Diagnosis
If a person has any signs or symptoms of multiple myeloma, the doctor will first take a complete medical history and conduct a physical examination. If the doctor suspects multiple myeloma, he or she may order the following types of tests to obtain an accurate diagnosis and determine the stage of the disease. These same tests may also be used to monitor treatment progress.
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Blood Tests
The doctor will first order blood tests such as a complete blood count (CBC) and blood chemistry profile to detect certain symptoms of multiple myeloma. A CBC measures the levels of different types of cells in a person’s blood, and can detect conditions such as anemia (low red blood cells), leukopenia (low white blood cells), and thrombocytopenia (low platelets) caused by multiple myeloma. A blood chemistry profile measures the levels of certain substances in the blood, such as protein, creatinine, calcium, and blood urea nitrogen (BUN). Blood chemistry allows the doctor to assess the function of different organs that may be affected by multiple myeloma. The doctor may then order additional blood tests to detect M-proteins in the blood and determine the specific characteristics of the disease.
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Urine Tests
The doctor may recommend urine tests to detect M-proteins in the urine. High levels of M-proteins in the urine may mean that a person may have multiple myeloma. A 24-hour urine test allows the doctor to determine the total amount of protein released into the urine over the course of 24 hours. The doctor may then order additional tests to determine the type of M-protein present.
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Bone Marrow Aspiration & Biopsy
In multiple myeloma, there are often too many abnormal plasma cells in the bone marrow. In this procedure, the doctor will extract a sample of bone marrow and have it analyzed under a microscope for these abnormalities. The doctor may then order genetic tests on the sample to determine the specific characteristics of the myeloma cells.
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Imaging Tests
The doctor may use different types of imaging to better identify extend of myeloma involvement an /or if myeloma is causing pain or fractures of the bones. Imaging tests such as X-rays of all of the bones of the body, MRI scan, or PET scan may be used to detect bone lesions and plasmacytomas. X-rays of bones can detect bone erosion and lytic bone lesions. MRIs and whole body PET/CT scans are more sensitive and can detect plasmacytomas that do not show up on normal X-rays, as well as abnormalities in the bone marrow. PET scans allow doctors to detect the locations and activity of cancer cells throughout the body.
