Skip to Navigation Skip to Search Skip to Content
Search All Centers

Can Diet and Supplements Prevent Smoldering Myeloma From Progressing?

Read Transcript
View next

Published on July 9, 2020

Can Diet and Supplements Prevent Smoldering Myeloma From Progressing?

Is there a proven diet that can keep smoldering myeloma from progressing? What about fasting and taking supplements? What do the experts recommend?

In this segment from our recent Answers Now program, smoldering myeloma patient and chef Jason Stefanko shares his diet, fasting strategy and the supplements he takes. His own specialist, Dr. James Berenson from the Institute for Myeloma and Bone Cancer Research, shares what he recommends to his patients. Dr. Ola Landgren from Memorial Sloan Kettering also joins to discuss research studies on diet and vitamins. Tune in to learn more!

This is Part 2 of 2 videos. Part 2 can be found here.

Featuring

Transcript | Can Diet and Supplements Prevent Smoldering Myeloma From Progressing?

Andrew Schorr:
Greetings. It's Andrew Schorr from Patient Power in Southern California. Thank you so much for joining us for this Myeloma Answers Now program. We're doing these programs every two weeks on important topics for people affected by myeloma. So Jason, you are a chef?

Jason Stefanko:
Yes.

Andrew Schorr:
You said that you were kind of a crazy man in earlier years, but now went to health and wellness. So there are a bunch of people asking, "Well, what about diet?"

Jason Stefanko:
Sure.

Andrew Schorr:
Diet and exercise. Some people even asked about fasting.

Jason Stefanko:
Sure.

Andrew Schorr:
I'll ask the doctors. Do you have any thought about that?

Jason Stefanko:
For me, I stick more towards a whole foods plant-based diet. I try and limit the amount of processed foods that I eat. I try and get plenty of fruits and vegetables, healthy amount of plant-based proteins.

Andrew Schorr:
But not fasting?

Jason Stefanko:
I do do fasting, but I do intermittent fasting. Fasting for me would be an early dinner and then extended the period between my dinner and when I'm having my first meal and trying to get to the 15- to 16-hour rule.

Andrew Schorr:
Do you take any supplements?

Jason Stefanko:
Yes.

Andrew Schorr:
I've got a bunch of people saying, "What's he taking?"

Jason Stefanko:
Yeah. I think that having visited a lot of the different forms, I think the gold standard supplement is curcumin in some of the conversation and study that's in curcumin versus smoldering myeloma and myeloma. I'm on that. I'm on turkey tail mushrooms, Boswellia and a pancreatic enzyme called Wobenzym N. Then I also take green tea and resveratrol.

Andrew Schorr:
Okay. Let's ask your doctor. Dr. Berenson, here's your patient. He says, "I'm doing this, doing that." Any comment from the clinical side?

Dr. Berenson:
Well, there's been work done with the curcumin. It's an interesting thought that that may do something. From a lot of work at MD Anderson at least in the laboratory, it acts a little bit like protozoan inhibitors and does some other good things as well. So, maybe. It's hard to say for sure. The Wobenzym is kind of like mucus or snot if you will. Whether that does anything, we really don't know.

I've had some patients take mushrooms and had interesting drops in M protein from the Maitake mushrooms specifically. I don't know about turkey tail. Green tea, I would tell you I don't know. I certainly would argue that the whole thing about green tea blocking bortezomib (Velcade) you probably have to have the amount of green tea that would take up my swimming pool to do that. I don't find that really relevant.

I would say Vitamin C, certainly tell patients to avoid Vitamin C when taking Velcade. I tell patients to avoid preserved foods. I don't think things like bacon, nitrates, nitrosamines are good for you. I also am a firm believer that Diet Coke, diet food, aspartame, is a bad thing. That's kind of the extent of what I tell patients.

Andrew Schorr:
Let me go to the East Coast for a second. We have these California guys. Dr. Landgren, anything you want to say about diet?

Dr. Landgren:
I think when it comes to plasma cell disorders, I was involved in a study a couple of years ago back in Europe where I come from originally. We did an epidemiologic study when we looked at people with MGUS and smoldering myeloma and the risk of developing multiple myeloma. Then we looked at food intake. We found that fruit and vegetable intake was associated with a lower rate of progression. That's data that was generated. I cannot tell you what the absolute risk decrease is, but that was the statistical correlation. That's the best evidence I have so far.

We have also done studies where we have looked at different types of food, plant-based food versus non-plant based food. We have studied a lot more cursors that were associated with immune activation. We have studied similar markers in people with obesity seeing that these markers are also much higher in people with obesity. We think that modifying food could potentially be a "medicine" for people who have precursor disease. We're trying to investigate that by putting these different pieces together by offering people plant-based food on protocols and then to offer people to do blood tests to monitor these markers and also see how they correlate with drops in M spikes.

We have not yet been able to move that forward. We were about to open it just before COVID happened, but we're looking into that. I do think food is probably very important. There are a lot of questions where we don't have scientific answers. They are to a high degree more personal beliefs, but there's nothing wrong with personal beliefs. A lot of things we do every day is kind of personal beliefs.

Andrew Schorr:
Anything you know about Vitamin D3 related to that?

Dr. Landgren:
I am not aware of any study showing that Vitamin D is significantly associated with worsening or better outcome when it comes to progression. I think there was a study done several years ago when people looked at people with low Vitamin D levels, and they also looked at supplement intake for correction of Vitamin D to see if there were any alterations either way. I'm not aware that that study showed either a worsening with low levels or an improvement with supplements. To my knowledge, the scientific literature has not really been able to generate data. I don't know, James may have other opinions.

Dr. Berenson:
We did publish data that Vitamin D is low in probably 35% to 40% of myeloma patients in a large study. And also Vitamin D levels that are low among patients on Velcade were associated with much worse neuropathy, and there's data in diabetics that the low Vitamin D is associated with a higher risk of neuropathy. We're very keen to check Vitamin D frequently and supplement appropriately.

But I will also chime in that when patients become hypercalcemic, meaning their calcium levels are too high, many of my colleagues forget to turn off the Vitamin D, which can push calcium up and their calcium, and they've got to remember that. If your calcium goes up, you don't want to be on Vitamin D.

Dr. Landgren:
Those studies, James, that you refer to when you show that lower levels of Vitamin D is associated with those outcomes, have you also been able to study if you supplement Vitamin D that these things reverse or if there is any sign of improvement?

Dr. Berenson:
No, we didn't get support from that from the company, you can guess who, to support the study. We certainly do that routinely. It seems to be true, but it's total antidotal. We didn't actually do the follow-up, which would've been the right thing if you supplement do you get better in a study. We did not do that part.

Dr. Landgren:
I think we're kind of saying the same thing that maybe there are correlations, but that we're missing pieces in the scientific literature.

Dr. Berenson:
Right.

Andrew Schorr:
Right. Jim, just to be clear, when you say Vitamin D is low, somebody said, "Well, what would that number be?" What is a low number?

Dr. Berenson:
Well, you're right. It's a very, very, very good question, Andrew, because if you look at labs, most clinical labs say 20. We say forget that. Our minimum is 30. My good friends who are more expert in this arena say you want to shoot for 50. But anybody less than 30, it's 50,000 once a week for eight weeks, gets retested, and then put on daily at 2,000 to 3,000. But patients who routinely come in with levels above 30, we have them take around 1,200 units daily. That's much more than I did a few years back. I think Vitamin D is something you want to watch. It's frequently low in myeloma patients.


Recommended Programs:

View next