Referral to a specialist

Your GP should arrange for you to see a specialist if you have symptoms or abnormal blood test results that could be due to myeloma.

Depending on your symptoms and other factors (such as blood test results), this might be an urgent referral.

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

UK referral guidelines

There are guidelines for GPs to help them decide who needs to have a blood test and who needs a referral to a specialist. This is a blood specialist called a haematologist. 

Usually doctors use blood and urine tests to look for abnormal proteins (monoclonal protein). These proteins might also be called M-protein or paraprotein. 

Most of the UK nations have targets for suspected myeloma, For example, you might have blood tests very urgently within 2 days. Or you may see a specialist immediately (within a few hours). These time frames are not included in Scotland guidance. But wherever you live, you are seen as quickly as possible.

Urgent referral

These guidelines vary slightly between the different UK nations. The following is a summary.

Guidelines say if you are:

• aged 60 years or over with persistent bone pain, particularly back pain, or have 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

Your GP will offer a special blood or urine test within 2 days at any age if your blood and urine tests are abnormal, and suggest that you could have myeloma. 

If the results of your urine or blood tests, or other tests such as bone X-rays, suggest you could have myeloma then your GP will make an urgent referral to a haematologist.

Remember that myeloma is uncommon, and very rare in people under 40. Having symptoms such as back pain can be caused by other conditions, and does not always mean that you have myeloma. But it is important to be checked out.

If you're still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to talk it through with you. Together you can decide if you should see a specialist.