The varying symptoms of multiple myeloma

The symptoms of myeloma vary between patients. In the beginning, myeloma may be asymptomatic. Sometimes myeloma can be detected by accident when blood tests are taken for another reason.

Symptoms of myeloma in the body

Sometimes multiple myeloma is difficult to detect based on symptoms. The symptoms may be very vague or resemble those of other diseases. Some symptoms may also be associated with the complications of myeloma.

Sometimes myeloma may progress quietly for a long time, without causing any symptoms. Sometimes the skeletal changes may be fast and even cause trouble moving.

The most common symptoms of multiple myeloma are described below.

Anaemia and fatigue

The general symptom of myeloma and a common symptom at the time of diagnosis is anaemia and the fatigue it causes. Anaemia may also cause palpitations, impaired performance and breathlessness.

Anaemia is caused by low levels of red blood cells in the blood. Red blood cells are needed to transport oxygen round the body. In myeloma, malign plasma cells interfere with the normal production of red blood cells in the bone marrow, which often results in anaemia. A decrease in red blood cells is found in about 60% of patients at diagnosis.

Most patients with myeloma experience fatigue at some point. The reason for fatigue is often anaemia, but it may also be due to renal impairment or increased calcium levels in the blood. In this case, the patient may experience extreme tiredness and fatigue that persists even after sleeping or resting.

Treatments for myeloma can often alleviate these symptoms. Anaemia and the resulting fatigue can be treated with dietary supplements, medicines and blood transfusions. Fatigue can sometimes also be alleviated by a healthy diet, regular light exercise and by ensuring sufficient sleep.

Skeletal pain and problems

Common symptoms of myeloma include back pain and skeletal pain in some part of the body. Multiple myeloma can also spread from the bone marrow into the skeleton and cause changes, damage and lesions, for example in spinal vertebrae, ribs, skull, pelvis and bones in the limbs.

The myeloma cells growing in the bone marrow often cause local bone damage or loss, i.e. osteoporosis. This may make the patient vulnerable to bone fractures, sometimes even as a result of a minor injury. Some degree of bone loss caused by myeloma is observed in 85% of patients at diagnosis.

Painful and extensive skeletal lesions caused by myeloma can be treated with radiation therapy. Skeletal changes can also be prevented with bisphosphonate medication. Read more on supportive care in myeloma.

Symptoms caused by increased calcium levels

The skeletal damage induced by myeloma may result in increased blood calcium levels (hypercalcaemia). The symptoms include:

• urinary changes

• restlessness and confusion

• increased thirst

• nausea and loss of appetite.

Renal dysfunction

Myeloma may cause kidney damage and result in renal impairment. This can cause oedema, tiredness and nausea.

Kidney problems may be the result of factors such as excessive blood calcium levels or an abnormal protein caused by myeloma, which damages the kidneys.

More than one half of patients with myeloma have impaired kidney function at some point of the disease.

Susceptibility to infections

As myeloma interferes with the immune system, it makes people with myeloma more susceptible to infections. Respiratory infections often occur in people with myeloma.

Please describe your symptoms to your doctor as closely as possible. Do not play down your symptoms or assume they are insignificant.