How multiple myeloma is diagnosed

To identify multiple myeloma, your doctor will look at any symptoms you may have and perform tests to look for signs ofmultiple myeloma throughout the body.

Signs and symptoms of multiple myeloma

The symptoms of multiple myeloma can vary from person to person. Some people have no symptoms at all.

According to the American Cancer Society, the most common multiple myeloma symptoms include:

  • Bone pain that can be in any bone but is most often in your back, hips, and skull
  • Bone weakness, either all over (osteoporosis) or where there is a bone tumor
  • Broken bones or fractures, sometimes from minor stress or injury
  • Anemia – low levels of red blood cells, which may cause weakness, fatigue, shortness of breath, and dizziness
  • Leukopenia – low levels of white blood cells, which can increase the risk of infections and weaken the immune system
  • Thrombocytopenia – low blood platelet counts, which may cause serious bleeding even with minor scrapes, cuts, or bruises
  • High levels of calcium in the blood, which can cause:
    • Extreme thirst
    • Excessive urination
    • Dehydration
    • Kidney problems and even kidney failure
    • Severe constipation
    • Abdominal pain
    • Loss of appetite
    • Weakness
    • Drowsiness
    • Confusion
  • Multiple myeloma patients are much more likely to get infections. Pneumonia is a common and serious infection often seen in myeloma patients
  • Which can make it harder for your body to remove excess salt, fluid, and body waste
  • This can lead to:
    • Weakness
    • Shortness of breath
    • Itching
    • Leg swelling
  • This can cause:
    • Sudden severe back pain
    • Numbness, most often in the legs
    • Muscle weakness, most often in the legs

Talk with your healthcare provider about any symptoms and questions you may have.

Testing

Your doctor will perform various tests to determine your diagnosis and understand the specifics of your disease.

blood-tests-iconBlood tests

  • To check for levels of different markers of multiple myeloma, including certain proteins and antibodies
  • Test results may help guide treatment decisions

imaging-tests-iconImaging tests

  • To check for bone loss and evidence of multiple myeloma inside and outside of the bones

procedures-iconProcedures

  • A bone marrow biopsy provides tissue samples to help doctors check for certain types of cancer cells in your body

Staging of multiple myeloma

The most commonly used staging system for multiple myeloma is the Revised International Staging System (R-ISS), which is based on 4 factors:

album-level-icon

Albumin level

  • Albumin is the main protein found in blood
beta-2-microglobulin-icon

Beta-2-microglobulin level

  • Beta-2-microglobulin is a protein found on the surface of most cells and sheds into the blood
lactate-dehydrogenase-icon

Lactate dehydrogenase (LDH) level

  • Lactate dehydrogenase is a protein that helps produce energy in the body
cytogenetics-icon

Cytogenetics

  • Cytogenetics is a lab test that looks at changes to genetic information (DNA) in cancer cells

As multiple myeloma progresses, you may start to show symptoms or the cancer might start to impact other parts of your body. This is why early detection and effective treatment are important in managing the disease. Staging can be complex, so discuss your diagnosis with your doctor.

Questions to ask your doctor or nurse

It’s important to have open, honest discussions with your healthcare team. They want to answer your questions to help you make informed decisions. Here are a few questions to help you get started:

  • What parts of the body does multiple myeloma affect?
  • How advanced, or at what stage, is the multiple myeloma, and what should I do?
  • Will I need other tests before we can make a treatment decision?
  • How many patients with multiple myeloma are you treating today?
  • Do you have an online portal for test results, appointments, and communications?
  • How do I communicate with you in case of an emergency?
  • How do we communicate for nonemergency interactions?

A multiple myeloma diagnosis can feel like a burden.Support groups can help you during your treatment journey.