Johnny 荷兰 has faced fierce foes for decades, first as a standout tackle in the National Football League, then as a beloved coach with the San Francisco 49ers. But when it comes to being poked by a nurse with a needle, the gridiron warrior shuts his eyes and scrunches his face.
他笑着说:“不管我得到多少次投篮，它总是让我跳起来。.
他是一群职业足球运动员鼓舞人心的榜样, 荷兰, 58, 有攻击性的形式 多发性骨髓瘤 一种发生在浆细胞(一种白细胞)中的血癌. 过去两年了, he’s participated in a groundbreaking clinical study at 加州大学旧金山分校健康, testing a combination of medications that have kept the cancer at bay.
荷兰, who helps guide the 49ers defense as the team’s linebackers coach, is sharing his medical journey to raise awareness about the disease. 多发性骨髓瘤, also called plasma cell myeloma, is among the most common blood cancers, 大约36个,000 new cases diagnosed annually in the United States, 根据 美国癌症协会.
The body generates too many cancerous plasma cells in myeloma, crowding out the normal cells that fight infection. 这些恶性浆细胞产生异常抗体，不能抵抗感染，并可能引起其他并发症, 比如对骨骼的损伤. It’s a serious disease with unknown causes, 但这些进步已经延长了患者的存活率，提高了患者的生活质量.
"I tell Johnny and my other patients, 我们有很多医疗选择可以尝试——我们左边口袋里有一些东西, 如果它不起作用, we have something in the right pocket that we can try next,” 荷兰's physician, Dr. 托马斯·G. 马丁, 他是血液学肿瘤学的权威专家，也是加州大学旧金山分校骨髓瘤项目的副主任, 同时也是血液恶性肿瘤临床研究主任 UCSF Helen Diller Family Comprehensive Cancer Center. "We always have something coming down the pipeline to help patients."
治疗方法, 从化疗和放疗到干细胞移植和免疫治疗, can relieve symptoms and prevent complications. 加州大学旧金山分校的专家们也在为新诊断的骨髓瘤、复发或进展的骨髓瘤患者测试新的治疗方法——比如荷兰参加的临床试验中的那些. 荷兰的审判, which included immunotherapy, 使用各种细胞疗法来加速人体自身的免疫系统来对抗癌症.
"These immunotherapy treatments, including CAR-T therapy and bispecific antibody therapy, are the wave of the future for cancer care,” 萨曼莎·谢诺, a 加州大学旧金山分校健康 nurse practitioner who regularly meets with 荷兰. “我们的研究正在帮助患者带来希望，并改善他们的治疗结果."
令人担忧的是物价上涨, 骨髓瘤的不成比例的影响-目前在美国有五分之一的患者被诊断患有这种疾病.S. “布莱克是谁?”马丁说. 关于这种疾病还有很多未知之处，以及为什么它对黑人的影响如此之大.
解开答案的一种方法是通过更多涉及不同种族人群的临床研究. 这就是为什么霍兰德十大赌博靠谱网络平台多发性骨髓瘤临床研究特别有价值, 谢诺伊说. 她说:“确保临床多样性对促进卫生公平很重要。.
霍兰德作为一名球员和助理教练在NFL工作了30多年. He was a four-year letterman as inside linebacker at Texas A&M University in his home state, 然后在1987年的第二轮选秀中被绿湾包装工队选中，在那里他打了七个赛季, 他连续多年都有100次以上的抢断，并帮助1992-93赛季的球队十多年来第一次进入季后赛. He was inducted into the Texas A&1999年入选M名人堂，2000年入选棉花碗名人堂，2001年入选包装工名人堂. Since hanging up his helmet, 霍兰德执教过六支球队，过去七年一直在49人队执教.
他做过髋关节置换手术，从球员时代起就饱受肩部和背部疼痛的折磨. But during the summer of 2019, the pain intensified. 他发现打高尔夫球、慢跑，甚至像往常一样每天走四五英里都很困难.
菲斯·霍兰德(Faith 荷兰)记得，她结婚34年、坚忍的丈夫不愿意去李维斯体育场(Levi's Stadium)的队医办公室. “他犹豫要不要去看十大赌博平台排行榜，尽管十大赌博平台排行榜每天都在那里，”她说.
最后, following the third game of the 2019 season, 霍兰德跟自己定了一个约定:如果没有别人，他就去看十大赌博平台排行榜. If someone was, he’d wait until the season ended, months later. "Sometimes, we can be hardheaded," he said ruefully.
Fortunately, no one else was in the office. The doctor sent 荷兰 for a CT scan and then a blood test. 几天后，他被诊断出患有III期骨髓瘤，并开始化疗.
那个赛季, the 49ers won the NFC championship and played in Super Bowl LIV, losing to the Kansas City Chiefs. 但对马丁来说，霍兰德赢了，因为他已经开始接受治疗了. "He wouldn’t have made it to the Super Bowl,”马丁说。. "He would have been too tired or too ill."
在UCSF的临床试验中, 荷兰 initially received medications weekly, 然后两周一次的, 然后每月. 他已经习惯了治疗，通常他会在同一天回到教练的岗位上.
"I don’t like to be late to practice," he smiled. "The team has been absolutely awesome. 凯尔·沙纳汉教练, (General Manager) John Lynch, the players – they got shirts saying they had my back. These dudes really have my back."
霍兰德最近躺在帕纳萨斯高地加州大学旧金山分校海伦·迪勒医疗中心输液中心的病床上. 透过他右肩的窗户，可以看到Kezar体育场，49人队在这里打了很多年球. 他撩起衬衫，肿瘤科注册护士朱莉·麦克卢格奇在他的腹部打了两针. "This is life-saving," he said quietly.
"The medical staff makes you feel like you matter,费思说。, who has two grown children with 荷兰. "When you’re in a fight like this one, you need it. 十大赌博平台排行榜和护士就像教练——他们真的很关心他们的病人."
通常, 多发性骨髓瘤的症状在开始时被掩盖，因为它们可能很常见, 尤其是老年人. "Back pain is one of the most common symptoms, and it happens pretty much in everybody 50 and older,”马丁说。.
Later on, symptoms can include broken bones and repeated infections. Advanced disease symptoms might include nausea, 呕吐, 便秘, and weakness or numbness in the legs.
荷兰, who once played in the NFL without missing a single game in five years, 仍然像年轻运动员一样锻炼自己的身体——在确诊四年后每天花十几个小时进行训练. Now that he's completed chemotherapy and adjusted to his monthly shots, his weight has returned along with his appetite. 神经性疼痛有时会影响他的神经，但并没有恶化. 每当他去加州大学旧金山分校骨髓瘤诊所时，他仍然要爬上四层楼梯.
"It gets the heart pumping," he said. "The more active I am, the better I feel. I try to listen to my body. My energy has been great and I'm feeling great.
"I tell players it isn’t the big things you do, it's the little things you do and the way you make people feeI. I tell them to try to have a positive mindset. 我们在生活中都会经历一些事情，所以试着用积极的方式影响别人."
约翰尼·霍兰德正在帮助加州大学旧金山分校研究多发性骨髓瘤的新治疗方法. 
约翰尼和结婚34年的妻子费思在加州大学旧金山分校帕纳萨斯高地校区. 
约翰尼和十大赌博平台排行榜谈话. 托马斯·马丁是加州大学旧金山分校骨髓瘤项目的副主任. 
Oncology nurse Julie McCluggage administers a treatment to Johnny. 
Faith and Johnny consult with his care team. 
Johnny and Faith with 萨曼莎·谢诺, a nurse practitioner who cares for patients in clinical trials. 
