Multiple Myeloma
Make an AppointmentHow is Multiple Myeloma Diagnosed?
Multiple myeloma is often detected during routine blood tests or when investigating unexplained symptoms. Diagnosis involves a combination of laboratory tests, imaging, and specialist procedures to confirm the presence of abnormal plasma cells and assess disease severity
Key Diagnostic Tests for Multiple Myeloma
- Blood tests: These detect abnormal proteins (M proteins) produced by myeloma cells. Additional blood tests measure kidney function, calcium levels, and the number of healthy blood cells. Abnormal results may suggest that myeloma is affecting the blood, bones, or kidneys.
- Urine tests: Some people with multiple myeloma have M proteins in their urine, known as Bence Jones proteins. Testing for these helps doctors understand how active the disease is and whether it is affecting the kidneys.
- Bone marrow biopsy and aspiration: A needle is used to collect solid and liquid bone marrow samples, usually from the hip bone. These samples are analysed for myeloma cells and genetic changes, such as those identified by fluorescence in situ hybridisation (FISH).
- Posture and Balance Issues: A stooped posture and impaired balance may lead to falls.
- Imaging tests: X-rays, MRI, CT, and PET scans help identify bone damage or masses (plasmacytomas) caused by myeloma.
Staging and Risk Assessment
Test results help determine the stage of multiple myeloma, ranging from stage 1 (slow-growing) to stage 3 (more aggressive). Staging and risk assessment guide prognosis and treatment planning. Risk levels are based on factors such as genetic markers, blood test results, and the extent of organ involvement.
Treatment Options for Multiple Myeloma
Treatment is tailored to each patient’s stage, symptoms, and overall health. Not all cases require immediate intervention; some may only need regular monitoring, especially if the disease is at an early stage or not causing symptoms (smouldering myeloma).
Main Treatments for Multiple Myeloma
- Targeted therapy: These medicines act on specific molecules that help myeloma cells grow. By blocking these “faulty switches,” targeted therapy slows or stops the disease while causing fewer side effects than traditional chemotherapy.
- Immunotherapy: These medicines act on specific molecules that help myeloma cells grow. By blocking these “faulty switches,” targeted therapy slows or stops the disease while causing fewer side effects than traditional chemotherapy.
- CAR-T cell therapy: Patient’s T cells are modified in a lab to target myeloma cells, then infused back into the body. CAR-T therapy is usually offered when other treatments no longer work and can provide new hope in advanced cases.
- Chemotherapy: Chemotherapy uses medicine to kill fast-growing cells, including myeloma cells. It may be given as tablets or through an intravenous drip. Side effects such as tiredness, nausea, or hair loss are temporary and can be managed with supportive care.
- Corticosteroids: Corticosteroids such as dexamethasone or prednisone help reduce inflammation and also have anti-myeloma effects. They are often used alongside chemotherapy or targeted therapy.
- Bone marrow (stem cell) transplant: Diseased bone marrow is replaced with healthy stem cells, either from the patient (autologous) or a donor (allogeneic). For the majority of patients, a stem cell transplant using their own cells (autologous) offers the best chance for long-term control or remission. This is now considered the gold-standard treatment and is offered to all able-bodied patients.
- Radiation therapy: High-energy beams can be used to shrink localised myeloma deposits (plasmacytomas) or relieve bone pain. It is a safe, focused treatment that complements other therapies.
How Treatments Are Selected
The choice of treatment depends on eligibility for bone marrow transplant, disease stage, age, and other health conditions.
- If a transplant is suitable, initial therapy often includes a combination of targeted therapy, immunotherapy, corticosteroids, and sometimes chemotherapy, followed by stem cell collection and transplantation.
- If a transplant is not an option, treatment focuses on medication combinations to control the disease.
- For relapsed or refractory myeloma, alternative therapies or clinical trials may be considered.
Managing Complications and Supportive Care
Multiple myeloma can cause problems such as bone pain, anaemia, infection, or kidney changes. Your care plan includes treatments to manage these effects, such as:
- Bone-strengthening medication to reduce pain and prevent fractures
- Blood transfusions or growth factors to treat anaemia
- Antibiotics and vaccines to prevent infections
- Dialysis or hydration therapy to protect the kidneys
Supportive care is a vital part of treatment — helping you stay comfortable and maintain quality of life.
Integrative and Supportive Approaches
White no attentive medicine cures multiple myeloma, supportive therapies like exercise, meditation, art or music therapy, and relaxation techniques can help manage stress and side effects. Always consult your healthcare provider before starting any complementary therapy.
Preparing for Your Appointment
If you are referred to a haematologist or oncologist at SJMC, prepare by listing your symptoms, medical history, current medications, and questions about diagnosis or treatment. Bringing a family member or friend can help you remember important information.
A Message of Hope
Multiple myeloma is a serious illness, but advances in modern medicine have transformed it into a condition that can often be well controlled for many years. Many people live full, active lives — working, travelling, and enjoying time with family — while on treatment.
At SJMC, we stand beside you every step of the way, combining the latest medical expertise with compassionate care.
Together, we work not only towards healing but also towards hope, strength, and peace of mind.