Factors Influencing Lifestyle Choices in Patients with Multiple Myeloma
Overview
Multiple myeloma (MM) patients experience significant symptom burden and reduced quality of life (QOL), with low rates of physical activity and challenges in adopting healthy lifestyle behaviors. Exercise interventions show promise but are underutilized due to disease-specific limitations and modifiable barriers such as fatigue and lack of knowledge.
Background
Multiple myeloma is the second most common hematological malignancy in the US and accounts for 1% of global cancer deaths. Advances in treatment have improved five-year survival rates to 55.6%, leading to longer-term management and highlighting the importance of supportive care to maintain QOL. MM patients report more symptoms and lower physical functioning compared to other cancers, emphasizing the need for lifestyle interventions targeting physical activity, nutrition, sleep, and substance use to improve outcomes.
Data Highlights
Study
Finding
Statistic
Physical activity adherence during treatment
MM patients meeting ACSM 2010 guidelines
6.8% during active treatment; 20.4% off-treatment (p < 0.001)
Pre- vs post-diagnosis physical activity
MM patients meeting 150 min/week moderate exercise
38.9% pre-diagnosis vs 20.1% post-diagnosis (p < 0.001)
41.1% MM vs 81.1% bladder, 81% lymphoma, 70% kidney cancer
Cardiopulmonary fitness post-transplant
Peak oxygen consumption and 6-min walk test
38 ± 18% and 25 ± 13% less than normative values, respectively
Key Findings
MM patients have significantly reduced physical functioning and low adherence to physical activity guidelines.
Only 6.8% of MM patients meet exercise guidelines during active treatment, increasing to 20.4% off-treatment.
Fatigue, injuries, and pain are the most common barriers to exercise; modifiable barriers include lack of knowledge and fear of injury.
MM patients are less likely to participate in disease-specific exercise programs compared to survivors of other cancers.
Older age at diagnosis (median ~70 years) presents unique challenges for lifestyle interventions.
Exercise capacity remains impaired long after autologous stem cell transplantation.
Clinical Implications
Clinicians should recognize the high symptom burden and physical limitations faced by MM patients when recommending lifestyle interventions. Tailored exercise programs that address modifiable barriers and accommodate age-related and disease-specific challenges may improve adherence and QOL. Education on safe exercise practices and support to overcome fatigue and pain are critical components of supportive care.
Conclusion
Lifestyle interventions, particularly physical activity, hold potential to enhance quality of life in MM patients but require adaptation to the unique challenges of this population. Further research is needed to develop and implement effective, disease-specific supportive care strategies.
References
Siegel et al. 2020 -- Cancer statistics, 2020
American College of Sports Medicine 2010 & 2019 -- Exercise guidelines for cancer survivors
Craike et al. 2021 -- Physical activity barriers and facilitators in MM
Other cited studies on exercise and hematological malignancies
