Why — and How — to Exercise When You Have Multiple Myeloma
Even if you don’t feel like moving, you should: Regular activity can help shore up weakened bones, fight weight gain from treatment, boost your mood, and more.
If you have multiple myeloma, a gym membership or good pair of walking shoes may be just what the oncologist ordered.
According to the American Cancer Society, regular exercise has benefits for people with any type of cancer, especially during treatment — so much so, guidelines published by the American Society of Clinical Oncology in 2022 encourage oncologists to recommend physical activity to patients, based on evidence that both aerobic exercise and strength training during cancer treatment can “reduce fatigue; preserve cardiorespiratory fitness, physical functioning, and strength; and in some populations, improve quality of life and reduce anxiety and depression.”
For people with multiple myeloma, a rare blood cancer that’s also referred to simply as myeloma, being active and physically fit can help counter side effects specific to the disease and its treatment.
Treatment advances have dramatically improved survival rates for multiple myeloma, meaning people with the disease are living long enough to be at risk for heart disease and other age-related conditions that regular physical activity can help prevent, according to Brea Lipe, MD, clinical director of Wilmot Cancer Institute’s multiple myeloma program at the University of Rochester Medical Center in New York.
Beyond that, regular exercise offers an array of benefits for people living with myeloma by helping to:
Control weight Excess pounds are a particular concern for people who take steroids, which is a standard treatment for multiple myeloma. “For many patients, a gain of 15, 20, or 25 pounds is not unusual,” says Arif Kamal, MD, chief patient officer for the American Cancer Society.
Prevent diabetes Steroids also increase the risk of diabetes, says Daniel Verina, DNP, RN, a nurse practitioner at the Center of Excellence for Multiple Myeloma at Mount Sinai Tisch Cancer Center in New York City. This is because steroids tend to increase blood sugar. And, of course, carrying extra weight is also linked to an increased risk of diabetes.
Boost energy Both myeloma and some medications that treat it can deplete red blood cells (known as anemia), according to the Multiple Myeloma Research Foundation (MMRF). This, in turn, can contribute to general fatigue, because red blood cells carry energizing oxygen to muscles and organs. A review published in October 2021 in Blood Cancer Journal found evidence that regular physical activity may help boost blood cell counts in multiple myeloma patients.
Improve sleep Insomnia and other sleep problems are common in people with myeloma due to factors such as pain, medication, depression, and anxiety, according to the Blood Cancer Journal review. Regular exercise can help improve them. Some cancer therapies, including steroids, can also cause insomnia and other sleep disturbances, Verina adds.
Battle blood clots Certain myeloma medications, especially when taken along with steroids, increase the risk of blood clots, according to the MMRF, as do obesity and lack of physical activity. Regular exercise can address the excess weight and physical activity factors to decrease blood-clot risk as well as risk of deep vein thrombosis, says Verina.
Support mental health From the moment of diagnosis, throughout treatment, and even while in remission, people with myeloma commonly experience anxiety or depression, according to the International Myeloma Foundation. Regular physical activity triggers the release of mood-boosting hormones (endorphins) and can also create a distraction from in-the-moment stress and worry.
Enhance treatment For people with any cancer, the physical fallout from too little exercise — weakness, fatigue, and shortness of breath — can affect how well they respond to and tolerate types of treatment and treatment as a whole.
Being active is sometimes easier said than done when you have multiple myeloma, for a number of reasons that are unique to the disease. The first is skeletal health: As many as 85 percent of people with myeloma have osteoporosis or bone lesions, often in the spine, pelvis, and rib cage, according to the MMRF, which can cause pain and increase fracture risk.
For that reason, it’s important to have your bones evaluated with imaging scans and other tests before starting an exercise program. If they’re strong enough to safely manage light weights, gentle resistance training can make your bones stronger and less prone to fracture.
Myeloma can affect body parts other than bone, including your kidneys, bowels, heart, and lungs, says Dr. Kamal, which also may affect which types of exercise — and how much — you can handle.
Peripheral neuropathy — pain, numbness, or weakness, usually in the hands and feet — is often a consideration, but there are options. A brisk walk may be challenging, but pedaling a stationary bike may be doable, says Michelle Porto, a certified clinical exercise physiologist and cancer exercise trainer at the University of Rochester Medical Center.
She motivates patients who simply don’t feel well by encouraging them to regard regular exercise as medication, something to be taken every day. “You have to look at exercise as, ‘I’m doing it even though I don’t feel well, because I’m going to get the protective benefits and I won’t be fatigued,’” she says.
Start and progress slowly. If you’re new to exercise, don’t immediately go all out. Porto usually starts out newcomers with 15 minutes of walking, which could be divided into three separate five-minute walks. For patients whose doctors have okayed strength training, she turns to resistance bands or light dumbbells or even has a client move through a range of motion without weights to see how their body responds.
Educate yourself. The American College of Sports Medicine provides great tips on how to maintain strength, endurance, and function during and after cancer treatment; how to exercise safely and avoid injury; and more.
Work with a cancer exercise specialist. Sources include The American College of Sports Medicine, your cancer treatment center, and your local YMCA, which may have a LiveStrong cancer exercise program that is supervised and free.
Listen to your body. Some degree of stiffness or soreness is okay, but don’t push yourself to the point of pain or potential injury. “If it hurts, stop,” says Dr. Lipe. “It’s okay to be sore, but it’s not okay to hurt.”
Be flexible. At times, you may need to adjust your routine. For instance, after receiving treatment, your doctor may advise you to swap out your vigorous aerobic routine for a stretching program or tai chi for a week or so, says Porto.
Don’t assume you can’t exercise. Even if you aren’t up to cardio or lifting weights, there are plenty of ways to move your body, such as chair yoga, tai chi, or pool workouts, says Kamal. When you have myeloma, “It’s not like you can act like nothing is happening, but it also doesn’t mean you can’t stay active because you have cancer,” he notes.
Physical activity can help counter side effects associated with multiple myeloma and its treatments. However, individuals with multiple myeloma might find it difficult to achieve a consistent exercise regimen. Experts recommend starting slow, adjusting your process as you go, and collaborating with a cancer exercise specialist to find the routine that’s best for you.
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