Multiple myeloma can be difficult to diagnose because it's an uncommon type of cancer that initially has few or no symptoms.
Your GP will examine you and ask about your symptoms, medical history and overall health. During the examination, your GP will look for things such as bleeding, signs of infection and specific areas of bone tenderness.
You may need urine and blood tests to check for certain types of antibodies and proteins (immunoglobulins).
If multiple myeloma is suspected, you will be referred to a haematologist (a doctor who specialises in conditions affecting the blood) for further tests and scans.
A number of blood tests are used to help diagnose multiple myeloma, and they may need to be repeated to monitor the condition.
These may include:
- erythrocyte sedimentation rate (ESR) or plasma viscosity (PV) – if you have multiple myeloma, your ESR or PV will usually be raised
- tests to measure the type and number of abnormal antibodies produced by the cancerous plasma cells
- a full blood count (FBC) to check levels of different types of blood cells – your doctor will be looking for a low number of red blood cells and platelets
- liver and kidney function
- blood calcium level
A urine sample will be checked for the abnormal proteins produced by the cancerous plasma cells. The abnormal proteins are known as monoclonal light chains, or Bence Jones protein.
These proteins can damage your kidneys as they pass through them from your blood to your urine. You may be asked to collect your urine over a 24-hour period. This will be used to check the quantity of proteins being produced and how well your kidneys are working.
X-rays and other scans
You will have X-rays taken of your long bones (arms and legs), skull, spine and pelvis to look for any damage.
Other scans, such as computerised tomography (CT) scans and magnetic resonance imaging (MRI) scans, may also be carried out.
Bone marrow biopsy
A bone marrow biopsy is usually needed to confirm multiple myeloma. A needle will be used to take a small sample of bone marrow from one of your bones, usually the pelvis. A sample of bone may also be removed.
This is carried out using a local anaesthetic (the area where the needle is inserted is numbed).
The sample of bone marrow and bone will be used to check for cancerous plasma cells.