Saraatje Naef was an active, young woman when she was unexpectedly diagnosed with multiple myeloma, a blood cancer. Multiple myeloma is the second most common blood cancer that occurs in the U.S., and the most common blood cancer in Black Americans.

Your Health | 3 years ago

An Unusual Multiple Myeloma Case Requiring Expert Care

Saraatje Naef was an active, young woman when she was unexpectedly diagnosed with multiple myeloma, a blood cancer. Multiple myeloma is the second most common blood cancer that occurs in the U.S., and the most common blood cancer in Black Americans. But Saraatje’s case grew more complicated when it was discovered during the course of her treatment that she also had thyroid cancer. Fortunately, Saraatje was referred to Dr. Saad Usmani, an expert in cases just like hers. Now, her cancer is in remission and she’s back to living her active lifestyle.

Saraatje Naef had a very active lifestyle – including a job with NASCAR, a robust social life, and lots of exercise. But one day, Saraatje hurt herself while working out with kettlebells. She was in tremendous pain, and a trip to the chiropractor and prescription pain medication didn’t bring her any relief. Saraatje’s friends were worried about her and urged her to see her doctor again. She went back for another visit, and her doctor was concerned that Saraatje was still in pain and couldn’t even stand up. Her doctor also noticed that Saraatje had lost a significant amount of weight. So she ran a full panel of tests to see what could be the root cause of Saraatje’s continued pain.

An unexpected diagnosis

In December 2014, Saraatje’s doctor diagnosed her with Stage II multiple myeloma – a type of blood cancer that forms in plasma cells (a type of white blood cell). Multiple myeloma is often a slow-growing cancer that may not show immediate signs of symptoms, but weight loss and pain are among the common signs.

According to Saraatje, “I was only in my 40s when I received my diagnosis. My life did a 180-degree turn right there, and there was no going back. When I heard that I’d had multiple myeloma for quite a while already, and that there’s no cure for this type of cancer, it was a lot to take in.”

Saraatje had crushed two vertebrae in her back, which caused the pain that led her to initially see her doctor. Because she had been living with multiple myeloma for some time, her body had slowly adapted to it, so she didn’t necessarily notice her symptoms right away – plus, “I thought I was losing weight because I worked out all the time,” says Saraatje.

When it comes to multiple myeloma, there are many treatment options available, including:

  • Chemotherapy
  • Radiation
  • Bone marrow (also known as stem cell) transplants, either autologous (from the body’s own bone marrow) or allogenic (from a donor)
  • Immunotherapy (or biological therapy), which activates the body’s immune system
  • Targeted therapy, using drugs targeted to each individual case
  • Clinical trials using novel approaches

Although the cancer can’t be cured, people with multiple myeloma can go into remission and stay in remission for long periods of time.  

A unique situation that requires a special approach

By 2015, Saraatje’s case was complicated by the fact that she didn’t respond well to her initial treatment (oral chemotherapy). Saraatje was then referred to Saad Z. Usmani, MD, FACP, the Director of the Plasma Cell Disorder program and Director of Clinical Research in Hematologic Malignancies at Atrium Health Levine Cancer Institute. Dr. Usmani is a specialist in hematology, medical oncology and bone marrow transplantation and is an expert in multiple myeloma.

Multiple myeloma is the second most common blood cancer in the world, and the most common blood cancer in Black Americans. Still, “Saraatje’s case is somewhat unusual, because the median age of diagnosis for myeloma patients is usually in their late 60s, and Saraatje was only in her 40s when she was diagnosed – she’s a very young myeloma patient,” says Dr. Usmani.

Then, while she was still undergoing her treatment for multiple myeloma, Saraatje was also diagnosed with thyroid cancer in 2015. “She had a nodule on her thyroid, and when we biopsied it, it turned out to be thyroid cancer,” explains Dr. Usmani. “She was a healthy young person who was suddenly faced with two different cancers at the same time.”

Saraatje had surgery performed on her thyroid by Zvonimir Milas, MD. She then received radio-iodine treatment for her thyroid cancer. 

After this, Saraatje received an autologous stem cell transplant (also known as a bone marrow transplant) – a type of treatment where the body’s own stem cells are harvested and used in the treatment – to treat her multiple myeloma.

Saraatje did worry sometimes about her health and managing her side effects from all her treatments. But, she says, her team did an outstanding job of coordinating her care and making sure all her concerns were addressed. “Dr. Usmani told me, ‘I will tell you when you need to worry’,” she recalls.

Dr. Usmani refers to Levine Cancer Institute as one of the “crown jewels” at Atrium Health. “We’ve developed a full service hematology program and that includes transplants, therapies, and clinical trials – specifically phase one clinical studies for blood cancer patients in in the greater Charlotte area and across the region,” he says. The plasma cell disorders department started off with only five doctors, but now has close to 30 faculty. “We are one of the largest myeloma centers in the United States, and we’re probably the busiest myeloma center in the southeast U.S.,” says Dr. Usmani. “We receive referrals from all over the U.S. and internationally, and the program is continuing to grow and to collaborate with other institutions when it comes to treating cancer and developing new clinical trials.”

A healthy outlook following multiple treatments  

Since her diagnosis in 2014 and multiple treatments in 2015, Saraatje has been doing well. “I live a very normal life,” she says. She still takes medication and is careful to maintain a healthy lifestyle, including eating right, working out, and exercising caution during the COVID-19 pandemic, strictly adhering to social distancing and masking guidelines.  

“Saraatje’s multiple myeloma is in remission and her thyroid cancer has never recurred,” Dr. Usmani concurs. “She's done exceptionally well.”  

Learn more about blood cancer care and treatment options at Atrium Health Levine Cancer Institute.