How to Remain an Elite Athlete With Multiple Myeloma

M.A., Health Writer
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Maybe you've run marathons, cycled 20 miles a day for years, or lifted twice your weight. Perhaps you work out five or six days a week, and you wouldn't miss a session for the world — that is, until you received your multiple myeloma diagnosis. If you're unsure and want help adapting your routine, oncologist Elizabeth K. O'Donnell, M.D., of Massachusetts General Hospital has tips to help you stay the course as the elite, competitive athlete you are.


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Weigh the risk factors

Dr. O'Donnell is a serious cyclist and also climbed Mt. Kilimanjaro with the Moving Mountains for Multiple Myeloma team — with five people with multiple myeloma — in January 2017, benefiting the Multiple Myeloma Research Foundation (MMRF). People with multiple myeloma are at risk for bone tumors and lesions, kidney disease, anemia, and elevated blood calcium levels. If you want to push on, your doctor will consider your risks as you work together on the best exercise regimen.


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Exercise is usually OK (really)

The American Cancer Society reports that exercise is linked with lower risk of 13 types of cancer, including multiple myeloma. There's not a ton of specific research around the topic of exercise and multiple myeloma. But there is research that finds exercise is a safe and feasible intervention for cancer patients during and after therapy.


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Bone basics

As Dr. O'Donnell wrote in a 2017 study, bone involvement manifesting as osteolytic bone disease (large areas of severe bone loss) or osteopenia (lower bone density) defines multiple myeloma. Bone tumors increase risk for compression fractures in the spine, pelvic girdle, or hips. An assessment of the serious athlete will need to focus on structural integrity of the bones. A skeletal survey would include MRI (magnetic resonance imaging) and a PET scan (positron emission tomography).


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Managing anemia

Approximately 60 percent of patients diagnosed with multiple myeloma have anemia, meaning they don't have enough red blood cells. Chemotherapy can also cause anemia, but conversely, treatment can make you feel better and feel more like exercising. "Often, anemia does make it a lot harder to exercise hard," says Dr. O'Donnell. "Some problems are correctable, some just more challenging. Let's figure out where you are, what you can and can't do, and make a plan to work around the 'can't.'"


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Exercise boosts energy, mood, and libido

Your intense exercise program may need to be modified to accommodate your treatment, whether you're having chemotherapy, radiation, or blood stem cell transplants. The goal is always to preserve your current muscle mass. Exercise is great medicine that research shows boosts energy, mood,  and libido, helps preserve range of motion, decreases stress and symptoms of depression and anxiety, and even stimulates your appetite. Gaining weight due to steroids? Exercise can help, says Dr. O'Donnell.


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Creating a balanced program

If you've been exercising at high levels and are worried about cutting back, rest easy: your previous fitness will help as you increase toward your previous levels again. The goal for most people, says Dr. O'Donnell, is 30 minutes of moderate exercise five days a week — recommended by the American Cancer Society. It also suggests two days a week of strength training. "The idea here is that if you've been doing it and are seriously committed to it — keep on exercising," she says.


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Warm up to exercise

No matter what you're doing, try to include a sufficient warm-up and cool down. To round out your complete program, add stretching or flexibility to counter stiffness. Now you're covering all the bases, for each type of exercise delivers specific benefits to your body. Because your goal is to return to more intensive exercise and even competition, showing a little love to all your body's needs will pay off when you're "back." Don't let tried-and-true positive habits go by the wayside.


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A sensible approach

Dr. Lee Jones at Memorial Sloan Kettering Cancer Center has done significant research to demonstrate that most people can exercise safely during cancer treatment. If you do have severe bone lesions, you could risk fractures from repetitive weight-bearing exercise. If platelets are very low, you may bleed into joints. Some medications to treat multiple myeloma could be potentially toxic to the heart, but "there is no data I know to suggest exercise is unsafe during treatment," Dr. O'Donnell says.


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Be inspired

A shining example of what you "can" do versus "can't," Gary Rudman of Columbia, S. C., is an endurance cyclist who has multiple myeloma — in remission. He's been honored by the MMRF for living his motto: “NEVER QUIT. NEVER STOP. NOT TODAY. NOT EVER.” Rudman says that when he rides, "I lock the door and I push forward. For whatever time I ride, an hour or four hours, nothing matters. I am FREE. I am NOT in pain. I am NORMAL." Go get your sports, he says, calling this "directed energy."


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Take your time

Your management of multiple myeloma is a marathon, not a sprint, says Dr. O' Donnell, so pace yourself. "You'll be on chronic therapy for the rest of your life, and the rest of your life also has to happen. As long as we determine your bones are doing OK, you really don't have to stop exercising. You want to continue to enjoy the life — and the fitness — you have and to make the most of every day." For more inspiration, look to multiple myeloma advocate and athlete Thomas Goode.