The diagnosis of multiple myeloma is a life-changing event. A complex, life-threatening problem has the power to overwhelm. The recent heatwave in California offered poignant examples of the impact of acute stress on ourselves and the environment.  Although the massive wildfires were not close to homes here in Los Angeles, temperatures above 100 degrees burned the leaves off trees and other plants. What was striking to me was the major sprouting and regrowth which has occurred in the three weeks since then. There are natural mechanisms to rebound and recover. These are the kinds of mechanisms and tools myeloma patients need.

At the recent IMF Support Group Leader Summit in Dallas, Texas, Sue Dunnett from the University of Edinburgh, Scotland discussed the importance of this type of resilience in enhancing decision-making and achieving the best outcomes for myeloma patients (presentation here). A recent publication in the BMJ confirms the value of resilience.

What is resilience?

The author of the BMJ article describes resilience as a “personality trait which has a moderating effect on negative feelings and stress and a flexible adaption to adverse situations.” This is seen as a dynamic process that can be fostered. As Sue Dunnett pointed out, resilience is not about “bouncing back,” but about working hard to stabilize emotions, taking advantage of support groups, and gaining strength from clear information used to make decisions.

Resilience is a natural process

As we look around, we can see that animals and plants have evolved to adapt to stress. I have previously written about elephants who have 20 copies of the p53 gene, which allows them to react to the cellular DNA damage and avoid cancer. A new article from the New York Times reconfirms this and reveals that the elephants have an extra gene called LIF6 (leukemia inhibitory factor 6). This extra gene leads to the death of damaged cells, allowing for the growth of normal cells. It is a process similar to what happened to the heat-wave-scorched plants in the garden, which lost their burnt leaves but recovered new shoots. With new CRISPR technology, it may be possible to add extra p53 to cells to get rid of bad cells and refocus growth on healthy cells.

In the plant world, a unique type of corn with built-in resilience grows in a region of Mexico called Sierra Mixe. This corn can grow to 16 feet in height in very poor soil without fertilizer because it can capture nitrogen needed for growth directly from the air. As a recent article notes, “This wonder plant… could slash fertilizer use.” With global fertilizer use at a crisis-high level—creating the terrible algae blooms off the Florida coast, for example—anything to help can be a godsend. This is another example of resilient potential in all living things.

Recognizing stresses and fostering best responses

Everyone has some degree of resilience. However, even the best and strongest have limits. It is important to acknowledge the stresses imposed by the diagnosis of myeloma and mobilize resources to adapt and promote achievement of best outcomes. Often, untapped strengths emerge, and family, friends, and support groups rally to provide needed help. Let resilience become your friend!

Image of Dr. Brian G.M. DurieDr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.


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