Booklet: What You Need to Know about Multiple Myeloma

Diagnosis

Multiple myeloma may be found as part of a routine physical exam before patients have symptoms of the disease. When patients do have symptoms, the doctor asks about their personal and family medical history and does a complete physical exam. In addition to checking general signs of health, the doctor may order a number of tests to determine the cause of the symptoms. If a patient has bone pain, x-rays can show whether any bones are damaged or broken. Samples of the patient's blood and urine are checked to see whether they contain high levels of antibody proteins called M proteins. The doctor also may do a bone marrow aspiration and/or a bone marrow biopsy to check for myeloma cells. In an aspiration, the doctor inserts a needle into the hip bone or breast bone to withdraw a sample of fluid and cells from the bone marrow. To do a biopsy, the doctor uses a larger needle to remove a sample of solid tissue from the marrow. A pathologist examines the samples under a microscope to see whether myeloma cells are present.

To plan a patient's treatment, the doctor needs to know the stage, or extent, of the disease. Staging is a careful attempt to find out what parts of the body are affected by the cancer. Treatment decisions depend on these findings. Results of the patient's exam, blood tests, and bone marrow tests can help doctors determine the stage of the disease. In addition, staging usually involves a series of x-rays to determine the number and size of tumors in the bones. In some cases, a patient will have MRI if closeup views of the bones are needed.

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