By Sue Rochman
Dear Ann Landers
New research has led to the approval of drugs that are helping patients live longer lives with multiple myeloma—a cancer that took the life of a beloved advice columnist less than a decade ago
By Sue Rochman
Treatment Options Expand
Since 2002, new therapies have dramatically reshaped multiple myeloma care. “There are now people in remission five years, eight years and beyond—which was virtually unheard of before 2002,” says Susie Novis, the president of the International Myeloma Foundation.
In the late 1990s, there were relatively few treatment options. At that time, says Jacob Laubach, a medical oncologist at the Dana-Farber Cancer Institute in Boston, patients were basically divided into two groups: those who were able to have a stem cell transplant and those who were older or had other serious medical conditions that precluded a transplant.
But by 2002, when Landers was diagnosed, excitement had been building about thalidomide. Researchers had realized in the mid-1990s that the widely feared and discredited drug—which was tied to devastating birth defects in the late 1950s—could slow the growth of the new blood vessels a tumor needs to thrive, a process known as angiogenesis. And positive results from studies testing the drug in patients with advanced multiple myeloma had stimulated further research. “Thalidomide was a revelation,” says Laubach, “and it ushered in a new approach to treating the disease.”
This success put multiple myeloma labs into overdrive to develop similar drugs that were safer and more effective than thalidomide. The U.S. Food and Drug Administration (FDA) approved the second-generation drug Revlimid (lenalidomide) in 2006, and a third-generation drug, pomalidomide, is now in phase II trials. In 2002, researchers also reported positive results from Velcade (bortezomib), a drug known as a proteasome inhibitor. It received FDA approval in 2003, and a second-generation proteasome inhibitor, carfilzomib, is now in phase II trials. “With these drugs,” says Sagar Lonial, a medical oncologist at Emory University in Atlanta, “we are finally able to start talking about maintenance therapy and putting people into long-term remission—and to occasionally even talk about the ‘cure’ word.”
Straightforward to the End
Landers orchestrated her cancer care in the same clear-cut fashion she answered readers’ questions on controversial topics. When she was informed that thalidomide, which had just started to be used for her disease, might prolong her life for 12 to 24 months, albeit with significant side effects, she had a straightforward response. “Mother said, ‘I will not go through this nonsense,’ ” says Howard. “And she left the hospital, and went home and prepared to die.”
Landers told very few people she had cancer, and she strictly controlled who visited, and when. “Most of her life had been on the public stage,” says Howard, “and she said, ‘This is for us.’ ” She died in her home, on June 22, 2002, six months after her diagnosis. Within hours, word of her death began to spread, and by the next day millions around the world were mourning her loss.
Months later, Howard put some of her mother’s items up for auction so that readers could obtain mementos. Recently, she donated a portrait of her mother by Roger Robles to the Smithsonian, where it will be unveiled at a dinner in November. And, says Howard, plans are under way for the United States Postal Service to issue an Ann Landers stamp.
“Mother enjoyed her fame,” says Howard. “She also really loved her readers. … Her mission really was to save the world, one letter at a time.”
(image: Reproduced with permission from Margo Howard)