Lymphoma survivor, Jessica Melore talks to Dr. Nichols about the Latest in Lymphoma Research and Treatment
Lymphoma survivor, Jessica Melore talks to Dr. Nichols about the Latest in Lymphoma Research and Treatment
September is Blood Cancer Awareness Month and The Leukemia & Lymphoma Society (LLS) is increasing awareness about the urgency to find cures for blood cancers – the third most common cancer killer in the U.S. Through our “Ask the Doctor” blog series, blood cancer survivors have the chance to ask LLS’s chief medical officer, Gwen Nichols, M.D., about the three main types of blood cancers: leukemia, lymphoma and myeloma.
Featured Lymphoma Survivor: Jessica
After noticing a lump on her neck, Jessica Melore was diagnosed with non-Hodgkin lymphoma (NHL) – just two years after surviving a massive heart attack, a heart transplant and a leg amputation at 16 years old. After months of treatment, her cancer was in remission. Then, six years later, another lump turned out to be a different form of NHL. Jessica told herself she'd been through cancer once before and there was no reason she couldn't beat it again. By January 2008 she was back in remission, and finished treatment that May. Through all of this adversity, Jessica graduated with high honors from Princeton University, was the youngest member of LLS's New Jersey Board of Directors, and has been a national ambassador for LLS.
Recently, Jessica had the chance to ask questions about lymphoma and the latest treatment advances to Dr. Nichols, who plays a critical role in advancing cures through a unique combination of clinical, academic and pharmaceutical experience. See what Dr. Nichols had to say.
1) Jessica:What makes lymphoma different from other blood cancers?
Dr. Nichols:“Lymphoma” is a general term for many blood cancers that originate in the lymphatic system. Lymphoma results when a lymphocyte (a type of white blood cell) undergoes a malignant change and multiplies out of normal control. Eventually, healthy cells are crowded out and malignant lymphocytes amass in the lymph nodes, liver, spleen and/or other sites in the body.”
2) Jessica: When I was diagnosed with non-Hodgkin lymphoma, I had no clue what that meant. How many types of lymphoma cancers are there?
Dr. Nichols:“There are many different subtypes of lymphoma, most of which are divided into two main types: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). About 90 percent of people diagnosed have one of the subtypes of non-Hodgkin lymphoma.”
3) Jessica:I know there aren’t screening tests for blood cancer, but are there any early signs to watch out for?
Dr. Nichols:“A common early sign of HL or NHL is a painless enlargement of one or more lymph nodes. However, enlarged lymph nodes may be the result of inflammation in the body and are not necessarily a sign of cancer. Other HL signs and symptoms may include recurrent high fever, persistent cough and shortness of breath, drenching night sweats of the whole body, itching and weight loss. Other signs and symptoms of NHL may include bone pain, cough, chest pain, abdominal pain, rash, fever, night sweats, enlarged spleen, unexplained fatigue or weight loss. Some individuals may have no symptoms, and a diagnosis of NHL is made as a result of a periodic physical examination and testing. It’s important to note that people on medications which suppress the immune system, to treat other illnesses, or have chronic inflammatory diseases are at increased risk of lymphoma, and should have heightened awareness of these symptoms and signs so they can alert their HCP.”
4)Jessica: How common is lymphoma?
Dr. Nichols: “More than 845,000 people in the United States (US) population are living with or in remission from lymphoma, and over 83,000 people in the US are expected to be diagnosed with lymphoma in 2018. The incidence of HL is consistently and considerably lower than that of NHL.”
5)Jessica:Are there any recent groundbreaking treatments patients or survivors like myself should know about?
Dr. Nichols: ““Our long-term investment in research and clinical trials has resulted in significant breakthroughs leading to higher survival rates and lives saved for patients with lymphoma. In 2017, the FDA approved CAR T-cell immunotherapy, axicabtagene ciloleucel (Yescarta®), for adults with several types of relapsed and refractory large B-cell lymphomas. In May 2018, the FDA granted tisagenlecleucel its second approval, also for patients with several types of large B-cell lymphomas. The FDA also approved another type of immunotherapy for a very rare subset of lymphoma called primary mediastinal large B-cell lymphoma (PMBCL) in June 2018. This immunotherapy, called pembrolizumab (Keytruda®), is known as a checkpoint inhibitor that works by releasing the brakes on the immune system so it can attack cancer cells. Pembrolizumab and another checkpoint inhibitor, nivolumab (Opdivo®), were also both recently approved for Hodgkin lymphoma patients who have relapsed from standard therapy.
With advances in biologic understanding of lymphoma subtypes, we are able to provide more precision therapies, both immunologic and targeted, along with chemotherapy to get better outcomes for patients. These groundbreaking treatments are only possible because of patient participation in clinical trials; increasingly important as we subdivide the lymphoma based on biomarkers of response. LLS provides personalized clinical trial navigation when appropriate. For more information, click here.”
Check out LLS’s education programs including webcasts, audio replays and program slides covering topics related to lymphoma and its subtypes here.
Myeloma Survivor, Sharon Clark Talks to Dr. Nichols about the Latest in Myeloma Research and Treatment
September is Blood Cancer Awareness Month and The Leukemia & Lymphoma Society (LLS) is increasing awareness about the urgency to find cures for blood cancers – the third most common cancer killer in the U.S. Through our “Ask the Doctor” blog series, survivors have the chance to ask LLS’s chief medical officer, Gwen Nichols,M.D., about the latest treatment and research advances for the three main types of blood cancers: leukemia, lymphoma and myeloma.
Featured Myeloma Survivor: Sharon
Sharon Clark was diagnosed with multiple myeloma in 2015. Her treatment included multiple courses of oral anti-cancer medication, countless injections, infusions and hospitalizations, a stem cell transplant and two spinal surgeries to repair cracked bones caused by the myeloma. Sharon continues to be treated with oral anti-cancer therapy called Revlimid to keep her cancer in remission. She recently shared her story at a U.S. Department of Health and Human Services in efforts to raise awareness about the high cost of care and need for access to cutting-edge treatment.
Recently, Sharon had the chance to ask questions about myeloma and the latest treatment advances to Dr. Nichols, who plays a critical role in advancing cures through a unique combination of clinical, academic and pharmaceutical experience. See what Dr. Nichols had to say.
1) Sharon:A lot of people have never heard of myeloma. Can you explain what this disease is?
Dr. Nichols: “Myeloma is a cancer of the plasma cells (a type of white blood cell). Plasma cells are found primarily in the bone marrow. Myeloma is an abnormal, malignant proliferation of a clone of plasma cells. Many people with myeloma have disease involving multiple sites at the time of diagnosis. Some individuals have myeloma that progresses very slowly (sometimes referred to as “smoldering” or “indolent” myeloma). The median age at diagnosis is 69 years; myeloma is seldom diagnosed in people younger than 40 years. Because of the similarity in names, many people confuse myeloma with melanoma (a cancer affecting the skin).
2) Sharon: How does myeloma develop?
Dr. Nichols: “Myeloma develops when a plasma cell is changed (mutated). Plasma cells are made from B lymphocytes (B cells), a type of white blood cell that is found in the bone marrow. Healthy plasma cells are part of the immune system and make proteins called “antibodies,” which help fight infection. The malignant plasma cell forms a clone that makes only one kind of protein meaning lower amounts of normal infection fighting antibodies for many patients. The abnormal myeloma protein can be measured in the blood of most patients with myeloma. Having an abnormal protein clone or “spike” is one way that myeloma may be diagnosed.
3) Sharon:Can you tell me about the latest in myeloma research or treatment advancements?
Dr. Nichols:“Remarkable advances have been achieved over the past decade in treating myeloma. While a cure has not yet been achieved, survival rates have been dramatically extended with the median five-year survival rate improved from 34.6 percent in 2000 to 52.4 percent in 2015, and currently may be even higher, thanks to a multitude of new therapies. With so many new agents to work with, the next phase for physicians who treat patients with multiple myeloma is to optimize dosing and combinations. CAR-T is now being tested in myeloma, targeting a protein on the surface of the cancer cells called BCMA. The data to date are encouraging for patients who have failed multiple therapies, showing in a small trial that more than 95% of the 22 patients in the study responded; 50% had a complete response, meaning no cancer cells could be detected. While it’s not yet clear if any cures are being achieved, the results are promising.”
4) Sharon: I’ve heard that blacks have more than twice the age-adjusted incident rate of myeloma than whites. Can you elaborate?
Dr. Nichols:“That’s correct. From 2010 to 2014, myeloma was the ninth most commonly diagnosed cancer among black males and black females. The median age at diagnosis is 66 years for blacks and 70 years for whites. Black males have a higher age-adjusted myeloma incidence rate than males or females of any other race or ethnicity. The highest incidence rates are found in black males who are ages 80 to 84 (108.8 per 100,000 population). We are so appreciative of your advocacy work and for getting the word out about myeloma to this higher-risk population. LLS is dedicated to improving access to the best therapies and quality of life among African Americans with myeloma, learn more here.”
5) Sharon:I know an early diagnosis is critical. Are there any signs or symptoms to watch out for?
Dr. Nichols:“Patients may have no symptoms or complain of fatigue due to the anemia associated with myeloma. Patients or their health care providers may be alerted to the possibility of myeloma by an elevated protein level in the blood. One important symptom of myeloma to know about is bone pain from the effects that myeloma cells are having on the marrow. Fractures may occur as a result of the weakened bones. While not specific to myeloma, unexplained or persistent bone pain should be evaluated by your HCP. Anemia, recurrent infections, or numbness or pain in the hands and/or feet (caused by a condition called “peripheral neuropathy”) can also be signs of the disease.”
Check out LLS’s education programs including webcasts, audio replays and program slides covering topics related to myeloma and its subtypes here.
For 36 years, The United Food & Commercial Workers International Union (UFCW) has been a committed supporter of The Leukemia & Lymphoma Society (LLS), raising more than $86 million to drive forward our goal to end blood cancers.
Led by members of the UFCW, Labor Against Cancer is a movement to end the devastation of cancer through fundraising drives among members, retail campaigns, and walking with LLS's Light The Night.
Labor Against Cancer allows members like Dean Nelson, to do what they do best, empower their membership to band together for the good of others in the communities where they work and live. A longtime UFCW member, Dean knows firsthand the urgent need for lifesaving treatments. Here is his story.
I’m a proud member of UFCW and I've worked as a retail meat cutter for our local grocer CUB foods for 24 years. I’ve always supported our partnership with LLS because I saw their dedication to find cures for blood cancers and help patients and families in need. Throughout the years, I’ve attended several of our annual Light The Night Walks with my local UFCW team, but it all became personal for me in June 2014.
After experiencing unusual symptoms such as difficulty breathing, I was diagnosed with chronic myelocytic leukemia. It wasn’t an easy journey, but because of the advancement in therapies LLS helped fund, I was in the hospital for just three and a half days, and back to work in less than three weeks.
Next June, I will celebrate five years of being cancer-free and I will continue to give back through Labor Against Cancer and my UFCW Light The Night Walk team.
I can honestly say that I am alive today because of LLS and UFCW. The medication I take is a direct result of research funded by LLS with money raised by UFCW and many others in the fight against cancer. I’m proud to say I played a role in bringing forth the treatment that saved my life. Words of gratitude are hard to express.
Today I am a UFCW board member and I wear a UFCW butcher’s cleaver tattoo on my left arm. It’s a reminder of my survivor story and I carry it with me always.
Left to right: UFCW Local 1189 President Jennifer Christensen; UFCW 1189 member, steward and executive board member Dean Nelson; and Cub Foods District Manager Bob Iacono.
After noticing a lump on her neck, Jessica Melore was diagnosed with non-Hodgkin lymphoma (NHL) – just two years after surviving a massive heart attack, a heart transplant and a leg amputation at 16 years old. After months of treatment, her cancer was in remission. Then, six years later, another lump turned out to be a different form of NHL. Jessica told herself she'd been through cancer once before and there was no reason she couldn't beat it again. By January 2008 she was back in remission, and finished treatment that May. Through all of this adversity, Jessica graduated with high honors from Princeton University, was the youngest member of LLS's New Jersey Board of Directors, and has been a national ambassador for LLS. 
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Dr. Nichols: “Myeloma is a cancer of the plasma cells (a type of white blood cell). Plasma cells are found primarily in the bone marrow. Myeloma is an abnormal, malignant proliferation of a clone of plasma cells. Many people with myeloma have disease involving multiple sites at the time of diagnosis. Some individuals have myeloma that progresses very slowly (sometimes referred to as “smoldering” or “indolent” myeloma). The median age at diagnosis is 69 years; myeloma is seldom diagnosed in people younger than 40 years. Because of the similarity in names, many people confuse myeloma with melanoma (a cancer affecting the skin).
