In 2021, approximately 34,920 adults in the United States will be diagnosed with multiple myeloma.
Multiple myeloma is a rare blood cancer that is often fatal. But survival rates are improving steadily over time, and multiple myeloma tests are a huge reason for that.
Diagnosing multiple myeloma can be time-consuming and scary, but the more you know about myeloma and the testing involved, the easier it will be.
If you have signs and symptoms of multiple myeloma and want to know what's next, you're in the right place. Keep reading this guide to learn everything you need to know about multiple myeloma and multiple myeloma tests.
What is Multiple Myeloma
Multiple myeloma is a blood cancer that forms in your plasma cells. Your plasma cells help fight infections by producing antibodies that can recognize germs and attack them.
When you have multiple myeloma, your body begins to produce abnormal plasma cells. These plasma cells try to make antibodies just like your normal plasma cells do, and only the difference is these antibodies don't function normally. The abnormal antibodies are monoclonal proteins or M proteins.
You then start to accumulate these abnormal plasma cells and antibodies in your body, leading to multiple myeloma symptoms such as fatigue, bone lesions, and the lack of ability to fight infections.
Types of Multiple Myeloma
There are two main types of multiple myeloma, indolent multiple myeloma and active multiple myeloma. There are also different subtypes of myeloma, categorized by their chromosomal abnormalities.
Indolent multiple myeloma is sometimes called asymptomatic myeloma because it doesn't cause symptoms. For a diagnosis of indolent myeloma, you need to have 10% or more of the blood cells in your bone marrow made up of plasma cells, or an M protein level of 30 g/L or higher in your blood.
Different risk levels predict when indolent myeloma might turn into active myeloma. These risk levels are low, intermediate, and high-risk.
The next type is active multiple myeloma, also known as symptomatic multiple myeloma. People with active multiple myeloma will have symptoms of multiple myeloma along with any of the following:
- 10% or more of the blood cells in your bone marrow are plasma cells
- M protein in your blood or urine
- Anemia, kidney failure, or hypercalcemia
- A tumor in bone or soft tissue that contains myeloma cells
- Osteolytic lesions
The Condition MGUS
A monoclonal gammopathy of undetermined significance (MGUS) can be a precursor to developing multiple myeloma in the future. This is a condition where you have a high monoclonal protein count in your blood but no other symptoms.
Usually, MGUS doesn't cause problems, but it can develop into multiple myeloma. For this reason, if you have MGUS, you'll need to have regular checkups to be sure it doesn't progress.
Risk factors for Multiple Myeloma
While cell mutations cause multiple myeloma, certain factors increase your risk of getting multiple myeloma like:
- Old age, especially if you're older than 65
- If you're male
- If you're African American
- If you have a sibling or parent with myeloma, your risk increases
- If you're diagnosed with MGUS
Causes of Multiple Myeloma
Researchers aren't entirely sure what causes multiple myeloma, but it seems to be related to DNA mutations that alter chromosomes and turn off genes that naturally suppress tumors.
Signs and Symptoms of Multiple Myeloma
Symptoms of multiple myeloma can vary, especially early in the disease process. When you do have symptoms, you can expect:
- Bone pain around your spine or chest
- Nausea and loss of appetite
- Constipation
- Fatigue
- Weight loss
- Extreme thirst
- Mental fogginess
- Weakness or numbness
- Frequent infections
- Elevated calcium levels
The most common symptoms of multiple myeloma are commonly referred to using the acronym CRAB.
C stands for elevated calcium levels from bones breaking down. R stands for renal (kidney) failure, which occurs from abnormal proteins in the kidneys. A stands for anemia which is caused by the abnormal plasma cells crowding out the healthy cells. And B stands for bone lesions that most commonly occur in the spine and ribs.
Complications of Multiple Myeloma
Multiple myeloma can cause your bones to become weaker, leading to multiple fractures. Myeloma also causes anemia, which means your body doesn't have enough red blood cells.
You can also experience low platelets in your blood, making it more difficult for your blood to clot. You're also more susceptible to infections and low white blood cells, which weaken your immune system even further.
The M proteins in multiple myeloma can clog your kidneys, causing them not to filter out toxins like they usually would. The build-up eventually leads to kidney failure.
How is Multiple Myeloma Diagnosed
Diagnosing multiple myeloma often happens by accident when you have blood drawn for another reason. Your doctor will ask you questions like:
- How long you have had symptoms?
- Are your symptoms becoming worse over time?
- Does anything improve your symptoms?
- Does anything make them worse?
Your doctor will order diagnostic tests and blood work. Initial bloodwork typically includes a complete blood count to measure the cells in your blood and kidney function tests to check how your kidneys are functioning.
Other blood and urine tests will be ordered to check if your body is making monoclonal proteins, and if so, how much.
More examinations include CT Scans and an MRI to check your bones for tumors or damage. And finally, a bone marrow biopsy will determine how many abnormal plasma cells are in your bone marrow.
Lab Tests For Multiple Myeloma
One of the first tests your doctor will order is a complete blood count. A complete blood count will show red blood cells and platelets and give an overall picture of how your immune system functions.
Next, your doctor will want to assess the overall health of your kidneys and other organs by checking a complete metabolic panel. This panel will check your kidney and liver function, as well as your calcium levels.
A lactate dehydrogenase level (LDH) is checked as elevations in your LDH can point to certain cancers like myeloma.
Next, an immunofixation urine test (IFE) is useful in evaluating the number of monoclonal proteins that collect in your urine which is one of the main signs of myeloma.
Your doctor will also want to check the levels of your immunoglobulins by ordering an immunoglobulin panel (IgA, IgG, IgM). Elevations of these immunoglobulins are found in certain cancers like multiple myeloma.
A total protein and electrophoresis is a blood test the measures specific proteins in the blood. In this test, proteins are separated by their electrical charge, and it's often used to detect if you have monoclonal proteins in your blood.
Other tests that help with the treatment, diagnosis, and type of myeloma you have include the kappa/lambda light chains lab test. This test measures how many immunoglobulin-free light chains you have. If these levels are high, you have what's called a light chain type of myeloma. The surface light chains test is another way to detect how many light chains are on the cell's surface.
A beta-2-microglobulin lab test measures another protein made by abnormal myeloma cells. This protein in itself doesn't cause problems, but in multiple myeloma, high levels of this may indicate a poor prognosis.
FAQS about Multiple Myeloma
Common questions about multiple myeloma usually start with asking if there is a cure. There is no cure for multiple myeloma, but treatments are improving every day. Life expectancy is also increasing, now extending over five years past diagnosis. And some people beat the odds, living another 10 to 20 years or more.
Are you wondering what happens if you are diagnosed with indolent myeloma? The good news is you only have a 10% risk each year of it progressing to active multiple myeloma. And people can have indolent myeloma for many years and never need treatment.
Do you need to see a specialist who explicitly treats multiple myeloma? Yes, it's a good idea to find an oncologist who focuses on treating and researching multiple myeloma. Specialists have better knowledge of new research, treatments, and clinical trials.
Resources
A great resource to check out is the National Comprehensive Cancer Network. This network is not for profit and combines 31 cancer centers devoted to research and education. You can find updates on webinars, conferences, and updated multiple myeloma guidelines for patients on this site.
Multiple Myeloma Tests at Ulta Lab Tests
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Order your multiple myeloma lab tests today, and your results will be provided to you securely within 24 to 48 hours in most cases.
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