How to Ease into Exercise With Multiple Myelomaby Stephanie Stephens Health Writer
If you've been diagnosed with multiple myeloma you may wonder, "How can I take the very best care of myself now?" Maybe you've never loved exercise, but you know of its benefits. Exercise helps control weight, blood sugar and insulin levels, reduces heart disease risk, and improves mood, libido, and sleep. It reduces the risk of cancers in general and, best of all, strengthens bones and muscles. Maybe you should take another look at this exercise thing, after all.
Find a program that's feasible and safe
You want to maintain flexibility and cardiovascular health during treatment. Great! A 2013 study in BMC Cancer found that a prescribed exercise program for multiple myeloma patients is feasible, acceptable, and safe. It requires suitable screening measures and appropriate input from physical therapists. Here's a "how-to" from Kathryn H. Schmitz, Ph.D., M.P.H., professor of epidemiology at the Penn State College of Medicine and president-elect of the American College of Sports Medicine (ACSM).
Mind your mass
"Undergoing multiple myeloma treatments generally means you're going to lose lean muscle mass," Dr. Schmitz told HealthCentral. "Take advantage of that period after diagnosis and before treatment, a kind of 'sweet spot,' to get fitter. With multiple myeloma, unlike other cancers, no one is going to say, 'We need to do surgery right now.' You may have to wait for the right donor or the right blood cell count, for example, before you can start a stem cell transplant."
Have more than you need
These "down" periods may occur again, as multiple myeloma is a repeat offender. "It's not a disease you get treated for and then you're done," Dr. Schmitz says. "Use this time to build that lean mass and develop more metabolically active muscle mass. That gives you a real advantage right from the start because there is little doubt your muscle mass will decline during treatment." Strive to be in the best shape of your life for the fight of your life.
Learn about lesions
Before an "all clear," your doctor will assess osteolytic lesions, or holes on your bone x-rays. They may hurt, weaken bone, and increase fracture risk. According to the Multiple Myeloma Research Foundation (MMRF), 85 percent of patients have bone loss. "Some lesions can be a risk for exercise, some not," Dr. Schmitz says. "Having people stop moving is harmful, but be careful not to exercise parts of the body at risk for bone breaks."
Let's talk about this
Your doctor says "no exercise"? Persevere, because you've made a smart, life-enhancing decision — and this is a fairly new trend. "In the 50s, cardiac rehab was highly controversial," Dr. Schmitz says. "Many thought patients simply couldn't safely manage exercise. It's taken decades to understand it lowers risk of a future cardiac event. If your multiple myeloma physician says 'no,' consider asking for the evidence that exercise would be harmful. In all likelihood, they can't produce it."
You're in charge here
The waiting game can be frustrating: waiting for blood draws, chemotherapy, or a transplant. But you control your exercise program and its intensity, Dr. Schmitz says. "Don't drive 60 miles an hour in a 5 mile an hour zone. Calibrate your program, starting slowly with something you enjoy. Get help initially from a certified trainer who specializes in cancer, certified by ACSM, or from a physical therapist with specialty training in oncology."
Do it yourself
You don't have to join a gym. But getting those first few lessons on how to proceed can save you time and ensure you're doing things right. You can buy dumbbells, an exercise band, and do body-weight exercises at home such as push-ups, planks, or squats. Add jumping jacks, lunges, marching in place, or dancing to your favorite jam. You can start by walking — in appropriately supportive shoes — around the block, and gradually add more distance. You've got this!
Mix it up
Everyone should aim for a nice mix of cardio or aerobic, strength or endurance, and stretching or flexibility. Older adults can find wonderful resources at the National Institute on Aging. "With multiple myeloma, strength is far more important than cardio," says Dr. Schmitz. "Yoga is great, with flexibility benefits exceeded by its psychosocial aspects. It enhances body awareness, reduces stress, muscle tension, and even inflammation. It helps you focus and relaxes the entire nervous system."
There's evidence that yoga aids cancer patients' sleep, says Dr. Schmitz. "Sleep can be disturbed when undergoing cancer treatment." Fatigue, often called a "bone-weary" exhaustion, plagues patients during systemic cancer treatment. She likes a 2017 study in the Journal of Clinical Oncology that suggests exercise for cancer patients protects against chemotherapy-induced muscle damage and helps with cancer-related fatigue. "Walking is the best exercise to combat fatigue," Dr. Schmitz says.
Exercise: Your life-long friend
A couch-potato lifestyle isn't going to help you live your best life with multiple myeloma. If you've always thought, "I should exercise...," then you didn't and felt bad, now's the perfect time to fulfill that promise to yourself. A stronger, fitter you means a stronger person to handle side effects of treatment. Because those may sometimes be discouraging, doing something for yourself that once seemed unachievable may give your self-esteem just the psychological boost it — and you — need.