Natural Smoldering Multiple Myeloma Therapies?

There is limited but growing evidence suggesting that certain non-conventional therapies—especially diet, exercise, and nutritional supplements—may influence the progression from smoldering multiple myeloma (SMM) to active multiple myeloma (MM). However, no large-scale randomized clinical trials have definitively proven that these interventions can prolong progression-free survival in SMM. Most evidence comes from observational studies, mechanistic research, and pilot trials.

Here’s a summary of what we know so far:

🥗 Diet and Nutrition

1. Anti-inflammatory diets (e.g., Mediterranean diet)

• Study type: Observational and preclinical.

• Findings: Diets rich in fruits, vegetables, whole grains, and omega-3s may reduce systemic inflammation, which is a known factor in myeloma progression.

• Example: A small pilot study at the Mayo Clinic investigated the impact of a Mediterranean diet in SMM patients and showed improvement in inflammatory markers, though not yet linked to progression delay.

2. Caloric restriction / intermittent fasting

• Preclinical models show that caloric restriction may modulate immune function and reduce cancer cell proliferation.

• No human trials in SMM have directly evaluated this.

3. Vitamin D

• Low vitamin D levels have been associated with worse outcomes in MM.

• One observational study suggested that vitamin D sufficiency in MGUS/SMM patients may be associated with lower risk of progression, though causality is unclear.

4. Curcumin

• A phase II trial (UK, 2018) found that curcumin supplementation (8g daily) in MGUS/SMM patients reduced paraprotein levels in some participants.

  • Citation: Golombick T et al., Am J Hematol. 2018.

  • Curcumin has anti-inflammatory and anti-myeloma activity in vitro and possibly in humans.

🏃 Exercise

• Chronic inflammation and immune senescence are associated with MM progression.

• Regular moderate exercise has been shown to:

  • Improve immune function (NK cell activity)

  • Reduce inflammatory cytokines (e.g., IL-6, TNF-alpha)

• No direct trial in SMM, but mechanistic rationale and indirect evidence suggest potential benefit in delaying progression.

🧘 Stress Reduction (e.g., yoga, meditation)

• Chronic stress is linked to immune suppression.

• Mind-body practices may improve immune surveillance.

• No clinical trials for SMM, but these are low-risk interventions with systemic benefits.

💊 Other Supplements Studied or Proposed

🧬 Ongoing Studies

• NUTRIVENTION Trial (NCT04920084):
  Testing whether a Mediterranean diet and lifestyle program can reduce progression in SMM.

  • Sponsor: Dana-Farber Cancer Institute.

  • Status: Recruiting or active.

• Curcumin + EGCG trials are being explored in preclinical and small-scale settings.

🔍 Summary

🧭 Bottom Line

There is no definitive clinical evidence yet that non-conventional therapies prolong time to progression from SMM to active MM, but:

• Curcumin, Mediterranean diet, vitamin D normalization, and moderate exercise show the strongest potential.

• These interventions are low-risk, and may complement standard observation in SMM.