Multiple myeloma often doesn’t have symptoms at first. This can make it difficult to diagnose in the early stages. If you have symptoms, they may include:
- Fractures: Myeloma cells produce substances called cytokines, which can trigger bone cells (osteoclasts) to destroy surrounding bone. When more than 30% of the bone has been destroyed, X-rays show a thinning of the bone (osteoporosis) or dark holes (lytic lesions). The weakened area of bone can break. This is called a pathological fracture.
- Bone pain, especially in the middle and/or lower back, rib cage or hips. The pain can be mild or severe depending on the extent of the multiple myeloma, the speed with which it has developed, and whether fracture or nerve compression has occurred. Typically, movement makes the pain much worse.
- Infection: Because myeloma cells crowd out normal white blood cells, which fight infection, there is a risk of infection. Symptoms depend on where the infection is. Pneumonia, bladder or renal infections, sinusitis and skin infections are common.
- Hypercalcemia: When the bone is destroyed, calcium is released into the blood. As the amount increases, the kidneys are unable to get rid of the calcium in the urine. Symptoms of hypercalcemia include thirst, nausea, constipation and confusion.
- Blood problems, including low levels of white or red blood cells or platelets.
- Renal failure or “myeloma kidney” caused by too much protein or calcium in the blood.
- Nervous system problems: Bones may press on nerves, causing pain, numbness or weakness. Too much protein in blood also may cause this.
- Many organs can be affected by multiple myelom. The signs and symptoms can vary greatly. The mnemonic CRAB is often used to remember some of the common symptoms: C = calcium (elevated), R = renal failure, A = anemia, B = bone lesions.
These signs and symptoms do not always mean you have multiple myeloma. However, it is important to discuss any symptoms with your doctor, since they may also signal other health problems.
Cancer screening exams are important medical tests done when you’re at risk but don’t have symptoms. They help find cancer at its earliest stage, when the chances for successful treatment are best.
Unfortunately, no standardized screening tests have been shown to improve multiple myeloma outcomes. However, here at Banner MD Anderson, we’re working to develop tests to detect multiple myeloma earlier.