Multiple myeloma is a kind of blood cancer that affects white blood cells called plasma cells. Abnormal plasma cells crowd out healthy cells in your bone marrow. And they flood your bloodstream with defective proteins that damage your bones and other areas.
Multiple myeloma is considered incurable, and most people end up with what’s called relapsed/refractory multiple myeloma. Relapsed means the disease has come back after treatment. Refractory means your treatment isn’t working.
At this stage, your doctor can change your treatment, or you can look into clinical trials of new medications. But it’s also important to take care of yourself. Healthy choices in your lifestyle, like eating well and being active, can improve your symptoms and your overall quality of life.
Challenges of Living With RRMM
Compared to people with other kinds of cancer, people with multiple myeloma have to deal with more health problems that make it hard to manage their daily lives. And symptoms increase as the disease becomes relapsed and refractory. These include:
- Fatigue. When your bone marrow doesn’t make enough red blood cells, you may feel tired all the time. It’s also a side effect of some treatments.
- Infections. Not having enough healthy white blood cells makes you more likely to get infections. That’s caused by the disease itself, and also many of the drugs that treat it.
- Bone damage. Multiple myeloma makes your bones thin and more likely to break. And steroids, which are a mainstay of treatment, also weaken your bones over time.
- Loss of appetite. It’s both a symptom of the disease and a side effect of some treatments. Treatments can also change how food tastes and smells, so you may not want to eat. But that can make you tired and weak.
- Pain. Bone damage can cause a lot of pain. And some of the drugs used to treat multiple myeloma – including some proteasome inhibitors and immunomodulating agents – can cause peripheral neuropathy. That’s pain and numbness in your hands and feet.
- Weight gain. The heavier you are, the greater your chances of dying of multiple myeloma. But having the disease for a long time can make you gain weight. Pain can keep you from being active. And steroids both increase your appetite and encourage your body to store fat.
You may think these are just things you just have to live with. But that’s not necessarily true. Let your doctor know what you’re feeling. There may be a medical treatment for some of your symptoms. And they can guide you through lifestyle changes.
Sports medicine experts recommend people with cancer get at least 30 minutes of moderate aerobic exercise at least 3 days a week, plus 2 days of resistance training. Being active can improve your overall quality of life. And for people with multiple myeloma, it can have specific health benefits, including:
- More energy
- Improved strength
- Better sleep
- Better mood
- Fewer side effects from treatment
- Stronger bones
- Stronger immune system
- Weight control
Most people with multiple myeloma aren’t physically active, even when they’re in between treatments. Fatigue and pain can hold you back. So can fear of getting injured. You may find that as you get older, you just have a harder time doing the things you used to do.
Talk to your doctor or get help from a physical therapist to plan a fitness program you can do safely. You’ll have special things to consider when you have relapsed/refractory multiple myeloma:
- Bone damage can make physical activity painful and put you at risk for a fracture. Exercises like water aerobics or a stationary bike can keep you safer from falls. Your doctor can also give you medicine to strengthen your bones.
- If you’re feeling weak, don’t push yourself too hard.
- Multiple myeloma can keep your body from making enough platelets. That can lead to easy bruising and uncontrolled bleeding. Steer away from activities where you might fall and hit your head or cut yourself.
- Because you’re at greater risk of infection, avoid a crowded gym and consider wearing a mask.
Know that any activity is better than no activity. Start as slowly as you need to. Many exercises can be done while you’re sitting in a chair, like stretches and arm and leg raises.
Food for Health
There’s no specific kind of diet recommended for people with multiple myeloma. But healthy eating can:
- Give you energy
- Prevent weight gain
- Prevent infection
- Boost your level of vitamins that are important for people with multiple myeloma
The American Cancer Society recommends a meal plan that includes:
- 2-3 cups of vegetables a day
- 1 ½-2 cups of fruit a day
- Whole grains and other high-fiber foods like beans
- Low-fat dairy products
- Limited or no red meat and processed food
- Limited or no sugary drinks
It’s also important to drink plenty of water when you’re living with relapsed/refractory multiple myeloma. Kidney damage is often a complication as the disease progresses. Your kidneys work better when you’re well hydrated.
Get Your Rest
Pain, worry, and medication side effects can all keep you from getting a good night’s sleep when you have multiple myeloma. That can make problems you’re already dealing with worse, including fatigue, infections, and weight gain.
Try these tips to get better sleep:
- Keep a consistent bedtime and don’t nap during the day.
- Avoid alcohol, caffeine, and sugar in the afternoon and evening.
- Keep your bedroom dark and quiet.
- Have a calm-down routine before bed. This might include meditation or relaxation exercises.
- If you are on steroids, take them in the morning.
- Get plenty of exercise.
Watch the Bad Habits
If you smoke, doctors recommend you stop. It doesn’t necessarily have an effect on multiple myeloma. But smoking raises your risk of other cancers and illnesses and makes you more susceptible to infections.
Research is mixed on multiple myeloma and alcohol. It’s considered a substance that causes cancer, and the American Cancer Society recommends not drinking at all. But there’s some evidence that light drinking may have some benefits.
Your doctor may be able to set you up with a more formal program of lifestyle changes. Many people being treated for cancer get what’s called cancer rehabilitation to help manage their physical and mental challenges. This can include:
- Physical therapy to teach you safe ways to exercise and to help with pain, strength, flexibility, and mobility issues.
- Occupational therapy to help you find easier ways to do daily tasks like getting dressed and to manage fatigue.
- Cognitive therapy to help with “brain fog” and other thinking and memory problems that can be a side effect of chemotherapy.
Think about lining this up before your next round of treatment. Some problems are easier to manage if you catch them early.
In addition to your medical treatment, you can make what are known as complementary therapies part of your healthy lifestyle. These can help manage your side effects, reduce your stress, and just make you feel better. Possibilities include:
Check with your doctor first to make sure these are safe for you.
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American Cancer Society: “What is Multiple Myeloma?” “Drug Therapy for Multiple Myeloma,” “Physical Activity and the Person with Cancer,” “Eating Well During Treatment,” “Eating Well After Treatment,” “Health Risks of Smoking Tobacco.”
Journal of Clinical Nursing: “Living with relapsed myeloma: Symptoms and self‐care strategies.”
Leukemia & Lymphoma Society: “Myeloma: Refractory and Relapsed,” Myeloma: Supportive Care and Disease Complications.”
Blood Cancer Journal: “Lifestyle considerations in multiple myeloma.”
Cleveland Clinic: “Multiple Myeloma.”
New England Journal of Medicine: “Overweight, Obesity, and Mortality from Cancer in a Prospectively Studied Cohort of U.S. Adults.”
Weill Cornell Medicine Myeloma Center: “Staying Active and Safe with Multiple Myeloma,” “Alternative Treatments for Multiple Myeloma: Friend or Foe?”
UpToDate: “Patient education: Multiple myeloma treatment (Beyond the Basics).”
American Society of Clinical Oncology: “Rehabilitation.”