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The possible symptoms of myeloma and when to see a doctor.

Lack of healthy blood cells

Myeloma does not always cause symptoms in its early stages, and might be picked up on a routine blood test.

Symptoms happen because there are abnormal plasma cells in your bone marrow. The abnormal plasma cells damage the bones and crowd out the normal blood cells. So you might have too few white cells, red cells and platelets.

You might be more prone to infection, such as chest infections. Once you have an infection, it might take longer to get better. This is because you do not have enough healthy white blood cells to fight the bacteria or viruses.

Abnormal bruising and bleeding can happen because the large numbers of plasma cells in your bone marrow have stopped platelets from being made. 

Breathlessness and tiredness can happen because you do not have enough red blood cells (anaemia).

Bone pain and bone damage

Up to 70 out of every 100 people (70%) have pain when they are diagnosed with myeloma. People mostly describe the pain as dull or aching, and it is often felt in the lower back or ribs.

Pain in the bones is caused by a lot of plasma cells collecting there. The large numbers of plasma cells damage the bones. Occasionally, a bone breaks (fractures).

Too much calcium in your blood

When the bones are damaged, calcium is released into the bloodstream. Too much calcium in the blood is called hypercalcaemia. This makes you feel very thirsty, sick and tired. You might also pass a lot of urine, as your body tries to get rid of the extra calcium. If hypercalcaemia is not treated and gets worse, it can make you drowsy and difficult to wake.

About 30 out of 100 people (30%) with myeloma have symptoms like these when they first go to the doctor.

Swollen ankles

Your ankles can get swollen because your kidneys are not working properly. This is a later symptom of myeloma.

The large amounts of antibody protein (immunoglobulin) made by the abnormal plasma cells can damage your kidneys as it passes through from the bloodstream to the urine.

The antibody protein is called the Bence Jones protein.

When to see your doctor

Your symptoms are unlikely to be cancer but it is important to get them checked by a doctor.

You should see your doctor if you have:

  • pain in your bones (especially in your lower back or ribs) 
  • tiredness, shortness of breath or weakness 
  • repeated infections or infection that is difficult to clear 
  • unusual bleeding or bruising 
  • swollen ankles 
  • symptoms that are unusual for you
  • symptoms that do not go away 
Last reviewed: 
01 Dec 2015
  • Review of 1027 patients with newly diagnosed multiple myeloma
    R Kyle and others
    Mayo Clinic Proceedings, 2003, Volume 78, Issue 1

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

  • Cancer: Principles and practice of oncology (9th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2011

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