Multiple myeloma often doesn’t have any symptoms in its early stages. Nonspecific symptoms, like bone pain, weakness, and fatigue, are often the first to appear.

Early stage multiple myeloma is often asymptomatic (has no symptoms). When early symptoms of multiple myeloma do occur, they’re often subtle and go overlooked. Failure to identify multiple myeloma early can delay diagnosis and treatment. In some instances, it may also affect survival rates.

In this article, we’ll discuss the early symptoms of multiple myeloma and when to get medical help.

Like most cancers, multiple myeloma causes rapid, irregular cell growth. When myeloma cells multiply, they reduce the space needed for healthy blood cell growth. This effect reduces the number of red blood cells, white blood cells, and platelets produced and housed within blood marrow.

As severe as this sounds, early stage myeloma often doesn’t cause apparent physical symptoms.

When early signs and symptoms of multiple myeloma do occur, they may include:

  • bone pain in the hips, chest, spine, or other areas
  • bones that break easily
  • anemia
  • reduced appetite
  • fatigue
  • frequent infections
  • severe constipation
  • weakness, swelling, or numbness in the legs
  • increased thirst and urination
  • brain fog or confusion
  • kidney disease or failure

Myeloma causes observable changes in blood and urine, which may show up during routine exams. These changes can show up before symptoms occur. They include:

What conditions can be mistaken for multiple myeloma?

The early symptoms of myeloma may be confused with a wide range of common conditions, including:

Multiple myeloma can also be confused with other blood cancers and disorders, such as Waldenstrom macroglobulinemia and light-chain amyloidosis.

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There’s no current standard screening test for multiple myeloma in the general population.

If you have a condition that increases your risk of multiple myeloma, such as monoclonal gammopathy of undetermined significance (MGUS) or solitary plasmacytoma, a doctor may order blood and urine tests to check for it regularly.

It’s easy to ignore feeling “not quite right.” You may have vague symptoms you suddenly realize you’ve been having for some time.

No one knows your body as well as you do. If you’re experiencing back pain, constipation, fatigue, or increased thirst and urination, speak with a healthcare professional. Even if these symptoms are mild, they may signal an underlying health condition.

These symptoms will often indicate a different diagnosis, but it’s always a good idea to know for sure, especially if you have certain risk factors. The earlier a condition gets a diagnosis of any type, the sooner treatment and improvement the outlook of a person with the condition can begin.

If a healthcare professional suspects you may have multiple myeloma, they can perform diagnostic tests, including:

If a doctor confirms a multiple myeloma diagnosis, they can recommend treatments to ease symptoms, reduce your chances of complications, and slow disease progression.

Who’s at risk of multiple myeloma?

Multiple myeloma is most common in people more than 65 years of age. It’s twice as common in Black people than in white people and is slightly more common in males.

Having overweight or obesity increases your risk. Having exposure to high levels of ionizing radiation, such as X-rays, may also increase your risk of multiple myeloma.

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Where does myeloma usually start?

Myeloma originates in bone marrow. Bone marrow is a gelatinous, spongy substance located in the inner cavity of bones that produce blood cells.

In adults, bone marrow is mostly found in the bones of the pelvis, skull, ribs, and spine. Myeloma may originate in any of these areas.

How long can you have multiple myeloma before knowing?

It’s possible to have multiple myeloma for months or years without knowing. The first stage, smoldering multiple myeloma (SMM), is rarely accompanied by symptoms that might clue you into its occurrence. You may not experience hallmark symptoms until SMM turns into active multiple myeloma.

Both SMM and active multiple myeloma produce irregular blood test findings.

How quickly does multiple myeloma progress?

According to 2020 research, about 42% of people with SMM progress to active myeloma within 5 years. After that time, the rate of progression decreases, but about 64% of people will progress to active disease within 10 years.

Active myeloma can spread out of the bone marrow and into other areas of the body. Once this occurs, the rate of progression depends upon various factors, including the extent of the spread, your age and health, and your treatment options.

Multiple myeloma typically has no symptoms during its early stages. When symptoms occur, they may be mistaken for other conditions. Potential early symptoms of myeloma may include bone pain, severe constipation, increased thirst, and increased urination.