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Tests for myeloma

Men and women discussing myeloma

This page tells you about tests to diagnose myeloma. You can find the following information

 

A quick guide to what's on this page

Tests for myeloma

You will usually see your GP first, who will examine you and ask about your general health and medical history. Your doctor will ask about your symptoms, and may carry out a physical examination to look for things such as bruising, bleeding or signs of infection. They may ask you to have blood and urine tests.

At the hospital

If your doctor suspects that you may have multiple myeloma, they will arrange for you to see a blood disorders specialist (a haematologist) at your local hospital. At the hospital, the haematologist will ask about your medical history and symptoms. They will examine you and arrange some more tests. You may have blood tests, a urine test, bone marrow tests and X-rays.

Getting your results

Waiting for test results is an anxious time. It may take a week or two to get all the results. You may find it helpful to take someone with you to the appointment for support.

While you are waiting for results, it may help to talk about how you are feeling with a close friend or relative. Or you may prefer to talk things through with one of Cancer Research UK's cancer information nurses. You can phone them on 0808 800 4040.

If you want to find people to share experiences with online, you can use CancerChat, our online forum.

 

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

 

 

At the GP surgery

Most people go to the GP when they first suspect they have a health problem. Your doctor will examine you and ask about your general health and medical history. They will also ask you about your symptoms. This will include what they are, when you get them and whether anything you do makes them better or worse.

Your doctor may give you a physical examination to look for things such as bruising, bleeding or signs of infection. They will probably ask you to have some blood tests. You may also have a urine test to look for particular proteins.

If your doctor suspects that you may have multiple myeloma, they will arrange for you to see a haematologist at your local hospital. A haematologist is a medical doctor who specialises in diseases of the blood.

 

At the hospital

At the hospital, the haematologist will ask about your medical history and symptoms. They will examine you and arrange some more tests. You may have any or all of the following tests.

 

Blood tests

There are various blood tests that help to diagnose myeloma. These include

Erythrocyte sedimentation rate (ESR)  

This test shows the doctor whether the red blood cells (erythrocytes) are sticking together, forming clumps. An abnormal ESR can be a sign of many illnesses or conditions, such as arthritis, infections and inflammation. But it can also be raised in myeloma, so an abnormal ESR may prompt your doctor to do further tests, particularly if there's no obvious reason for the ESR to be raised.

Serum protein electrophoresis

Serum protein electrophoresis (SPEP) measures the amount of immunoglobulins (antibodies) in the blood. Another test called immunofixation electrophoresis shows the exact type of abnormal antibody (also called M protein or paraprotein), such as IgG or IgA. Doctors can also use these tests to monitor how well treatment for myeloma is working. 

Full blood count

Your specialist will do a full blood count to check the levels of the different types of blood cells. If any of the blood cells are abnormal, it can indicate how your bone marrow has been affected by the myeloma. The doctor will be looking out for low numbers of red blood cells or platelets. Sometimes there are low numbers of the different types of white blood cells as well. 

Read about different blood cells.

Serum free light chain (SFLC) assay

The serum free light chain (SFLC) assay picks up tiny amounts of small proteins called free light chains in the blood. It is particularly useful for diagnosing and monitoring light chain myeloma and some non secretory myelomas. 

Urea and creatinine

Urea and creatinine are waste products that your body gets rid of in the urine. Raised levels mean that your kidneys aren't working properly.

Calcium level

Your doctor will also check your blood calcium level. The calcium level can be raised if the myeloma cells are speeding up the breakdown of bone.

Beta 2 microglobulin (ß2-microglobulin)

This blood test measures the level of a protein called beta 2 microglobulin. The level is raised in myeloma. This test can help the doctor know how advanced your myeloma is (the stage).

Albumin level

Albumin is a protein in your blood that is produced by your liver. If you have myeloma your albumin level can be low. This test can help your doctor know more about the stage of your myeloma.

Read about the stages of myeloma.

 

Urine tests

Your doctor will ask you for a urine sample. They will send the sample off to the lab, where a pathologist checks for abnormal antibodies (paraproteins) made by the myeloma cells. One part of the paraprotein is the light chain or Bence Jones protein, which the body gets rid of in the urine. Many people with myeloma have Bence Jones protein in their urine. These protein molecules can damage the kidneys as they pass through them from the blood to the urine. 

Your doctor or nurse may ask you to collect all the urine you pass for 24 hours. This shows how much Bence Jones protein you are producing. Doctors are increasingly using the SFLC blood test instead of this.

 

Bone marrow test

This is called a bone marrow aspirate and biopsy. It is a test to see if there are any abnormal plasma cells in your bone marrow and how many there are. For this test, the doctor removes a sample of bone marrow cells (aspirate) to look at under the microscope. They may also remove a sample of bone (biopsy).

Your doctor may also do some tests called cytogenetics (pronounced sigh-toe gen-et-ics). These tests, such as FISH (fluorescence in situ hybridisation), look for abnormalities in your chromosomes. Various research studies are looking into this. A few chromosome changes have been found that can affect how quickly the myeloma develops and how well treatment may work. Doctors may be able to use this information in the future to help decide which patients need more intensive treatment.

 

X-rays

The large numbers of plasma cells being made in the bone marrow can cause damage to the hard outer covering of the bones. It will help your doctor to find this damage if you mention any bones that are painful. Your doctor will ask you to have X-rays of all your long bones, and your spine, pelvis and skull, to find any areas of damage. This is called a skeletal survey. Your doctor may also ask you to have a chest X-ray to check your general health.

 

Getting your test results

Waiting for test results is always an anxious time. It may take a week or two to get your results. It may help to take someone with you to the appointment for support.

While you are waiting for results, it may help to talk about how you are feeling with a close friend or relative. Or you may prefer to talk things through with one of Cancer Research UK's cancer information nurses. You can phone them on 0808 800 4040.

If you want to find people to share experiences with online, you can use CancerChat, our online forum.

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Updated: 7 December 2015