, Colorectal, Kidney, Liver, Cervical, Pancreatic, Glioblastoma, Melanoma, Head and Neck, Gallbladder	Follow supplier guidance on dosage and use. https://shop.lantmannenfunctionalfoods.com/? Lowering tumor fluid pressure helps treatments work, start these before your treatment if possible. Use egg based salovum for short term "pulse" during therapy and oat products for sustained use over longer time periods	This trial in glioblastoma used 16g egg based Salovum four times daily. It discusses lowering that regime in follow on trials.	LINK
Coffee	Breast, Prostate, Colorectal, Liver, Non Melanoma Skin	Most dietary studies use standard 8oz servings as a guide. In many cases the findings are that benfits increase with intake. But in some cases such as prostate cancer there are important details in the PATHFINDER	No, but chlorogenic acid and, separately, green coffee extracts are used at 400mg and up to 2000mg
Flax	TNBC, Ovarian	Crushed flaxseed alone or in foods around 1/4 cup daily	Doses up to 50g daily in clinical trials for various diseases. Here a fairly typical 30g regime in inflammatory liver diseases	LINK
Propolis	Breast	Typical supplements range from 400 to 1000mg	Here 400mg x3 daily help recovery from radiotherapy	LINK
Walnuts	Prostate, Colorectal, Melanoma, Head and Neck	Dietary food item shown even at low useage to be helpful even at a few oz per week	Here, 2oz (56g) daily showed measurable activity in breast cancer	LINK
Mushroom	Prostate	Both dietary sources and many commercial supplements normally taken with food	In this example some patients saw responses between 8 and 14g daily of button mushroom extract	LINK
Zinc	Kidney, Ovarian, Cervical, Endometrial, Head and Neck, Non Melanoma Skin	Commercial supplements vary considerably . Moderate 20mg range generally advised	No
Intravenous HIgh Dose Vitamin C	Pancreatic, Glioblastoma	Commercial supplements vary. A moderate range around 20mg with food is generally accepted as safe.	Same as general guidance
Alpha Ketoglutarate	Melanoma, Kidney, TNBC, Non Hodgkin, Lymphoma	Typical usage is 1000mg daily with or without food, safety is good. Its especially important to ramp up and sustain your levels for maximum immunotherapy responses.	Larger doses of several grams have been safely used in various trials including here in bone disease at 6g daily	LINK
Horse Chestnut (Escin)	Thyroid	Common 300 to 600mg supplements contain 50 to 120mg of active compound, escin taken with food	Escin up to 150mg daily in vascular health. In oncology 0.6 mg/kg/day for 9 days, intravenous injection has been used, high absorption premium supplement would reacj this level	LINK

Myeloma is treated with a growing list of targeted drugs and immunotherapies, sometimes stem cell therapy. Its more common to be diagnosed with smoldering multiple myeloma which has a low be significant risk of progression.

Your PATHFINDER brings together research that may help slow down early phase SMM progression considerably. And, with advancing disease, the Pathfinder helps you maximize the effects of targeted drug treatments or immunotherapy. The IMPACTS tab summarizes these and can lead to Many more Good days by helping these treatments work, reducing your risk for progression and by easing treatment side effects. You can continue to look for ways to increase the results and reduce possible toxicities;

Be sure to fully read and absorb the PATHFINDER and its Impacts summary
If you have metastatic sites or so called extramedullary disease take a look into the corresponding Pathfinder for those too, for inspiration.
Use the Supplement Library Index and filter on “Immunotherapy” and “Targeted drugs” for ideas.
The Foods Library can complement your plan, including anti-metastatic strategies and metabolic health
In the Lifestyle section gathers fascinating evidence for diets and exercise
The PLANS section may have information from what others are doing and have learned

Myeloma

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