Bone health is a lifelong pursuit for all those who have been diagnosed with pre-myeloma (SBP, MGUS, SMM) as well as full multiple myeloma- bone mineral density, imaging, etc.
Hi David- I’m looking for tips on bone health management without the heavy drugs. I have three compression fractures T 6,7,8 and live with chronic pain. I am interested in the the yoga practice but don’t know what is ok to do with my back. I do take CBD oil for pain which helps somewhat. I take a bone formula called Osteoprime Forte everyday.
Any help would be much appreciated.
I received your information many years ago shortly after I was diagnosed in 2015. Thank you. Carol
Hi Carol-
If you were diagnosed with Multiple Myeloma in 2015, you have managed your myeloma for more than seven years now. Well done. I hope that you are in remission and otherwise doing well. The next step is to combine conventional with evidence-based non-conventional bone health management as well.
Further, as you probably know, bone health management- imaging, strengthening, etc. is a lifelong pursuit for us myeloma survivors. As you can see from the first study linked and excerpted below, conventional bone therapies are just not enough when it comes to life long bone health management.
As for your bone mineral density, several considerations.
- The short term solution to reduce your risk of “skeletal-related events” (SRE) aka bone fractures is a bisphosphonate therapy. While bishosphonate therapy is a toxic, conventional treatment, several monthly infusions wouldn’t be “heavy drugs” in my thinking. Your call, of course. This would be several months of aredia, zometa, etc. Studies cite bisphosphonates as hardening the surface of bones but not necessarily enhancing bone mineral density.
- Kyphoplasty/vertebroplasty- if myeloma has created a lesion in one or more of your vertebra, you have to figure out how to both stabilize the bone damage as well as get rid of the lesion itself IN the bone. Talk to a specialist about the possibility of bone cement stabilizing the vertebra.
- I will link the MM CC bone health guide below. Studies cite a number of evidence-based, non-conventional therapies such as curcumin that will enhance bone mineral density. This is a long-term effort, not the short term solution provided by bisphosphonate therapy or bone cement.
- Physical therapy– you are correct in thinking that yoga can strengthen the muscles in your back and help to stabilize your vertebra, according to research. Again, however, this is a longer term solution. Also, you need to work with someone to figure out how strong or weak you spine is.
- CBD oil has been shown to enhance bone mineral density. I put a few drops of Charlotte’s Web under my tongue before bed both to help me sleep as well as to enhance my own bone health.
Let me know if you have any questions.
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
“Highlights-
- •No decrease in fracture risk over time was found for multiple myeloma patients.
- •New treatment options do not guarantee a corresponding reduction in bone lesions.
- •There is a strong clinical need for new bone-sparing strategies in multiple myeloma.
Objective- To determine the effect of different treatment periods (1996–2000, 2001–2006 and 2007–2011) on the risk of fractures in patients with multiple myeloma…
Results- The study population consisted of 925,341 cases, and the same number of matched controls, of whom 1334 patients with multiple myeloma. Among cases, the risk of any fracture was higher in multiple myeloma patients compared to patients without multiple myeloma (any fracture: ORadj[95% CI] 1996–2000: 1.7[1.3–2.3]; 2001–2006: 1.3[1.1–1.6]; 2007–2011: 1.7[1.4–2.2]). Although fractures were mainly non-vertebral, the risk of vertebral fractures in particular was higher in multiple myeloma patients (vertebral fracture: ORadj[95% CI] 1996–2000: 3.5[1.4–8.6]; 2001–2006: 4.0[1.9–8.2]; 2007–2011: 3.0[1.6–5.7]).
Conclusions- Despite new treatment strategies and improved supportive care, this study showed no decreased fracture risk for multiple myeloma patients over time. New treatment strategies, even if they have a positive impact on overall survival, offer no guarantee for a corresponding reduction in bone lesions.”
“Focal or diffuse spinal osteolysis may result in significant morbidity by causing painful progressive vertebral compression fractures (VCFs) and deformities. Advances in the systemic treatment of myeloma have achieved high response rates and prolonged the survival significantly.
Early diagnosis and management of skeletal events contribute to improving the prognosis and quality of life of MM patients. The management of patients with significant pain due to VCFs in the acute phase is not standardised. While some patients are successfully treated conservatively, and pain relief is achieved within a few weeks, a large percentage has disabling pain and morbidity and hence they are considered for surgical intervention.
Balloon kyphoplasty and percutaneous vertebroplasty are minimally invasive procedures which have been shown to relieve pain and restore function. Despite increasing positive evidence for the use of these procedures, the indications, timing, efficacy, safety and their role in the treatment algorithm of myeloma spinal disease are yet to be elucidated…”
“There is a steadily growing body of evidence suggesting that the skeletal endocannabinoid system plays an important role in the regulation of bone mass in health and in disease. Cell and tissue based studies showed that bone cells express cannabinoid receptors and the machinery for the synthesis and breakdown of endocannabinoids, thereby indicating that endocannabinoids influence bone remodelling acting on CB1 and CB2 receptors expressed on bone cells. Expression of CB1 within innervating neurones however raises the possibility that cannabinoids regulate bone mass by a neuronal mechanism…”
