What is ALS, the rare disease making it 'impossible' for Roberta Flack to sing?

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R&B fans around the world were shocked when American singer Roberta Flack's manager announced she had been diagnosed with ALS, making "it impossible to sing.”

The rare disease, commonly called Lou Gehrig’s disease, has also made it difficult for Falck to speak, her rep, Suzanne Koga, said.

The announcement of the amyotrophic lateral sclerosis diagnosis comes ahead of the premiere of "Roberta," a feature-length documentary debuting Thursday at the DOCNYC film festival.

Flack, 85, is known for Billboard hits including "Killing Me Softly With His Song,"  "The First Time I Ever Saw Your Face," and “Feel Like Makin’ Love.”

But what is ALS? How can it affect people and are there any treatments?

'Impossible to sing,': Music icon Roberta Flack has ALS

Here's what it is and how it works:

Roberta Flack arrives at the Pre-Grammy Gala And Salute To Industry Icons at the Beverly Hilton Hotel on Saturday, Jan. 25, 2020, in Beverly Hills, Calif. A representative for Roberta Flack has announced that the legendary singer has ALS, commonly known as Lou Gehrig’s disease.
Roberta Flack arrives at the Pre-Grammy Gala And Salute To Industry Icons at the Beverly Hilton Hotel on Saturday, Jan. 25, 2020, in Beverly Hills, Calif. A representative for Roberta Flack has announced that the legendary singer has ALS, commonly known as Lou Gehrig’s disease.

What is ALS?

According to the National Institutions of Health, ALS progressively degrades, then kills nerve cells in the brain and spinal cord.

It's commonly called Lou Gehrig’s disease, named after the famous baseball player who got the illness and had to retire in 1939.

It's a noncommunicable disease and cases are not reported to federal health officials. The Centers for Disease Control and Prevention conducts surveys to study how common it is.

According to one of the most recent surveys published about the disease in 2017, there were between nearly 18,000 and 31,000 cases of ALS in the United States.

Roberta Flack diagnosis: Music icon Roberta Flack has ALS, making it 'impossible to sing,' her rep reveals

What are early signs of ALS?

ALS is found equally among men and women.

About 5-10% of ALS cases occur within families, according to the CDC. This is called familial ALS and it means that two or more people in a family have ALS. These cases are caused by several inherited factors.

Signs and symptoms of ALS, and the order they occur, vary from one person to another.

According to the ALS Society of Canada, potential early signs of the disease include tripping, dropping things, slurred or “thick” speech, difficulty swallowing, weight loss, decreased muscle tone, shortness of breath, increased or decreased reflexes and uncontrollable periods of laughing or crying.

What are the symptoms?

Potential early symptoms include:

  • Feeling weak

  • Fatigue

  • Muscle cramping or twitching

  • Muscle stiffness or rigidity

Over time, the muscle weakening will continue to spread throughout the body, eventually causing difficulties with breathing, chewing, swallowing and speaking.

The senses of sight, touch, hearing, taste and smell are usually not affected, and for many people, muscles of the eyes and bladder remain functional until very late in the disease, according to the ALS Society of Canada.

It is not known what causes most cases of ALS, but some inherited factors have been found to cause familial ALS.

Other factors that scientists are studying to find links to ALS include environmental exposures, diet and injury, according to the CDC.

Is ALS curable?

So far, a cure has not been found for ALS.

People with ALS live from 3 to 5 years after symptoms develop, according to the CDC,

How long a person lives with ALS seems to be related to age; people who are younger when the illness starts live slightly longer.

People with familial ALS typically live only one to two years after symptoms appear, the CDC reports.

How can it affect speech and singing?

ALS causes nerve cells to slow and die, according to the Centers for Disease Control and Prevention.

A lack of functioning nerve cells robs people of the ability to trigger specific muscles, including the muscles around the lungs and mouth along with the vocal cords, according to the ALS Association.

Are there treatments for ALS?

There is no cure for ALS, but there are treatments that can slow the progression of the disease.

The drug riluzole, marketed under the brand name Rilutek, was the first treatment approved by the Food and Drug Administration. The drug was approved in 2017. A glutamatergic antagonist, it's a disease-modifying treatment shown to extend life in patients with ALS, associated with a 35% reduction in mortality.

Edaravone, sold as Radicava, was approved in its pill form by the FDA in May. A third treatment is Amylyx Pharmaceuticals’ Relyvrio, which the company announced was approved by the FDA in September.

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What celebrities have ALS?

In addition to baseball great Lou Gehrig, notable individuals who have been diagnosed with ALS include:

  • Bruce Edwards, golf caddie

  • Charles Mingus, jazz musician

  • David Niven, actor

  • Dennis Day, entertainer

  • Eddie Adams, photographer

  • Ezzard Charles, boxing champion

  • George Yardley, NBA Hall of Fame basketball player

  • Henry A. Wallace, former U.S. Vice President

  • Huddie Ledbetter, musician (Lead Belly)

  • Jacob Javits, U.S. Senator

  • Jenifer Estess, theatre producer

  • Jim "Catfish" Hunter, Hall of Fame pitcher

  • Jon Stone, “Sesame Street” creator

  • Kim Shattuck, singer/songwriter (The Muffs)

  • Maxwell Taylor, U.S. Army General

  • Mike Porcaro, bassist (Toto)

  • O.J. Brigance, NFL football player

  • Stephen Hawking, world-renowned physicist

  • Stephen Hillenburg, "SpongeBob SquarePants" creator

  • Steve Gleason, NFL football player

  • Tim Shaw, NFL football player

Natalie Neysa Alund covers trending news for USA TODAY. Reach her at nalund@usatoday.com and follow her on Twitter @nataliealund.

This article originally appeared on USA TODAY: What is ALS or Lou Gehrig’s disease? What are symptoms, treatments?