Symptoms and diagnosis of multiple myeloma

Early symptoms of multiple myeloma

The symptoms of myeloma are often vague at first and can vary from person to person. You may get a lot of infections or feel very tired (fatigue). As the condition develops it can affect your bones, blood and/or kidneys. You will have treatment to help with any symptoms. 

CRAB: The symptoms associated with myeloma are often described as ‘CRAB’ because they are due to: 

• Calcium in the blood - too much calcium in the blood
• Renal (kidney) damage
• Anaemia (lack of red blood cells) 
• Bone damage

Bone effects

Myeloma cells can destroy bone tissue, creating soft spots or holes.  Symptoms include:

• Bone pain and swelling, particularly in your middle or lower back, ribcage and hips
• Osteoporosis – thinning of the bone
• Bone fractures  – due to weakened bones
• Numbness and/or pins and needles – this may be a sign of spinal cord compression. This needs to be treated straight away, so get medical help if you have myeloma and develop this symptom.

Blood effects

The build-up of myeloma cells in your bone marrow can stop enough healthy blood cells being made. Symptoms include:

• Anaemia – not having enough red blood cells
• Fatigue – extreme tiredness caused by a lack of red blood cells
• Shortness of breath – caused by a lack of red blood cells
• Infections  – caused by fewer infection-fighting white blood cells
• Bruising – caused by fewer platelets, which help the blood to clot.

Hypercalcaemia 

High levels of calcium in your blood caused by bone cells being destroyed. Symptoms include: 

• Feeling sick/poor appetite
• Getting sick (vomiting)
• Hazy vision
• Muscle weakness
• Constipation
• Feeling tired and possibly a little confused/dazed
• Being thirsty/dehydrated
• Depression / drowsiness

Kidney problems / kidney failure

Paraproteins released by the myeloma cells can affect how your kidneys work and stop them from filtering waste product properly. Symptoms include:

• Feeling sick
• Fluid retention causing breathlessness/swollen ankles 

All these symptoms can be caused by conditions other than cancer, but it’s important to go to the GP and get any unusual changes checked out. 

If you’ve already been diagnosed with myeloma, let your medical team know if you get any new symptoms. 

Can I be screened for multiple myeloma?

Testing for multiple myeloma when you have no symptoms is called screening. There is no multiple myeloma screening programme. This is because there have been no tests proven to help predict this cancer.

If you are worried about myeloma, write down the symptoms you have noticed and whether you have any family history of myeloma and contact your family doctor (GP). 

Diagnosing multiple myeloma 

Your family doctor (GP) will talk to you about your symptoms and arrange blood tests, if needed. If your blood test is abnormal you will be referred to hospital for more tests, such as further blood and urine tests and scans.  Read more about tests for multiple myeloma.