BETA - Can an individual do anything to make the bone marrow (immune) microenvironment less conducive to myeloma cell development?

In this Health Tree University lesson, you'll discover how both lifestyle choices and certain medications can help change the bone marrow microenvironment, making it harder for myeloma to grow. By targeting things like immune responses, cell-to-cell communication, and specific signals that support cancer, we can create a less welcoming space for myeloma to survive. Can an individual do anything to make the bone marrow microenvironment less conducive to myeloma cell development? When we think about the microenvironment or the immune system, we want to think about all of these things, diet, physical activity especially, and lifestyle changes, better sleep, all of those things make a difference. What I can say is that we have very clear data from our nutrient prevention studies showing how we could reduce inflammation and improve anti-tumor or anti-cancer immunity with changes in the diet. So what we did see was that people who eat more of the fiber-rich plant foods had lower inflammation in their body, and with lower inflammation there was a shift in immune cells that are like, we have many types of white blood cells, so certain white blood cells that are considered anti-inflammatory, like the classical monocytes, they increased, and certain white blood cells that are considered inflammatory, like non-classical monocytes, they decreased. So we do see a shift, and these actually abnormal immune cells are seen in myeloma or MGAS and smoldering to the opposite, where MGAS and smoldering in myeloma may have more non-classical monocytes and less classical monocytes. So we showed with diet that we are able to reverse or reduce the skew that is abnormal. Another thing is also that the function of the cells changes and the interactions. So we did see, this is of course an exploratory analysis, meaning it was a small sample size, but we did see that the myeloid cells or some of these monocytes are interacting with exhausted CD8 cells at the beginning of the study, and one year later as the dietary changes have been made, they are now interacting with cytotoxic or cytotoxic CD8 T cells and natural killer cells, suggesting improvement in anti-tumor or anti-cancer immunity. So I think similar findings have been seen with physical activity too. So when we think of the pillars of lifestyle medicine, diet, physical activity, sleep, eating substances that we know are unhealthy like alcohol, smoking, things like this are associated with better outcomes. Besides lifestyle interventions, are there other things that can change the bone marrow microenvironment making it less hospitable to myeloma? Definitely. We have drugs that help the bone marrow microenvironment become less hospitable for the myeloma and in fact even help the patient develop stronger bones. Historically we've used drugs like Zometa, now there are also antibody based drugs that block the bone remodeling that causes osteolytic lesions and makes bones weak. So definitely patients that have bony lesions and benefit from these drugs should receive them. They have a very small risk of getting complications in terms of teeth and jaws. So I recommend patients that are on these get regular dental checkups at least twice a year. But in general, they're extremely safe drugs and very effective at both reducing myeloma growth and making the bone strong. In terms of other cells that I mentioned and immune cells particularly, we have drugs like the imid analogs. Now Revlimid and Pomalidomide are used very commonly. We know these activate the T and NK cells as well in the bone. So patients that are on this should be aware that they can actually activate their own immune system and help kill myeloma as well.