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Should I see a myeloma specialist?

Men and women discussing myeloma

This page tells you about the guidelines that GPs in the UK have. The guidelines help them decide who needs to see a specialist if they have symptoms that could be due to myeloma and how soon. You can go straight to sections about

 

A quick guide to what's on this page

Guidelines for urgent referral

Myeloma is rare and the symptoms can be similar to other medical conditions. So it can be very difficult for GPs to decide who may have myeloma and who has something less serious. But there are particular symptoms that mean your GP should refer you to a specialist straight away. The National Institute for Health and Care Excellence (NICE) guidelines say if you are

  • Over 60 with persistent bone pain, back pain or an unexplained fracture you should be offered a full blood count and other blood tests.
  • Over 60 with a high calcium level or low white blood cells and other symptoms that seem like you could have myeloma, you should be offered special blood and urine tests within 2 days
  • If you have abnormal blood test results at any age that suggest you could have myeloma, your GP should arrange a special urine test within 2 days
  • If the results of your urine or blood tests suggest you might have myeloma, your GP should make an urgent referral to a haematologist within 2 weeks

If you are concerned that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it with you to an appointment.

 

CR PDF Icon You can view and print the quick guides for all the pages in the about myeloma section.

 

 

How common myeloma is

Myeloma is an uncommon type of cancer that develops from cells in the bone marrow called plasma cells.

 

About UK referral guidelines

The symptoms of myeloma are similar to some other medical conditions. So it can be very difficult for GPs to decide who may have myeloma and who may have something much more minor that will go away on its own. With many symptoms, it is perfectly right that your GP should ask you to wait to see if they get better or respond to treatment such as antibiotics. If GPs referred everyone who came to see them to a specialist immediately, the system would get jammed and people needing urgent appointments wouldn't be able to get them.

The National Institute for Health and Care Excellence (NICE) has produced guidelines for GPs to help them decide which patients need to be seen urgently by a specialist. There are particular symptoms that mean your GP should refer you straight away.

Seeing a specialist

While reading these guidelines, it is important to remember that

  • Nearly everyone diagnosed with myeloma is over 50
  • Fewer than 2 in every 100 people diagnosed (2%) are under 40
  • The most common symptom is bone pain, which may affect more than 7 out of 10 people (70%) with myeloma
  • Other common symptoms are fractures, kidney problems and symptoms from a low red blood cell count (anaemia) such as tiredness and breathlessness
  • Myeloma is rare – on average, a GP will only see about 2 cases during their career
 

Guidelines for urgent referral

The National Institute for Health and Care Excellence (NICE) guidelines say if you are

  • Aged 60 years or over with persistent bone pain, back pain or an unexplained fracture you should be offered a full blood count and other blood tests
  • Aged 60 or over with a high calcium level or low white blood cells and other symptoms that seem like you could have myeloma, you should be offered special blood and urine tests within 2 days

The NICE guidelines also say that your GP should arrange for you to have a special urine test within 2 days if

  • Your blood test results are abnormal and suggest that you could have myeloma (at any age)

If the results of your urine or blood tests suggest you could have myeloma then your GP should make an urgent referral to a haematologist within 2 weeks.

 

If you are worried

It is important to bear in mind that some of these symptoms can be caused by other less serious medical conditions and do not always mean that you have myeloma. The doctor's experience helps them to work out who may be showing signs of a serious illness and who is more likely to have something more minor that will go away on its own.

If you are worried that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it along to an appointment. Ask your GP to talk it through with you and then you may be able to decide together whether you need to see a specialist and if so, how soon.

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Updated: 2 July 2015