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RENEE MONTAGNE, host:

Let's turn now to one of the most dramatic success stories in cancer care. It involves multiple myeloma. This bone marrow cancer used to be one of the deadliest forms of the disease. As NPR's Richard Knox reports, that's changed.

RICHARD KNOX: Hardy Jones is a documentary filmmaker and a recreational surfer. He knew something was wrong when he lost his usual energy.

Mr. HARDY JONES (Documentary Filmmaker): I just couldn't get that stoked feeling, no matter what I did. I was just always dragging. And to get off the beach, I had to carry my surfboard and wetsuit and stuff up a fairly steep hill, and I just started to have these heart palpitations.

KNOX: His doctor did some tests. He mentioned that among other things it might be cancer. While Jones waited for the results, he started reading up on the possibilities. Some of them were scary.

Mr. JONES: I had vowed that I would go in there and no matter what the diagnosis was, I'd be cool. And when the doctor said, well, its multiple myeloma, I said, oh, my God.

(Soundbite of laughter)

Mr. JONES: I totally cracked. I wasn't cool. But he said, stop it, stop it. This is not a death sentence.

KNOX: Not any more. Jones, who was almost 60 when he got the diagnosis, got it at the right time, just when new drugs were turning the tide against multiple myeloma. Multiple myeloma is a painful cancer of the bone marrow. It weakens bones so much that patients can break a bone just stepping off a curb. Now there are easy-to-take drugs that keep myeloma at bay for years.

Dr. KEN ANDERSON (Dana Farber Cancer Institute, Boston): Everybody responds, and the majority have a very significant response. So it's clearly a new day in myeloma.

KNOX: That's Dr. Ken Anderson of Dana Farber Cancer Institute in Boston. He says the big breakthrough came a decade ago. The late Dr. Judah Folkman of Harvard suggested that doctors try treating myeloma with thalidomide. You may have heard of it. Thalidomide caused an epidemic of birth defects when doctors prescribed it to pregnant women 50 years ago. Hardy Jones' doctor put him on thalidomide, which is now considered safe when used in the right patients. That was five and a half years ago. He's still doing well. Successes like this touched off an explosion of drugs effective against myeloma, some related to thalidomide, others that work in a different way.

Dr. ANDERSON: The excitement here is that we have six new treatment options that we didn't have only five years ago. And we have three additional treatment strategies that are in the last stages, so-called phase three clinical trials, that likely will create additional options.

KNOX: Having drugs to mix and match gives myeloma patients hope of remissions even after they relapse. This is unusual in cancer treatment.

Dr. ANDERSON: It really offers for us opportunity to treat patients even when their myeloma has come back not once, but perhaps even many times.

KNOX: Doctors can't yet cure myeloma, but they're turning it into a disease that patients can live with for many years. Meanwhile, researchers are about to launch an international study to see if the new drugs are better than bone marrow transplants, which are grueling. Officially bone marrow transplants are still the first-line treatment for myeloma, although many patients like Hardy Jones are looking at transplants as a last resort.

Dr. ANDERSON: Now, the question becomes relevant, do you actually need the transplant? That question couldn't even have been asked before.

KNOX: But the picture's not all positive. Dr. Brian Durie of the International Myeloma Foundation says more patients are being diagnosed with myeloma.

Dr. BRIAN DURIE (International Myeloma Foundation): In the United States, there are approximately 20,000 new patients diagnosed each year. The incidence used to be 12,000 new cases a year. So it's a significant upward trend.

KNOX: Other experts say the increase in numbers is from aging of the population, not from a real increase in the rate of myeloma. Durie is convinced that younger people are getting myeloma, which used to be an older person's disease, but others are skeptical. There's also debate about whether environmental toxins are causing myeloma.

Dr. DURIE: The commonest chemical that has been linked to myeloma is dioxin.

KNOX: That's why some Vietnam veterans are thought to have gotten myeloma - from exposure to Agent Orange. There's emerging evidence that civilians exposed to herbicides and pesticides do have a higher risk of myeloma. But experts say it's too soon to conclude that environmental toxins are the cause. Richard Knox, NPR News.

MONTAGNE: Many of you listened to our commentator, the late Leroy Sievers, and read his blog "My Cancer" on npr.org. This week that blog becomes an online community forum called "Our Cancer." You can join in the discussion at npr.org/ourcancer.

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