Ralph Markham, a 65-year-old man from Melbourne, is navigating the challenges of an aggressive blood cancer diagnosis while hoping for new treatment options to extend his time with his wife, Cathy, and their blended family. Their journey began decades ago in Canada, where they first met as teenagers. After reconnecting years later through Facebook, their friendship blossomed into a loving relationship, leading to marriage and a life together in Cranbourne South, Victoria.
“Back in the day, we were part of the same friend group,” Mr. Markham reminisced. “I always remembered Cathy fondly.” Their romance took flight with a memorable first date in Honolulu, Hawaii, which set the stage for a long-distance relationship filled with love and commitment.
Three years ago, Ralph’s life took a drastic turn when he began experiencing unexplained health issues, including shingles and recurrent infections. “I went to give blood, and the Red Cross rejected me. They said something was wrong with my blood,” he recalled. After a year of testing, he was ultimately diagnosed with multiple myeloma, a serious and incurable blood cancer.
Multiple myeloma impacts plasma cells in the bone marrow, leading to a weakened immune system and various complications. In Australia, approximately 22,000 individuals are living with this condition, with more than 2,600 new cases diagnosed each year. The five-year survival rate is just 60.7 percent, significantly lower than that of other cancers, such as breast or prostate cancer.
Initially, Mr. Markham underwent a treatment regimen that included VRD therapy and a stem cell transplant. Unfortunately, these interventions proved ineffective. “That pretty much didn’t work at all,” he stated, leaving the family uncertain about the future. The emotional strain deepened when a friend in Canada also succumbed to the same illness within a year of diagnosis.
“It’s a very strange place to be in because you are in anticipatory grief all the time,” Mrs. Markham shared. “Time is very important. We don’t want to waste the time we have right now.” The couple strives to enjoy each moment despite the challenges, running in half-marathons and walking daily to maintain their health.
“Outwardly, you don’t look ill,” Mr. Markham noted, explaining how fatigue can be debilitating. He retired from his role as a process engineer in late 2023 after the fatigue made commuting increasingly difficult. “What should have been a 30-minute drive to work took me two hours because I had to constantly pull over to sleep,” he said. His wife also left her position in mental health to care for him full-time.
Despite their circumstances, the Markhams are committed to their community, participating in Myeloma Australia support groups and fundraising efforts. “Earlier this year, we raised a few thousand dollars by running a half-marathon,” Mr. Markham said. “It’s not the same pace as before, but it keeps us moving and focused.”
New treatment options, particularly the recently approved drug Blenrep (belantamab mafodotin), offer hope to patients like Mr. Markham. Described as a “trojan horse” therapy, Blenrep targets myeloma cells and kills them from within. It is the first drug of its kind approved for multiple myeloma and can be used in combination with other treatments after at least one prior therapy. An application for reimbursement through the Pharmaceutical Benefits Scheme (PBS) will be reviewed in November.
Additionally, the Australian federal government has included the immunotherapy drug Daratumumab (Darzalex) on the PBS as a first-line treatment for patients unable to undergo stem cell transplants. Previously costing up to **AUD 440,000** for a full course, it is now available for as little as **AUD 31.60** a month, significantly improving access for nearly 1,200 patients annually.
Experts have welcomed the availability of new treatments, emphasizing the urgent need for effective therapies in light of the challenges of multiple myeloma. Professor Hang Quach, director of clinical haematology at St Vincent’s Hospital, noted that while initial treatment often involves a combination of therapies, myeloma can eventually become resistant. “Having a new ‘trojan horse’ treatment like Blenrep represents an important advance for patients who need new options,” he stated.
Mark Henderson, chief executive of Myeloma Australia, highlighted the growing myeloma community and the increasing demand for novel therapies. “Unfortunately, fewer than 60 percent of these patients currently survive five years post-diagnosis, underlining the urgent need for new treatment approaches,” he said.
For the Markhams, every breakthrough signifies more than just medical progress. “Every new treatment is another chance,” Mr. Markham expressed, illustrating his determination to explore all available options. He remains optimistic about participating in clinical trials and believes that a cure may be on the horizon within the next decade.
Blenrep is part of a broader international pipeline of new therapies, with approvals across Canada, the UK, the US, Europe, and Japan. It is administered as a 30-minute outpatient infusion, delivering anti-cancer medicine directly into myeloma cells while also aiding the immune system in recognizing and combating the disease.
As the couple faces the uncertainties of the future, their commitment to each other and their community remains steadfast, underscoring the importance of hope in the fight against cancer.
