At Mount Sinai Brooklyn, Providing Access to Advanced Care for Multiple Myeloma

It started when Chantal Pierre-Louis, then age 50, developed back pain so severe that it was difficult for her to stand for long periods of time. She chalked it up to aging, though she felt a little young for the degree of pain she was experiencing. Then she lost her appetite—often eating only ice. When she went for her annual physical, she mentioned these changes to her doctor. After Chantal’s bloodwork came back abnormal, her doctor tried a few different medicines, but none helped. Then she went to Mount Sinai for a second opinion, which revealed she had multiple myeloma, a type of blood cancer.

“Multiple myeloma is not a very common cancer,” says Cesar Rodriguez Valdes, MD, Associate Professor of Medicine (Hematology and Medical Oncology), Icahn School of Medicine at Mount Sinai, and Clinical Director of Multiple Myeloma at The Mount Sinai Hospital.  “It only composes 2 percent of all cancers. It tends to affect men more than women. It tends to affect the Black community more than any other ethnicity.”  

Dr. Rodriguez is also director of the multiple myeloma practice at Mount Sinai Brooklyn, where Chantal is his patient. The clinic is dedicated to addressing disparities in health and offers specialized and attentive care, clinical trials, and a warm and welcoming environment.

Multiple myeloma can be challenging to diagnose because symptoms vary from person to person and often mimic other diseases. Some people have only one symptom, others have several. And some people don’t have any symptoms at all in the early stages of the disease. Usually, abnormal bloodwork is the first hint of a problem. But even so, no single blood test pinpoints the disease. Typically, doctors use a combination of blood tests, urinalysis, and imaging scans to diagnose multiple myeloma.

“Chantal’s case is a very unique case in many ways,” Dr. Rodriguez said in a report about her health journey on the Today site. “Normally we diagnose myeloma in people in their 60s and 70s.” The condition is not unfamiliar to Chantal. Her mother died of multiple myeloma in 2010. The disease isn’t considered to be hereditary, yet people whose parent or sibling has the condition carry increased risk of developing it. “I try not to look at it as a death sentence,” Chantal says. “I don’t want anyone to see me suffering. I don’t want to put my family through what my mother went through.”

Multiple myeloma patients often have recurrences of their disease. This means, says Dr. Rodriguez, that most patients will likely be receiving some form of treatment for the rest of their lives.  “We keep patients on a low dose of treatment as maintenance even if they have achieved a remission to keep the myeloma from coming back,” says Dr. Rodriguez. “Hopefully in the future we will find new therapies that will not require having to be on some type of therapy forever.”

Chantal understands the situation. “From the beginning they told me chemo was for life. Even right now, it’s not active, but if I see a slight percentage change, cancer will be there,” says Chantal. “You can’t just stop chemo.”

Chantal has had multiple therapies and participated in two clinical trials, Dr. Rodriguez says, which controlled her cancer for a few years and bought time for more effective treatments to be developed.  “Now we have been able to transform this cancer, which normally killed patients within a few years to a more chronic-behaving disease,” Dr. Rodriguez says.

Chemotherapy makes Chantal very tired, and she still has pain that is partly controlled with medication. Since she began treatment, she has developed thyroid cancer and had 10 nodules removed as treatment. She has also developed COVID-19, pancreatitis, and a blood clot under her arm. Chantal is now fully recuperated from these conditions. Attitude is key, says Chantal, who tries to stay upbeat. “I try to say to myself, ‘You have cancer. Cancer does not have you,’” she explains. “I think about it like having diabetes or hypertension. You take your medication. You follow your doctor’s advice and you try to keep moving.”

Health insurance has been another challenge. When Chantal switched jobs, she lost her health insurance and her old clinic wouldn’t accept Medicaid. Her cost would have been more than $30,000 for each round of chemo. “This was my biggest fear—not having treatment,” she remembers. But the Mount Sinai Health System accepts Medicaid, so she switched to it. And began seeing Dr. Rodriguez. “I feel safe,” she says. “Even if I’m going to be unable to work, I will still receive treatment.”

Since its opening in January 2022, the clinic in Brooklyn has seen a 50 percent increase in patients each month, offering advanced therapies and fulfilling Mount Sinai’s mission to address disparities in health care. “Our motto is ‘we find a way,’ and we’re trying to find a way of narrowing the gap in access to a specialist. Instead of having a patient come to us,” says Dr. Rodriguez, “we go to them.”