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Multiple myeloma is a rare blood cancer that develops in the plasma cells, which are white blood cells that help you fight infection by making antibodies. Multiple myeloma starts in the plasma cells inside your bone marrow.
People with multiple myeloma have high levels of certain proteins in their blood and urine. An oncologist (a medical doctor specialized in diagnosing and treating cancer) will test for and diagnose multiple myeloma.
Here are the diagnostic steps you might go through if a healthcare provider suspects you could have multiple myeloma:
Multiple myeloma causes changes in the blood cells that may lead to physical signs and symptoms. When you see your healthcare provider, they will probably ask about your symptoms and when they began.
They may ask about possible multiple myeloma symptoms you may have, including:
They may also ask about symptoms related to multiple myeloma complications. Thirst, increased urination, and constipation can be signs of hypercalcemia (too much calcium in the blood), a complication of multiple myeloma. Leg swelling and itching are potential signs of kidney damage caused by multiple myeloma.
Your healthcare provider will also probably ask about your medical history.
After reviewing your symptoms and medical history, the provider will likely perform a physical exam, paying special attention to any areas of bleeding or bruising. They may also assess for any bone fractures or breaks since multiple myeloma cancer cells can weaken bones, increasing the risk of bone fractures.
Multiple myeloma affects the health of several types of blood cells. Your blood may show signs of multiple myeloma, like abnormal levels of specific proteins or antibodies.
Blood tests that healthcare providers use to help diagnose multiple myeloma include:
Multiple myeloma can damage the kidneys, causing high levels of protein in the urine. To test for signs of kidney damage and multiple myeloma, a healthcare provider may ask you to collect all of your urine over 24 hours. They will then send the 24-hour sample to a lab for testing.
A biopsy involves taking a sample of body tissue and sending it to a lab for testing. For a multiple myeloma diagnosis, your healthcare provider will take a sample of bone marrow.
Bone marrow is the soft, spongy tissue in the center of your bones. It’s where blood cells are made. Multiple myeloma starts in the plasma cells in the bone marrow, and people with multiple myeloma have too many plasma cells.
During a bone marrow biopsy, your healthcare provider will use a hollow needle to take a sample of bone marrow, usually from inside your hip bone. The sample will then be examined under a microscope at the lab to determine if cancer cells are present.
They may also want to test the liquid part of the bone marrow, called aspirate. There are several tests they can run on aspirate to confirm whether it has cancer cells.
Imaging tests provide pictures of the tissues inside your body. These can help your healthcare team determine if you have multiple myeloma and how far it may have spread throughout your body. Imaging studies used to diagnose multiple myeloma may include:
When a person is diagnosed with multiple myeloma, their healthcare team conducts additional tests to determine the cancer’s stage. Staging is essential for developing an effective treatment plan and giving an accurate prognosis (disease outlook).
Healthcare providers use the Revised International Staging System (RISS) to stage multiple myeloma. This system is based on the amounts of certain cells and substances in the blood.
Multiple myeloma stages include:
Besides the stage of cancer, other factors that influence a person’s prognosis with multiple myeloma include their age, kidney function, and overall health.
Other chronic health conditions can cause changes to your plasma cells. These conditions may cause similar symptoms to multiple myeloma, but they are not considered cancerous. A healthcare provider may need to rule these out before diagnosing you with multiple myeloma.
Other plasma cell disorders they may test for include:
Multiple myeloma is a rare blood cancer that develops in the plasma cells in your bone marrow. If your healthcare provider suspects you may have multiple myeloma, they’ll likely refer you to an oncologist for testing.
Diagnostic tests for multiple myeloma may include blood, urine, and imaging tests, as well as biopsies. Multiple myeloma may cause high calcium and low red blood cell levels, poor kidney health, and weak bones. Diagnostic tests help detect these and other signs of multiple myeloma.
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