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Diagnosis of Myeloma

Diagnosing myeloma

Doctors sometimes find myeloma following a routine blood test. Other times, they suspect multiple myeloma after an x-ray for a broken bone.

But most often, patients consult their doctor because they are experiencing symptoms, such as pain (the reason 70% of patients seek medical advice).

Because the symptoms of myeloma are often vague and resemble symptoms associated with other health issues, patients suspected of having myeloma will usually be referred to a hematologist (blood specialist) for further tests to confirm the diagnosis. 

Types of tests performed

  Diagnostic testing Prognostic testing
Objectives To determine if the patient has myeloma, and at which stage of the disease he or she is in.  To determine how aggressive the disease is and identify the best course of treatment.
When performed When myeloma is suspected. As required to assess the progression of the disease and the effectiveness of treatment.

Blood tests

  • Complete blood count (CBC) to measure the number of red blood cells, white blood cells and platelets.
  • Blood chemistry to measure total protein and calcium in the blood, as well as indicators of kidney function.
  • Other specialized blood tests to confirm the diagnosis and assess disease progression.

Urine tests

  • Urinalysis to measure the amount of protein, free light chains (from immunoglobulins), creatinine (a waste product excreted by the kidneys) and bilirubin (a breakdown product of red blood cells)
  •  24-hour urine test to measure the amount of protein in urine over a day
  • Other specialized urine tests to help determine the disease stage and the response to treatment

Tests conducted on the bone

  • X-rays to check for changes in the bone structure and identify weak spots (if any).
  • Bone (skeletal) survey of the skull, spine, arms, ribs, pelvis and legs.
  • Less frequently, other tests such as magnetic resonance imaging (MRI), computerized axial tomography (CAT or CAT-scan) or positron emission tomography (PET-scan).
  • Bone marrow aspiration, a test that involves drawing a sample of liquid bone marrow through a needle, so the genetics of the plasma cells can be studied. (May need to be repeated, if required.)
  • Bone marrow biopsy, a test that involves inserting a needle into the bone and taking a small sample of solid bone tissue. (Usually performed at the time of initial diagnosed and may not need to be repeated.)

When undergoing treatment, some people may need to undergo prognostic tests monthly or even weekly. At other times, tests may not be required for much longer periods of time.

There is no single schedule for testing. Each patient's condition must be assessed and treated individually.

For more information, download the Multiple Myeloma Patient Handbook
Designed to provide educational support to patients, caregivers, families, and friends, this handbook gives accurate, reliable, and clear information on myeloma. Topics cover its causes and effects, how it is diagnosed, and the treatment options available in Canada.
Download it now.