Myeloma: symptoms, tests, treatment and outlook

The NHS lists the main symptoms below. Some of them are very common and can be caused by other conditions, so having them does not definitely mean you have myeloma, but it is important to get checked by a GP. If symptoms are caused by cancer, finding it early may make it easier to treat.

The NHS also says that sometimes myeloma does not cause symptoms at first, and that people may find out they have it after having a blood test for another reason.

• Bone pain, which you may feel in your back, hips, shoulders or ribs.

• Feeling very tired for no reason.

• Shortness of breath.

• Muscle weakness.

• Headaches.

• Feeling very thirsty and needing to pee more often than usual.

• Losing weight without trying.

Cancer Research UK describes myeloma as a type of blood cancer that develops from plasma cells in the bone marrow. Plasma cells make antibodies to fight infection. In myeloma the bone marrow makes lots of abnormal plasma cells, which make abnormal antibodies called paraproteins that cannot fight infection normally. "Multiple myeloma" and "myeloma" mean the same thing.

Myeloma does not form a lump or tumour. Cancer Research UK explains that most of the problems it causes come from the build-up of abnormal plasma cells in the bone marrow and the paraprotein in the body. The abnormal cells crowd out normal blood cell production, so there may be too few white cells (more infections), red cells (anaemia, tiredness and breathlessness) or platelets (bruising and bleeding).

It affects areas with active bone marrow, including the arms, legs, shoulders, spine, skull, pelvis and rib cage, which is why it is called multiple myeloma. The NHS says it can also affect the kidneys and immune system, and that it is more common as you get older.

At your GP appointment, the NHS says the doctor may check painful parts of your body and may ask for a pee sample or blood test. If they think you have a condition that needs investigating you may be referred to a specialist, which does not definitely mean you have cancer.

If a GP refers you to a specialist because they think you could have myeloma, the NHS says the main tests usually include a CT or MRI scan and a bone marrow biopsy, where a small piece of bone marrow is removed for testing. You should get your results in 1 to 2 weeks. Cancer Research UK explains that blood and urine tests can detect the paraprotein or its light chains to diagnose and monitor myeloma.

If you are told you have myeloma, you may need more tests such as further blood tests and scans, which help your treatment team decide on treatment. The NHS says you will be helped by a team of specialists including a clinical nurse specialist who is your main point of contact.

The NHS says myeloma can be difficult to treat, and the treatment you have depends on your symptoms, whether the myeloma has come back (relapsed), and your age and general health. Sometimes you may not need any treatment straight away. You may be offered a combination of treatments, and your specialist team will explain the benefits and side effects and agree a plan with you.

The NHS says myeloma cannot usually be cured and may be very hard to treat. The aim of treatment is often to limit the cancer and its symptoms and help you live longer. You will be referred to a palliative care or symptom control team, who work with you to manage symptoms and help you feel more comfortable. The NHS says your clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.

Your outlook depends on your own situation, which only your haematology team can discuss with you. If you are newly diagnosed or your myeloma has returned, charities such as Myeloma UK and Macmillan Cancer Support provide information and support.

The NHS says it is not clear what causes myeloma, but you may be more likely to get it if you are overweight, if a close relative has had myeloma, if you are from a Black African or African Caribbean background, or if you have a condition called monoclonal gammopathy of unknown significance (MGUS) or pernicious anaemia. You are more likely to get myeloma as you get older, and it is slightly more common in men.

Cancer Research UK says myeloma develops when there is a change in the DNA of plasma cells as the bone marrow makes new ones. The NHS says you cannot always prevent myeloma, but losing weight if you are overweight may reduce your risk.

See a GP if you think you may have myeloma. The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have difficulty breathing or are more short of breath than usual.

Call 999 if you or someone else suddenly loses feeling in the arms or legs, cannot walk or stand, suddenly feels confused, or suddenly cannot control when they poo or pee. The NHS says these could be signs of spinal cord compression, which needs treating immediately. Do not drive yourself to A&E.

On the NHS, myeloma is diagnosed and treated by haematology specialists after GP referral, with a clinical nurse specialist as your main point of contact. Treatment is agreed with you by the specialist team.

Some people also see a private haematologist for a second opinion or quicker tests. Ask which treatments are available and whether they are funded, and make sure your NHS team receives all results.