Spotlight on Jessica Slack:

Finding myeloma by fluke

March 2024

Jessica Slack

My name is Jessica Slack. In February 2023, I was diagnosed with multiple myeloma at the age of 43.

My journey to diagnosis began the previous summer.

I was feeling perfectly healthy and living a busy life as a full-time working mom to two teenagers, completely unaware of the danger lurking within.

At the time, someone dear to me was facing a difficult period with myeloma.

Feeling helpless over his situation, I wanted to do something constructive. As he was

the recipient of blood transfusions, I donated plasma at our local Canadian Blood Services centre as an indirect way to honour him, something that I had sadly never done before.

A few weeks later, I received a letter with a bunch of graphs from Canadian Blood Services from their routine screening on my donation.

The letter indicated that there were abnormalities in my blood protein levels and that I should consult my family doctor.

My family doctor consulted a hematologist who advised about what would be the first of many follow-up tests needed. I received assurances not to worry too much

in the meantime.

Once the abnormal proteins were confirmed in follow-up testing, my GP referred me to a hematologist. The waiting for definitive answers began, as did my voracious reading online about all the different problems I might have.

Even though I had some familiarity with myeloma, I did not initially understand the intricacies of immunoglobulins, monoclonal bands, and light chains.

Finding the waits between tests and appointments painfully long, I spent a lot of time Googling, Redditing and Facebooking various combinations of terms to see if I could get a handle on what the concern could be based on the tests that were being run and the lab results. 

I came across the term MGUS (monoclonal gammopathy of uncertain significance) and it seemed like that’s what I might have given the fact that I was feeling well. I was relieved when my GP also mentioned this term as I had read that it can be a benign condition for which only monitoring is required.

From my readings, I also learned that my results could equally point to smouldering myeloma or even active myeloma, so I was grateful to have a hematologist looking at my case.

When I first met the hematologist, she seemed doubtful that there was anything seriously wrong given my age, overall health and lack of any meaningful symptoms.  

Thinking that some of the bloodwork irregularities could be attributed to a recent case of Covid-19, she ordered repeated testing, but results came back roughly the same. 

By this point, in the fall of 2022, my hematologist informed me

that I had monoclonal gammopathy [MGUS] and the only way to “rule out” active myeloma was to do a bone marrow biopsy.

The biopsy showed just over 10 per cent monoclonal plasma cells, the cut-off point from MGUS to smouldering myeloma. Given that, the hematologist referred me to the Multiple Myeloma Program at the Ottawa Hospital for further work-up and possible treatment. 

All the while, I felt physically well but increasingly frightened. 

When I met with the myeloma specialist at the Ottawa Hospital, I was relieved to be told that typically smouldering myeloma was closely monitored and no treatment was necessary. All that was left to do was a few final tests, again to “rule out” active myeloma. X-rays showed nothing suspicious, but I was given an MRI to be absolutely certain that it was smouldering and not active disease.

The MRI was in early December, two weeks before a family trip to Mexico that we had postponed several times during the pandemic.

I hoped to receive an “all-clear” regarding the MRI report before travelling so that I could relax and be fully present with my family.

No such luck.

That said, I was still feeling fine

and there was no concern at the time about me travelling, so off

we went for a week of fun in the sun! 

We had no sooner checked into our resort than I received the much-anticipated email alert from “MyChart.”. (MyChart is The Ottawa Hospital’s centralized patient portal where we can access our test results and health information.) The MRI results were in.

The four of us in a cave in Mexico, December 2023

Some people may have enough self-control to avoid checking medical results when they are about to start a family vacation. I am not one of those people.  I opened the report and read that they found a lesion and mild compression fracture at my T7 vertebra.

Time for the pool! 

I was heartbroken.

From what I understood about the diagnostic protocols,

I expected that I was now on the cusp of a myeloma diagnosis.

Nevertheless, my husband and I carried on with our trip as cheerfully as we could, suspecting that it would probably be our last one abroad for a while.

When we returned home to Ottawa, I again saw the myeloma specialist. They seemed surprised by the MRI finding and the increasing likelihood that I had active disease. I needed more tests.

In January, I had a repeat bone marrow biopsy, as well as a PET scan, which showed a second lesion and cortical break on my left scapula.

Who knew one could have these kinds of issues without pain or symptoms? I was shocked, but as I read more about myeloma I learned of others with similar experiences.

So, roughly 7 months after donating blood, I received my

official diagnosis of high risk IGA lambda multiple myeloma.

They recommended quad induction therapy,

followed by an autologous stem cell transplant (ASCT)

in the summer.

Given the months of tests and consults, it was not completely unexpected but it was still devastating and overwhelming news.

Having to tell our teens about the diagnosis and treatment plan was painful, though we did our best to frame things positively, stressing how fortunate I was to have this detected early and the expected success of the treatment to come.

Despite a maelstrom of emotions, I was determined that this would impact their busy teenaged lives as little as possible.

Upon reflection, this approach benefitted me as much as them. It motivated me to embrace normalcy and positivity. To get off the couch more than I wanted to in those first few months of treatment. To maintain our familial rhythm.

In late February, I started my treatment of the steroid dexamethasone and injections of daratumumab and Velcade weekly, with lenalidomide daily for 3 weeks and one week off.

Despite a brief hospitalization for an infection in the second week of my treatment, my induction went fairly well and I received a VGPR (very good partial response) after this four-month cycle.

The four of us at my son’s high school graduation,

June 2023

I am so grateful for the wonderful care I received from the Medical Day Care Unit at The Ottawa Hospital.

Over those four months, the chemo sessions got easier and easier thanks to the staff’s compassionate care.

I had a break in treatment just before my transplant and was relieved to be able to attend my son’s high school graduation.

My stem cell collection took a full two days and only yielded enough cells for one transplant. This was upsetting at the time, though I now know to be hopeful about other treatments.

My transplant was to be done on an outpatient basis, something I was very apprehensive about. I did end up needing to stay in hospital for about 5 days for antibiotics and monitoring because I developed a fever.

Despite that brief hospitalization, not uncommon for outpatients of ASCTs, the transplant went well. I received fantastic care from the Transplantation and Cellular Therapy Program at the Ottawa Hospital.

The nursing staff were relentlessly encouraging! Even though I barely had the energy to make it to the car some days, I did look forward to seeing these dedicated professionals every day during those delicate weeks after transplant. All in all, the experience was not as difficult as I feared.

The lovely Nurse Pam and me with my stem cells on the day of transplant, July 2023

Anyone who has undergone this procedure understands

the importance of having the right caregiver.

I’m so grateful to my husband for taking such good care

of me during recovery.

By September, I was able to participate in the Myeloma Canada fundraising walk with family and friends, rocking a fabulous wig!

My husband and me at Pink Lake, Gatineau, one month after transplant,

August 2023

Me with my dear aunt and uncle

who have always been my

biggest supporters in life

My dear friend Janet and me in my wig, September 2023

Fast forward to March 2024. I no longer need that wig! I’ve started treatment again with a two-drug regimen of lenolidamide and bi-weekly Velcade injections to maintain remission for as long as possible.

I have returned to work full-time and, for the most part,

I feel like my old self.

Being diagnosed with a complicated and incurable cancer in my early forties obviously evoked feelings of frustration and sadness,

but I am learning not to dwell.

Instead, I try to focus on more productive feelings: gratitude and hope.

After all, it was a fluke that my cancer was found.

I am followed by a competent and caring medical team who followed the proper diagnostic protocols. I am not in pain. I have responded to treatment and am tolerating the ongoing therapy needed to keep my cancer in check. I can continue working and caring for my family. I have supportive colleagues, friends, neighbours and family.

Through Myeloma Canada, I have also met a supportive group of patients and caregivers online who are also relatively young to be facing myeloma.

Looking back, I see that I overzealously consumed online information and others’ experiences to the detriment of my mental health.

This community has helped me find perspective, balance, and calm amidst the uncertainty and unpredictability of this disease.

Selfie on my first day back to work,

February 2024

Most importantly, I have every hope that when the myeloma returns, there will be other successful treatments to pursue.

One year into this unexpected and unwelcome journey, I am doing well and getting back to everything that comes with normal life. I’m so grateful to be able to share my story for Myeloma Awareness Month.

Jessica Slack

Editor’s note:

We hope you enjoy meeting our Spotlight Stars and your fellow Myeloma Canada community members. The Spotlight section of Myeloma Matters features stories and reflections supplied by members of our community - those living with myeloma, caregivers, healthcare professional - in their words. The views expressed and shared are those of that individual. We recognize that everyone’s journey and experience with myeloma is different.

To all of you who have shared your stories in the past, and those of you who continue to do so today, we are indebted...you are an inspiration.

If you would like to share your experience in a future issue of Myeloma Matters, please contact us at contact@myeloma.ca.

Myeloma Canada's promise: To improve the lives and empower all Canadians affected by myeloma, accelerate access to the best care, while supporting the pursuit of its cure and prevention.