DEAR DR. DONOHUE: My husband is 64 and has just learned that he has multiple myeloma. No treatment has been discussed as yet. We wonder what that might entail and would appreciate anything you can tell us to help us understand this illness. He complained of back pain for many months. Could the back pain have been a sign of myeloma? – J.T.

ANSWER: The “myel” in multiple myeloma indicates trouble in the bone marrow, the place where all blood cells are made. The “multiple” suggests that there are many marrow sites involved with this trouble, but that is not always true. Sometimes it is a single marrow site.

One blood cell suddenly begins producing astonishing numbers of self-replications. It’s like a copy machine that has gone wild. In the section of bone where the marrow is acting up, bone loss occurs, and that can be quite painful. Your husband’s back pain could have been an indication of multiple myeloma.

Myeloma accounts for about 1 percent of all cancers. It most often appears in a person’s late 60s. It is twice as common in blacks as whites, and that’s something that has never been explained. Nor has its cause.

Patients complain of bone pain. They also complain of enervating weariness. Myeloma cells are the kind of cells that, when normal, produce antibodies, the body’s protective ammunition. Once these cells have become myeloma cells, they make abnormal antibodies, ones that are not protective. Infections, therefore, are common in myeloma patients.

Treatment of myeloma is age-dependent in some respects. For people younger than 70, large doses of chemotherapy are given to wipe out the marrow and all myeloma cells. Then, after an interval, the patients are given adult stem cells to reconstitute their marrow. This treatment is not the treatment for all myeloma patients. Conventional chemotherapy is the usual treatment.

DEAR DR. DONOHUE: My husband has had diabetes for 20 years. He doesn’t take insulin, but he does take a diabetes pill. On his last doctor visit, the doctor said he could eat an occasional piece of cake. I haven’t served him any desserts in 20 years. Can I believe the doctor really said this, or is my husband giving me a story to satisfy his sweet tooth, something diabetes hasn’t taken from him? – K.J.

ANSWER: You can believe your husband. I do.

In the past, anything with sugar was supposed to be poison for a person with diabetes. However, the newer diabetic diets allow people to indulge in sugar. The diet emphasizes total carbohydrates. Carbohydrates are sugars and starches, and starches are nothing more than long chains of sugar. Your husband can have his cake and eat it if the carbohydrates in it don’t put him over his daily carbohydrate limits.

People with diabetes shouldn’t go hog wild with sugary desserts. Sugar raises blood sugar somewhat rapidly, usually more so than starches. That’s not true in all cases. A baked potato raises blood sugar faster than does a spoonful of pure sugar.

The diabetes booklet gives a detailed picture of this illness and its treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: More than once I have read in your column about polycythemia. I have it, but my doctor calls it polycythemia vera. Is that the same as the polycythemia you have written about? – G.C.

ANSWER: Polycythemia (POL-ee-sigh-THEME-ee-uh) is an overproduction of blood cells, mainly red blood cells. The blood thickens as a result.

“Vera” means true. Polycythemia vera is the kind that comes on without some other process having caused it. When there’s another process as the cause – cigarette smoking, living at high altitude, chronic obstructive pulmonary disease – then polycythemia is called “secondary.” I write about the “vera” variety.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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