Understanding Multiple Myeloma: The Diagnosis

Doctors sometimes find multiple myeloma after a routine blood test. Often, doctors suspect multiple myeloma after an X-ray for a broken bone. Your doctor will probably order some of the following tests:

Blood tests: The lab does several blood tests:

  • Multiple myeloma causes high levels of proteins in the blood. The lab checks the levels of many different proteins, including M protein and other immunoglobulins (antibodies), albumin, and beta-2-microglobulin.
  • Myeloma may also cause anemia and low levels of white blood cells and platelets. The lab does a CBC (complete blood count) to check the number of your white blood cells, red blood cells, and platelets.
  • The lab also checks for high levels of calcium.
  • To see how well your kidneys are working, the lab tests for creatinine.

Urine tests: The lab checks your urine for Bence Jones protein, a type of M protein. The lab measures the amount of Bence Jones protein in urine collected over a 24-hour period. If the lab finds a high level of Bence Jones protein in your urine sample, doctors will monitor your kidneys. Bence Jones protein can clog your kidneys and damage them.

X-rays: You may have an X-ray to check for broken or thinning bones. An X-ray of your whole body can be done to see how many bones could be damaged by the myeloma. 

Bone Marrow Biopsy: This is the only way to know for sure whether myeloma cells are in your bone marrow. In a biopsy, your doctor removes tissue to check for cancer cells.

Bone Marrow Biopsy

Here’s what you can expect from a bone marrow biopsy. Before the biopsy begins, your doctor will use local anesthesia to numb the area so the procedure is not painful. Then your doctor will remove some bone marrow. This is taken from either your hipbone or another large bone. A pathologist uses a microscope to check the tissue for myeloma cells.

There are 2 main types of biopsy procedures:

  • Bone marrow aspiration: Your doctor uses a thick, hollow needle to remove samples of bone marrow fluid and cells.
  • Bone marrow biopsy: Your doctor uses a thick, hollow needle to remove a sample of bone marrow and also a small sample of bone.

You may want to ask your doctor these questions before having a bone marrow aspiration or biopsy:

  • Will you remove the sample of bone marrow from the hip or from another bone?
  • Where will I go for this procedure?
  • Will I have to do anything to prepare for it?
  • How long will it take? Will I be awake?
  • Will it hurt? What will you do to prevent or control the pain?
  • Are there any risks? What are the chances of infection or bleeding after the procedure?
  • Do I need to take any special precautions after the procedure?
  • How long will it take me to recover?
  • How soon will I know the results? Who will explain them to me?
  • If I do have multiple myeloma, who will talk to me about next steps? When?

Next: What are the stages of multiple myeloma?

Back to “Understanding Multiple Myeloma: An Introduction”