Multiple myeloma is a rare type of cancer that affects your bone marrow and changes your blood’s plasma cells. There are several signs and symptoms, including fatigue, frequent infections, and bone problems.

Multiple myeloma leads to a buildup of cancer cells in your bone marrow. Eventually, the cancer cells overtake healthy blood cells, and your body can no longer produce disease-fighting antibodies. Instead, it creates harmful proteins that damage your kidneys and cause other signs and symptoms.

Knowing the most common signs and symptoms of multiple myeloma may help you detect it before it becomes advanced. You should consult a doctor immediately if you notice any of the potential warning signs.

Symptoms of multiple myeloma aren’t always easy to detect, and some signs can be detected only by a healthcare professional. You might not experience symptoms in the early stages of multiple myeloma. And as the cancer advances, the symptoms can vary greatly.

The most common signs and symptoms of multiple myeloma include:

  • Fatigue: Healthy cells allow your body to fight invading germs easily. As myeloma cells replace bone marrow, your body has to work much harder with fewer disease-fighting cells, which may cause you to tire more easily.
  • Bone problems: Myeloma can prevent your body from making new bone cells, leading to problems such as bone pain, weakened bones, and broken bones.
  • Kidney problems: Myeloma cells produce harmful proteins that can cause kidney damage and even kidney failure.
  • Low blood counts: Myeloma cells crowd out healthy blood cells, leading to anemia (low red blood cell count) and leukopenia (low white blood cell count). Low blood cell levels make it harder for your body to fight infections.
  • Frequent infections: Fewer antibodies in your blood make fighting infections more difficult.

Other common symptoms of multiple myeloma include:

Unlike healthy cells, cancer cells don’t mature and function properly, and they don’t die when they are no longer needed (a process called apoptosis). Instead, they continue to live and build up. In the case of multiple myeloma, cancer cells rapidly multiply and eventually overwhelm your bone marrow.

The production of cancer cells outpaces the production of healthy blood cells, and the cancer cells crowd out the healthy ones. This can lead to anemia, fatigue, and frequent infections.

Instead of producing helpful antibodies such as healthy plasma cells, myeloma cancer cells produce abnormal and harmful antibodies. Your body can’t use these antibodies, which are called monoclonal proteins or M proteins. Over time, these proteins build up in your body and can damage your kidneys.

If a doctor suspects that you have cancer, they may order several tests, such as a CT scan, an MRI scan, or a bone X-ray to confirm the presence of cancer. Doctors diagnose multiple myeloma when there is evidence of a plasma cell tumor or at least 10% of plasma cells in the bone marrow.

Lab tests, such as blood and urine tests, are some of the first tools for diagnosing multiple myeloma. These tests can include:

  • complete blood counts
  • blood chemistry tests
  • different types of urine tests
  • quantitative immunoglobulins
  • electrophoresis
  • serum free light chains
  • beta-2 microglobuin

Unlike blood tests, which require a liquid sample, a biopsy involves taking a tissue sample from the tumor, lymph node, or bone marrow. Common biopsies used to diagnose multiple myeloma are:

  • bone marrow biopsy
  • fine needle aspiration biopsy
  • core needle biopsy

Once a doctor has confirmed a diagnosis of multiple myeloma, the next step is to see how far the cancer has spread in your body. Multiple myeloma is categorized into three stages, and the stage can determine the survival rate and treatment options.

In stage 1, you will have:

  • serum beta-2 microglobulin of less than 3.5 milligrams per liter (mg/L)
  • albumin level of 3.5 grams per deciliter (g/dL) or greater
  • bone marrow test results that do not classify you as high risk
  • healthy lactate dehydrogenase (LDH) levels

In stage 3, you will have:

  • serum beta-2 microglobulin of 5.5 mg/L or greater
  • bone marrow test results that classify you as high risk
  • high LDH levels

Doctors may classify your cancer as stage 2 if it does not meet the criteria for stage 1 or stage 3.

Several factors can increase your risk of developing multiple myeloma, including:

  • Being older: Risk increases with age. Most people who receive a diagnosis of this disease are in their mid-60s. According to the American Cancer Society, fewer than 1% of people who receive a diagnosis of multiple myeloma are younger than 35 years old.
  • Being African American: African Americans are twice as likely as white Americans to develop this type of cancer.
  • Being a man: Men are more likely to develop multiple myeloma than women.
  • Having a family history of the disease: If you have a sibling or a parent who has had myeloma, you’re more likely to develop it than someone without a family history. However, family history accounts for only a small number of myeloma cases.
  • Having obesity: Research suggests that having obesity in early or late adulthood increases the risk of multiple myeloma.
  • Having MGUS: In almost all cases, multiple myeloma begins as a benign condition called monoclonal gammopathy of undetermined significance (MGUS), which involves low levels of monoclonal proteins (M proteins).

Multiple myeloma is typically not curable, and people often need many treatments throughout the course of the disease, especially because some treatments may stop working and new ones will need to be introduced.

Multiple drug therapies are available to manage the symptoms, eliminate multiple myeloma cells, and slow the spread of the cancer.

If you have multiple myeloma, a doctor may offer you one or more of the following treatments:

  • Proteasome inhibitors: drugs that destroy cancer cells by preventing them from removing old proteins
  • Immunomodulatory drugs: drugs that activate immune cells to better detect and dispose of myeloma cells
  • Histone deacetylase inhibitors: drugs that suppress the cell cycle and stop cancer cells from growing and dividing
  • Monoclonal antibodies: a treatment that boosts your immune system by bringing in antibodies that target specific proteins on myeloma cells
  • Chemotherapy: drugs with powerful chemicals that destroy rapidly growing and dividing cells
  • Radiation therapy: a treatment in which high energy particles are administered to your body or a specific bone area to injure cancer cells and stop them from growing

Steroids are another common treatment for multiple myeloma. They help manage pain and pressure by decreasing inflammation. They also work to reduce side effects of chemotherapy, such as nausea and vomiting.

Dexamethasone and prednisone are two prescription steroids that, when given in high doses, can reduce the number of myeloma cells.

To better manage multiple myeloma symptoms such as kidney failure, a doctor may add supportive care drugs to your treatment regimen.

Every person is different, as is their outlook and the way the disease will ultimately affect them.

It’s important to pay attention to any persistent and unexplained symptoms you experience — even minor ones. In many cases, these symptoms can be easily explained, but if unusual symptoms persist, you should speak with a doctor.

Did you know?

According to the American Cancer Society, about 35,780 people will be diagnosed with multiple myeloma in 2024.

Was this helpful?

Multiple myeloma is a rare type of blood cancer that affects your bone marrow and changes your plasma cells.

There are many symptoms to look out for, including:

  • fatigue
  • frequent infections
  • bone problems

Knowing the most common signs and symptoms of multiple myeloma may help you detect the disease before it becomes advanced. If you notice any of the potential symptoms, consult a doctor immediately.