Hi all,
I was recently diagnosed with smoldering multiple myeloma and have been trying to figure out how to maximize my chances.
Other than seeking out a myeloma specialist and hopefully getting into a good treatment program, I am thinking there is not much that patients with multiple myeloma have control over except diet and exercise.
So that is my question: How much does exercise really count?
In other words, can you substantially increase your odds of survival, or increase your life, if you undertake or continue with an exercise program?
I have been active all my life and am still working out (no treatment yet) and am hoping that it will count for something!
thx Mike
Forums
8 posts
• Page 1 of 1
Re: How much does exercise help?
mdszj,
This is a very important question and one that I discuss with all of my patients with newly diagnosed MGUS and smoldering myeloma, as well as with patients with myeloma who are in remission.
The issue that we discuss is: What can I do to prevent the development of symptomatic myeloma? What control do I have with diet, exercise, lifestyle, supplements etc.
Firstly, in myeloma, we don't know for certain the answer to the question, based on any currently available, large, high quality clinical research. We do know, however, that obesity is related to the development of MGUS and myeloma. So, if exercise helps maintain a normal weight, then it should help.
What I advise for all of my patients is to exercise regularly, maintain a normal weight (not be obese), and eat a healthy diet. It sounds like you are already doing those things. And, remember, patients with myeloma – and especially smoldering myeloma – can live a long time and you still have to be conscientious about other diseases where you know you can modify your risk with diet, weight control, and exercise.
One final comment, I do recommend that you see a specialist with expertise in myeloma as there may be clinical trial in which you could participate.
Best wishes to you,
Jlk
This is a very important question and one that I discuss with all of my patients with newly diagnosed MGUS and smoldering myeloma, as well as with patients with myeloma who are in remission.
The issue that we discuss is: What can I do to prevent the development of symptomatic myeloma? What control do I have with diet, exercise, lifestyle, supplements etc.
Firstly, in myeloma, we don't know for certain the answer to the question, based on any currently available, large, high quality clinical research. We do know, however, that obesity is related to the development of MGUS and myeloma. So, if exercise helps maintain a normal weight, then it should help.
What I advise for all of my patients is to exercise regularly, maintain a normal weight (not be obese), and eat a healthy diet. It sounds like you are already doing those things. And, remember, patients with myeloma – and especially smoldering myeloma – can live a long time and you still have to be conscientious about other diseases where you know you can modify your risk with diet, weight control, and exercise.
One final comment, I do recommend that you see a specialist with expertise in myeloma as there may be clinical trial in which you could participate.
Best wishes to you,
Jlk
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Dr. Jonathan Kaufman - Name: Jonathan Kaufman, M.D.
Beacon Medical Advisor
Re: How much does exercise help?
Thanks, Dr Kaufman, for giving me feedback on this issue. Even tho there do not seem to be any studies or results, it certainly can't hurt to keep on working out as long as I can.
Regarding a myeloma specialist, I have an appointment in a couple of weeks up at Sloan Kettering, so hopefully I will learn more then.
thx Mike
Regarding a myeloma specialist, I have an appointment in a couple of weeks up at Sloan Kettering, so hopefully I will learn more then.
thx Mike
Re: How much does exercise help?
My husband's oncologist said the same thing - there's not much data indicating what does, or does not, contribute to recovery, but improving (or maintaining in your case) your general health will help you if treatment becomes necessary.
I was hoping for a ringing endorsement from him to eat more vegetables and eat less Sweet-n-Low, but not to be. (I am still lobbying hard against the Sweet-n-Low and making headway ... )
I was hoping for a ringing endorsement from him to eat more vegetables and eat less Sweet-n-Low, but not to be. (I am still lobbying hard against the Sweet-n-Low and making headway ... )
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KS1960 - Name: Kate
- Who do you know with myeloma?: Husband
- When were you/they diagnosed?: 02/2015
- Age at diagnosis: 67
Re: How much does exercise help?
Hi Mike,
You might want to see this study on the impact of exercise on a SMM patient.:
DA Boullosa et al, "Exercise Is Medicine: Case Report of a Woman with Smoldering Multiple Myeloma," Medicine & Science in Sports & Exercise, July 2013 (full text PDF)
Abstract:
Purpose: This study aimed to evaluate the influence of a supervised training program on the changes in serum monoclonal protein level (i.e., IgG), percentage of bone marrow plasma cells (BMPCs), fitness performance, and cardiac autonomic control (i.e., HR variability [HRV] and HR complexity [HRC]) in a female diagnosed with smoldering multiple myeloma (SMM).
Methods: A middle-age female patient with smoldering multiple myeloma and former elite athlete was monitored for 4 yr while participating in a supervised multimodal training regimen designed for the development of various physical capacities. The patient had the possibility of self-selection of daily training volume. Changes in fitness components, IgG levels, and BMPCs were evaluated throughout a 4-yr monitoring period (i.e., follow-up). HRV was examined via 24-h HR recordings during a 6-wk period at the second and the third year of the follow-up.
Results: Exercise performance in all fitness components was improved while IgG levels and BMPCs decreased (from 2.53 to 1.84 g·dL−1 and from 20% to 10%, respectively). Time and frequency domain HRV parameters exhibited significant increases (18%–29%) with HRC remaining unchanged.
Conclusions: The current case report results indicated that a multimodal training program designed for the development of various physical capacities improved exercise performance, hematological function, and cardiac autonomic control that may improve long-term prognosis for SMM. Examination of similar exercise training regimens for hematological and other cancer populations may assist in the development of simple nonpharmacological treatments for improved prognosis.
Note that I personally don't think that one can really draw any scientific conclusions from a one-person study and I also doubt that the above study was peer-reviewed. I also think that the IgG and BMPC changes in the report can be attributed to normal variations in the disease and/or the hit-and-miss nature of BMPC measurements. Lastly, it would have been nice if they had tracked M-spike and FLCs, not just IgG and BMPC. But, heck, it still makes me feel like I'm on the right track by significantly boosting my exercise routine since my SMM diagnosis.
If one is undergoing treatment, then you might find the two studies below to be of interest.
With regard to KS1960's comment on Sweet-n-Low, Dr. Berenson's #1 piece of advice regarding what NOT to eat if one has multiple myeloma are artificial sweeteners. Glad to see you also railing against them. See this thread ("Do you drink pop / soda?]Do you drink pop / soda?", started Jul 15, 2014) for an earlier discussion on the topic.
FC Dimeo et al, "Aerobic exercise in the rehabilitation of cancer patients after high dose chemotherapy and autologous peripheral stem cell transplantation," Cancer, May 1997 (full text)
Abstract:
Background: Fatigue and loss of physical performance are frequent problems of cancer patients. In a pilot study, the authors evaluated the feasibility and effects of aerobic training in the rehabilitation of cancer patients after completing high dose chemotherapy.
Methods: Sixteen patients participated in a specially designed rehabilitation program for 6 weeks. The patients entered the program, which consisted of walking on a treadmill, shortly after completing treatment. Sixteen patients who did not train served as controls. Physical performance (maximum speed on the treadmill test), cardiac function, and hemoglobin concentration were compared at the time of discharge from the hospital and 7 weeks later. At the second examination, fatigue and limitations in daily activities due to impaired endurance were assessed during personal interviews.
Results: At the time of discharge from the hospital, maximum physical performance (training group: 6.2 +/- 1.1 km/hour; controls: 6.2 +/- 1.3 km/hour) and hemoglobin concentration (training group: 10.1 +/- 1.4 g/dL; controls: 10.1 +/- 1.2 g/dL) were similar for both groups. After 7 weeks, improvement in maximum physical performance (training group: 8.3 +/- 1.6 km/hour; controls 7.5 +/- 1.3 km/hour) and hemoglobin concentration (training group: 13 +/- 1 g/dL controls: 12 +/- 1.4 g/dL) were significantly higher for the training group (P < 0.05). By the second examination, no patient in the training group but 4 controls (25%) reported fatigue and limitations in daily activities due to low physical performance.
Conclusions: Aerobic exercise improves the physical performance of cancer patients recovering from high dose chemotherapy. To reduce fatigue, this group of patients should be counseled to increase physical activity rather than rest after treatment.
FC Dimeo, "Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy," Cancer, Nov 2000 (full text)
Abstract:
Background: Fatigue is a common and often severe problem in cancer patients undergoing chemotherapy. The authors postulated that physical activity training can reduce the intensity of fatigue in this group of patients.
Methods: A group of cancer patients receiving high dose chemotherapy followed by autologous peripheral blood stem cell transplantation (training group; n = 27) followed an exercise program during hospitalization. The program was comprised of biking on an ergometer in the supine position following an interval training pattern for 30 minutes daily. Patients in the control group (n = 32) did not train. Psychologic distress was assessed at hospital admission and discharge with the Profile of Mood States and Symptom Check List 90.
Results: By the time of hospital discharge, fatigue and somatic complaints had increased significantly in the control group (P for both < 0.01) but not in the training group. Furthermore, by the time of hospital discharge, the training group had a significant improvement in several scores of psychologic distress (obsessive-compulsive traits, fear, interpersonal sensitivity, and phobic anxiety) (P value for all scores < 0.05); this outcome was not observed in the control group.
Conclusions: The current study found that aerobic exercise can reduce fatigue and improve psychologic distress in cancer patients undergoing chemotherapy.
You might want to see this study on the impact of exercise on a SMM patient.:
DA Boullosa et al, "Exercise Is Medicine: Case Report of a Woman with Smoldering Multiple Myeloma," Medicine & Science in Sports & Exercise, July 2013 (full text PDF)
Abstract:
Purpose: This study aimed to evaluate the influence of a supervised training program on the changes in serum monoclonal protein level (i.e., IgG), percentage of bone marrow plasma cells (BMPCs), fitness performance, and cardiac autonomic control (i.e., HR variability [HRV] and HR complexity [HRC]) in a female diagnosed with smoldering multiple myeloma (SMM).
Methods: A middle-age female patient with smoldering multiple myeloma and former elite athlete was monitored for 4 yr while participating in a supervised multimodal training regimen designed for the development of various physical capacities. The patient had the possibility of self-selection of daily training volume. Changes in fitness components, IgG levels, and BMPCs were evaluated throughout a 4-yr monitoring period (i.e., follow-up). HRV was examined via 24-h HR recordings during a 6-wk period at the second and the third year of the follow-up.
Results: Exercise performance in all fitness components was improved while IgG levels and BMPCs decreased (from 2.53 to 1.84 g·dL−1 and from 20% to 10%, respectively). Time and frequency domain HRV parameters exhibited significant increases (18%–29%) with HRC remaining unchanged.
Conclusions: The current case report results indicated that a multimodal training program designed for the development of various physical capacities improved exercise performance, hematological function, and cardiac autonomic control that may improve long-term prognosis for SMM. Examination of similar exercise training regimens for hematological and other cancer populations may assist in the development of simple nonpharmacological treatments for improved prognosis.
Note that I personally don't think that one can really draw any scientific conclusions from a one-person study and I also doubt that the above study was peer-reviewed. I also think that the IgG and BMPC changes in the report can be attributed to normal variations in the disease and/or the hit-and-miss nature of BMPC measurements. Lastly, it would have been nice if they had tracked M-spike and FLCs, not just IgG and BMPC. But, heck, it still makes me feel like I'm on the right track by significantly boosting my exercise routine since my SMM diagnosis.
If one is undergoing treatment, then you might find the two studies below to be of interest.
With regard to KS1960's comment on Sweet-n-Low, Dr. Berenson's #1 piece of advice regarding what NOT to eat if one has multiple myeloma are artificial sweeteners. Glad to see you also railing against them. See this thread ("Do you drink pop / soda?]Do you drink pop / soda?", started Jul 15, 2014) for an earlier discussion on the topic.
FC Dimeo et al, "Aerobic exercise in the rehabilitation of cancer patients after high dose chemotherapy and autologous peripheral stem cell transplantation," Cancer, May 1997 (full text)
Abstract:
Background: Fatigue and loss of physical performance are frequent problems of cancer patients. In a pilot study, the authors evaluated the feasibility and effects of aerobic training in the rehabilitation of cancer patients after completing high dose chemotherapy.
Methods: Sixteen patients participated in a specially designed rehabilitation program for 6 weeks. The patients entered the program, which consisted of walking on a treadmill, shortly after completing treatment. Sixteen patients who did not train served as controls. Physical performance (maximum speed on the treadmill test), cardiac function, and hemoglobin concentration were compared at the time of discharge from the hospital and 7 weeks later. At the second examination, fatigue and limitations in daily activities due to impaired endurance were assessed during personal interviews.
Results: At the time of discharge from the hospital, maximum physical performance (training group: 6.2 +/- 1.1 km/hour; controls: 6.2 +/- 1.3 km/hour) and hemoglobin concentration (training group: 10.1 +/- 1.4 g/dL; controls: 10.1 +/- 1.2 g/dL) were similar for both groups. After 7 weeks, improvement in maximum physical performance (training group: 8.3 +/- 1.6 km/hour; controls 7.5 +/- 1.3 km/hour) and hemoglobin concentration (training group: 13 +/- 1 g/dL controls: 12 +/- 1.4 g/dL) were significantly higher for the training group (P < 0.05). By the second examination, no patient in the training group but 4 controls (25%) reported fatigue and limitations in daily activities due to low physical performance.
Conclusions: Aerobic exercise improves the physical performance of cancer patients recovering from high dose chemotherapy. To reduce fatigue, this group of patients should be counseled to increase physical activity rather than rest after treatment.
FC Dimeo, "Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy," Cancer, Nov 2000 (full text)
Abstract:
Background: Fatigue is a common and often severe problem in cancer patients undergoing chemotherapy. The authors postulated that physical activity training can reduce the intensity of fatigue in this group of patients.
Methods: A group of cancer patients receiving high dose chemotherapy followed by autologous peripheral blood stem cell transplantation (training group; n = 27) followed an exercise program during hospitalization. The program was comprised of biking on an ergometer in the supine position following an interval training pattern for 30 minutes daily. Patients in the control group (n = 32) did not train. Psychologic distress was assessed at hospital admission and discharge with the Profile of Mood States and Symptom Check List 90.
Results: By the time of hospital discharge, fatigue and somatic complaints had increased significantly in the control group (P for both < 0.01) but not in the training group. Furthermore, by the time of hospital discharge, the training group had a significant improvement in several scores of psychologic distress (obsessive-compulsive traits, fear, interpersonal sensitivity, and phobic anxiety) (P value for all scores < 0.05); this outcome was not observed in the control group.
Conclusions: The current study found that aerobic exercise can reduce fatigue and improve psychologic distress in cancer patients undergoing chemotherapy.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: How much does exercise help?
Hi Mike,
I've been wondering the same thing. I was diagnosed with smoldering multiple myeloma 18 months ago (the doctor at Mayo Clinic lowered that to MGUS) and was told that, if / when my disease progresses, I will most likely experience bone damage.
I've been an exercise nut all of my adult life but, since this diagnosis, have been trying to focus on weight-bearing activities that might help strengthen my bones.
I'd love to hear from others on this topic.
Sherie
age 59
I've been wondering the same thing. I was diagnosed with smoldering multiple myeloma 18 months ago (the doctor at Mayo Clinic lowered that to MGUS) and was told that, if / when my disease progresses, I will most likely experience bone damage.
I've been an exercise nut all of my adult life but, since this diagnosis, have been trying to focus on weight-bearing activities that might help strengthen my bones.
I'd love to hear from others on this topic.
Sherie
age 59
-
Sherie
Re: How much does exercise help?
Multibilly,
That was a good paper even though it was about only one patient; agreed you can't hang your hat on data from one person. However, as far as I can tell, everything still points to continuing with your workout program as long and as much as possible. Thx for the link.
Mike
That was a good paper even though it was about only one patient; agreed you can't hang your hat on data from one person. However, as far as I can tell, everything still points to continuing with your workout program as long and as much as possible. Thx for the link.
Mike
Re: How much does exercise help?
Hi Multibilly.
I am impressed how you always have a study to share
.
I was very weak after my SCT - felt like an old lady when I would try to stand up! I started with the resistance bands, then slowly progressed to small weights and then to heavier ones. I also try to walk 30 minutes per day. My quality of life is much better because I am stronger..
I also avoid artificial sweeteners, though I will have some Stevia in my coffee (which is not technically an artificial sweetener)
I am impressed how you always have a study to share
.I was very weak after my SCT - felt like an old lady when I would try to stand up! I started with the resistance bands, then slowly progressed to small weights and then to heavier ones. I also try to walk 30 minutes per day. My quality of life is much better because I am stronger..
I also avoid artificial sweeteners, though I will have some Stevia in my coffee (which is not technically an artificial sweetener)
-
antelope1225 - Name: Cathy1225
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: May 25 2012
- Age at diagnosis: 55
8 posts
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