Sometimes myeloma isn’t diagnosed until a health care professional finds it during other tests for another illness. These include blood and urine tests. They can find the abnormal proteins myeloma cells make, called M protein or Bence Jones proteins.
Your doctor might use a bone marrow biopsy to confirm the diagnosis. You may also get treatment with medicines, such as lenalidomide (Revlimid) or bortezomib (Velcade).
1. Bone pain
Bone pain is a common myeloma symptom. The pain may be a dull or deep ache that affects one or more bones, such as the back, pelvis, legs or ribs. It’s different than muscle or joint pain, because it usually feels more intense and lasts longer.
Plasma cells are made in the bone marrow, the spongy interior of your bones where blood is produced. These cells are part of your immune system and make proteins called antibodies that help fight infection. When plasma cells become cancerous, they can build up and damage your bones, causing them to weaken and break.
Multiple myeloma is a type of blood cancer that affects plasma cells. It’s most often found in the bones of your spine, but it can also form in other places around your body. Some types of myeloma, including solitary plasmacytoma and extramedullary plasmacytoma, involve only one area of the bone.
Other symptoms and signs of myeloma include a lot of infections, such as pneumonia; high calcium levels that lead to kidney damage or hypercalcemia; and fatigue that makes you feel more tired than usual. You might also have a fever for no clear reason or have trouble breathing.
2. Loss of appetite
A loss of appetite is common in people with multiple myeloma. It can make it difficult to get the nutrients you need. If your appetite is loss, ask your healthcare team for advice.
The plasma cells in myeloma crowd out the bone marrow and leave little room for healthy white blood cells, red blood cells and platelets. If you don’t have enough red blood cells, you can become anaemic (low levels of haemoglobin that carry oxygen to the tissues). This can lead to tiredness and breathlessness on exertion.
Fatigue is also a common myeloma symptom and can make it hard to keep going. It can be caused by myeloma, treatment or other factors. It is a particular problem for people with solitary plasmacytoma and extramedullary plasmacytoma, which are tumours that develop outside the bones in soft tissue.
If you are losing your appetite, try a variety of foods to find what you can eat and enjoy. Eating a balanced diet will help you feel stronger and healthier. You can also talk to your doctor about taking nutritional supplements that may help improve your appetite.
3. Fatigue
Fatigue is one of the most common symptoms of multiple myeloma. It can affect many parts of your body and make it harder to perform daily tasks. Your fatigue may be caused by a tumor, low blood count (anemia), pain or stress. It also can be a side effect of some treatments for multiple myeloma.
Plasma cells, which are cancerous in multiple myeloma, can suppress or crowd out healthy red blood cell production and lead to anemia. Multiple myeloma can cause low platelet counts, which can interfere with blood clotting and lead to bleeding problems.
Your healthcare provider will examine you for signs of myeloma. You will have blood work, urine tests and X-rays. A bone marrow biopsy is often done to check for myeloma. This involves inserting a needle into your hip to get a sample of bone marrow to test for myeloma. Your doctor will probably also order an imaging test, such as a CT scan or an MRI.
A recent scoping literature review investigated how fatigue is described and measured in non-oncologic medical conditions. Researchers found that how people report their fatigue experience is sensitive to context and varies by the medical condition they have. They suggest that future studies should include more standardized definitions, validated clinical measures and a greater diversity of participants to enhance the validity of fatigue research.
4. Shortness of breath
Breathing is a normal, automatic process, but if you feel short of breath while doing activities or when lying down, it may be a sign that your myeloma has gotten worse. This symptom can also be caused by low levels of oxygen in the blood (hypoxemia). Breathing techniques, certain body positions and medication can help with breathing.
Multiple myeloma can cause back pain in your lower spine, ribs and hips. It can also cause a feeling of weakness, fatigue or tiredness, loss of appetite, confusion and high calcium levels in the blood, which can lead to kidney failure.
Sometimes myeloma isn’t diagnosed right away because it only causes symptoms in some people and health care professionals may mistake them for other problems. If your health care professional suspects you have multiple myeloma, he or she might run blood tests to check for plasma cells in your bone marrow. They might also do urine tests to check for Bence Jones proteins, which myeloma cells make.
Multiple myeloma can be treated with medications that reduce pain and prevent the cancer from growing, but they don’t cure it. Your health care team will discuss managing your symptoms with you to improve your quality of life, which is called palliative and supportive care.
5. Weight loss
Some people with myeloma do not experience any symptoms and are only diagnosed when a blood or urine test for another reason shows high levels of protein. This is called smoldering myeloma or asymptomatic myeloma.
People with multiple myeloma may feel a loss of appetite or not be able to eat as much as usual. This can be caused by the cancer or by medications such as steroids. Steroids are a vital part of the treatment for myeloma, helping to treat the disease and ease symptoms such as fatigue and nausea.
Myeloma causes changes in the blood and bone marrow that can cause a range of symptoms. Often, people who have myeloma look back and realise they had some of these symptoms for a long time before their diagnosis, such as back pain or fatigue.
Doctors do not know what causes most cases of myeloma and there are no known ways to prevent it. However, there are things that can increase your risk of developing it, such as age, gender (more men than women), and race (Black people are twice as likely to develop myeloma). If a family member has had myeloma, this also increases your risk.
6. Diarrhea
Having loose, watery stool on a regular basis can make it hard to function. It can also lead to dehydration, which can be dangerous. You should always drink plenty of fluids when you have diarrhea, and eat foods that are rich in nutrients, especially calcium, iron and fiber.
Some people get diarrhea because of a virus or other health problems, such as Crohn’s disease, ulcerative colitis and irritable bowel syndrome. Others have it because of medical procedures, such as colonoscopies and surgery.
Diarrhea is an important symptom of multiple myeloma because it can help the cancer spread. It can also help your doctor figure out how advanced the myeloma is.
If you have chronic diarrhea, talk to your doctor about it. Your doctor may ask about your symptoms and do a physical exam, including feeling your abdomen. Your doctor might also ask for a blood test or provide a stool sample.
Other symptoms of multiple myeloma include bone pain, a pale complexion, weakness and fatigue, anemia (low red blood cell count), and frequent infections due to a weakened immune system. You might also have a feeling of coldness in your legs or arms or have numbness in your hands or feet (caused by low levels of platelets, which are involved in blood clotting). Other symptoms might be a high level of calcium in the blood or hypercalcemia, a condition that can affect your bones and nerves.
7. Nausea
A feeling of nausea can be uncomfortable, and it often comes with the urge to throw up. It happens when your brain detects a substance that it thinks is harmful, such as a virus or spoiled food. Nausea is also a side effect of many types of cancer medications, and it may be experienced during pregnancy as morning sickness.
A common symptom of myeloma is nausea. Your doctor will want to find out what’s causing it and help you manage your symptoms. They might recommend avoiding trigger foods, taking medication and getting rest when you feel nauseous.
If your nausea is accompanied by a stiff neck, severe headache or blood in your vomit, it could be a sign of a medical emergency and you should seek emergency medical care right away. Nausea is usually not a serious symptom of multiple myeloma, but it can be an uncomfortable one.
Relieving your symptoms is an important part of the treatment for multiple myeloma. This is called palliative care and it’s available to patients at any stage of their disease. It can include pain relief and other treatments that will improve your quality of life. Visit the WeCan website to learn more about the resources and support available for people with myeloma.