No snide remarks, please, in regard to the question in this column’s title. It’s a bit rhetorical – I don’t ex­pec­t a response. Instead, the question is a play on words, as you’ll shortly see.

Regular readers of my column and my postings in the Beacon’s forum ^[1] know that I make no secret of my belief in the value of exercise. Clearly, exercise produces all kinds of benefits. It strengthens the bones and muscles. It promotes cardio­vas­cular health. And it has been shown to im­prove mental health by stimulating chemicals in the body that simply make you feel better.

For cancer patients, or anyone facing a chal­leng­ing disease, the sig­nifi­cance of main­taining good physical health cannot be overestimated. The disease can put a great strain on the body. Obviously, the better your health, the more you are able to with­stand the effects of the ailment.

The same can be said of the ability to tolerate treat­ment. The strong chemicals used to fight multiple myeloma and other cancers can take a serious toll. A strong body can help the patient deal with the side effects.

This is particularly true for those who choose to undergo a stem cell trans­plant. Even the strongest among us is severely tested by what the high-dose mel­phalan used as part of the trans­plant process does to the im­mune system and the consequent physical effects that it causes.

Having gone through a stem cell trans­plant myself, I am convinced that being in above-average physical con­dition prior to the trans­plant, and making a concerted effort to exercise as best I could while recuperating from the trans­plant, helped immeasurably in my quick and com­plete re­cov­ery.

That ex­peri­ence convinced me that an emphasis on physical exercise had been and would con­tinue to be a critical part of my effort to combat myeloma.

Now it’s im­por­tant to under­stand that when it comes to exercising, I can be a bit over the top. My fiancée Audrey, after hearing my rendition of what I did while she was at work that day, often remarks: “You realize that you are insane, right?”

It is quite possible that her assess­ment is accurate.

It does seem a bit extreme for someone to get up at 5:00 a.m., go to the gym for an hour and a half, come home and eat breakfast, do a few chores, go for a three-hour bike ride, have lunch, mow the grass, and then perhaps do some yard work. I try to justify this borderline behavior in a number of ways.

I assert that it keeps me looking young – and who can argue with that! I extol the health benefits mentioned above. A commitment to exercising pretty clearly keeps me out of trouble since I am so tired by the end of the day that I cannot possibly go out and tear it up.

I also have argued that my regular exercise helps me fight the cancer that hit me so hard more than three years ago, but now appears to be in com­plete remission. Until now, how­ever, I had no scientific basis to sup­port this contention.

Several months ago, The Beacon published an article ^[2] about myeloma-related presentations at the April 2016 meeting of the American Association of Cancer Research. Among those presentations was one titled “Dopamine inhibits growth of multiple myeloma” (abstract ^[3]).

When I saw the Beacon’s summary of this presentation, I was ecstatic! I may be a dummy (or a dope), but even I know about dopamine.

Dopamine is a chemical in the brain that acts as a neurotransmitter and has a role in all kinds of im­por­tant body functions. I admit that I had to look some of that up, but I did know that exercise in­­creases the amount dopamine released in the brain, and that’s part of the reason we feel good – at least mentally – when we exercise.

So I read the abstract about dopamine and multiple myeloma. It is im­por­tant to stress that the researchers’ conclusions are theoretical based on how dopamine reacts with other chem­i­cals in the body that play a role in the “survival, growth and proliferation” of multiple myeloma cells. And I must admit that no matter how many times I read the abstract, I cannot readily under­stand or explain what these obviously smarter-than-I-am scientists are saying.

But I can read, and their conclusion is that dopamine could be “a new and effective ap­proach to retard the pro­gres­sion of multiple myeloma.”

There is no suggestion that we can simply “exercise away” myeloma. The authors of the article recog­nize the need to use dopamine, or other so-called “D₂ re­cep­tor agonists,” in conjunction with traditional treat­ments to help stop multiple myeloma from progressing. But this is a poten­tially im­por­tant finding, since dopamine and other com­pounds like it are inexpensive and have known and man­ageable side effects.

For an arguably insane person like me, this report just adds fuel to a fire already burning out of control. I find myself work­ing harder, pedaling farther, and adding more to my activity plate, all with the intention of generat­ing in­­creased levels of naturally produced dopamine. After all, it may be the most im­por­tant thing that I can do on my own to keep the myeloma buried below detectable levels.

I remember when I was a kid there was an advertising campaign for a cereal which used the tag line “I’m cuckoo for Cocoa Puffs!” It came to mind when thinking about my reac­tion to the dopamine article. Am I “dopey for dopamine”?

One of the chal­lenges of a multiple myeloma diag­nosis is that there are so many unanswered questions. Why is it that two newly diag­nosed patients with the same symp­toms and laboratory findings, and who re­ceive the same treat­ment, can have radically dif­fer­en­t out­comes? Why is it that some of us have long drug-free remissions, while others have multiple myeloma that is dif­fi­cult to control even for a little while?

There are many theories on how best to attack the disease. Some believe in special diets or over-the-counter supple­ments, either to the exclusion of, or in addi­tion to, traditional treat­ments. No one really knows for sure what is best for a given case of multiple myeloma.

I have followed the conventional induction, to trans­plant, to main­te­nance route. But now I believe I have a wild card in in my arsenal: I am continuing to crank up the dopamine pro­duc­tion in my brain to help keep those nasty myeloma cells at bay.

I may be, as Audrey suggests, insane, but I am not crazy enough to ignore the poten­tial benefit of in­­creased dopamine levels.