Multiple Myeloma: Maximizing Your Exercise Investment. Lexi Harlow, PT, DPT, CLT Physical Therapy Seattle Cancer Care Alliance

Transcription

1 Multiple Myeloma: Maximizing Your Exercise Investment Lexi Harlow, PT, DPT, CLT Physical Therapy Seattle Cancer Care Alliance

2 What are common physical side effects reported by patients with multiple myeloma?

3 Physical Side Effects Chronic Pain Recurrent infections Fatigue Osteoporosis Nausea/vomiting Osteolytic bone lesions Anemia

4 What does the research tell us about exercise and multiple myeloma?

5 Research Summary Physical activity is safe and feasible before, during, and following treatment for multiple myeloma. Exercise can alleviate some of the side effects, especially fatigue, and enhance quality of life for patients. Participation is lower for people with multiple myeloma than other cancer survivors. (25% vs %) Physical activity/exercise participation may reduce the number of attempts for stem cell collection and number of overall days for collection in patients receiving stem cell transplant.

6 How much is enough?

7 World Cancer Research Fund: Physical Activity Recommendations for Survivors Be physically active as part of everyday life Be moderately physically active, equivalent to brisk walking, for at least 30 minutes every day As fitness improves, aim for 60 minutes or more of moderate, or for 30 minutes or more of vigorous, physical activity every day Limit sedentary habits such as watching television

8 US Dept of Health and Human Services: 2008 Physical Activity Guidelines for Americans 2.5 hours/week of moderate intensity or 1.25 hours/week of vigorous intensity Should increase to 5 hours/week of moderate intensity or 2.5 hours/week of vigorous intensity 2x/week of strengthening of major muscle groups

9 ACSM Cancer Exercise Guidelines (2010) 1) Exercise training is safe during and after cancer treatments. 2) Improvements in physical functioning, quality of life, and cancer-related fatigue in several CA groups (breast, prostate, colon, blood, stem cell transplant, and gynecologic). 3) Survivors should follow the 2008 Physical Activity Guidelines for Americans, with specific individualized exercise prescription based on their disease and treatment related side effects.

10 American Cancer Society (2012) Achieve and maintain a healthy weight Be active on a regular basis Fill your plate with vegetables, fruits, and whole grains gala.acsevents.org

11 Specific Recommendations for Multiple Myeloma 150 minutes per week of moderate to vigorous intensity exercise (30 minutes, 3-5x/week) Should include both aerobic and resistance training activities Exercise should be altered or individually tailored to take into account a patient s physical condition and treatment regimen. Good options include walking, gardening, aquatics, cycling Having an exercise partner is helpful, especially for women

12 What are the specific exercise benefits for patients with multiple myeloma?

13 Reported Benefits Coping with symptoms Improved physical appearance Weight loss Enjoyment Recovery from disease and treatment Improved cognition Improved mood Social interaction

14 What are barriers to exercise for patients with multiple myeloma?

15 Reported Barriers Fatigue (most prominent in patients receiving SCT) Pain (specifically in bones) Concerned about fractures Fear of infection Timing of taking medications Self-conscious Anemia Back pain Foot weakness Decreased concentration and ability to focus Depression Low self-motivation

16 Who can help me?

17 PHYSICAL THERAPY! Survivors should get consultation as soon as possible after diagnosis Focus on education, especially exercise precautions and safety Manual therapy (stretching, scar tissue mobility, etc.) Exercise prescription and consultation for managing fatigue and improving endurance Comprehensive individually tailored exercise program prescription which includes cardiovascular conditioning, strength training, and flexibility exercises

18 EXERCISE! By exercising regularly, you are helping yourself to heal, potentially preventing new cancers from developing and preventing previous cancers from recurring, and at the same time lowering your risk of developing the most common life threatening medical condition heart disease. The benefits of exercise are enormous. -Dr. Julie K. Silver

19 Questions? Thanks for coming and stay active! S

20 Acknowledgments and References Perceived benefits and barriers to exercise for recently treated patients with multiple myeloma: a qualitative study; Craike et al.; BMC Cancer 2013, 13:319. Physical Exercise for Patients Undergoing Hematopoietic Stem Cell Transplantation: Systemic Review and Meta-Analysis of Randomized Controlled Trials; van Haren, Timmerman, Potting, et al.; Physical Therapy 2013;93:

21 Acknowledgements and References After Cancer Treatment: Heal Faster, Better, Stronger. Julie K. Silver, MD. Baltimore: Johns Hopkins University Press, Exercise Prescription; Leiserowitz & Watchie; Topics in Geriatric Rehabilitation, Volume 27, Number 3, World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: AICR, US Department of Health and Human Services: 2008 Physical Activity Guidelines for Americans American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors; Schmitz et. al; Medicine & Science in Sports & Exercise American Cancer Society. Nutrition and Physical Activity Guidelines for Cancer Survivors,