Common Signs and Symptoms of Multiple Myeloma

A Complex Cancer of the Plasma Cell in the Bone Marrow

Multiple myeloma can lead to bone fractures.
Multiple myeloma can lead to bone fractures. ultura RM Exclusive/PhotoStock-Israel/Getty Images

Multiple myeloma is a cancer of the plasma cells—a type of infection-fighting cell—in a person's bone marrow. When the initial symptoms of multiple myeloma begin to appear, they often go unnoticed because they are vague and non-specific.

In fact, symptoms are similar to those of other, less serious illnesses and conditions, often causing a delay in diagnosis. Also, some people with multiple myeloma never experience any symptoms, but signs shown up on blood work (for example, a decline in kidney function).

Signs and Symptoms of Multiple Myeloma

The signs and symptoms of multiple myeloma, like bone pain, fatigue, and numbness and tingling, can be described as complications of the disease. While a combination of these symptoms can suggest multiple myeloma, the actual diagnosis of multiple myeloma is detected though blood tests and other medical tests like a bone marrow biopsy.

Bone Pain and Bone Loss/Fractures in Multiple Myeloloma

Bone pain is a commonly experienced symptom of multiple myeloma. Low back pain is frequent, but pain can occur in other areas, like the ribs, hips, and skull. Bone pain can be caused by other non-malignant conditions, so it isn't exactly an initial red flag for multiple myeloma among doctors.

Bone loss, called osteoporosis, and unexplained fractures are also a symptom of multiple myeloma. The spine, ribs, and pelvis are common sites of bone breaks, or fractures, caused by bone weakening due to multiple myeloma.

Elevated Calcium Levels in the Blood in Multiple Myeloma

Elevated levels of calcium in the blood, termed hypercalcemia, is also a sign of multiple myeloma. As myeloma cells break down bone, calcium is released into the bloodstream. Hypercalcemia can cause:

  • nausea
  • loss of appetite
  • fatigue/weakness
  • excessive thirst/urination
  • constipation
  • mental confusion
  • kidney failure

Anemia in Multiple Myeloma

As myeloma cells begin to replace red blood cells in the bone marrow, normal cells are crowded out. This leads to a decline in the number of healthy red blood cells. When the amount of red blood cells decreases in the body, the resulting condition is anemia, which causes paleness, dizziness, weakness, fatigue, and shortness of breath.

Other blood cell counts may similarly be affected by multiple myeloma, including infection-fighting cells, called white blood cells, and platelets, which are involved in the clotting process. A low number of white blood cells can make a person prone to infections, especially pneumonia, urinary tract infections, and kidney infections. A low number of platelets can predispose a person to bleeding.

Kidney Damage in Multiple Myeloma

High levels of calcium and excess myeloma proteins in the blood are filtered through the kidneys, causing damage. As kidneys begin to fail, they lose their ability to regulate fluids and electrolytes in the body and remove waste products from the body.

Swelling, especially in the legs, is a symptom of kidney failure, along with weakness and itching. Kidney failure tends to occur most often in people with advanced cases of multiple myeloma, but is occasionally the first sign of multiple myeloma.

Hyperviscosity in Multiple Myeloma

Thickened blood, or hyperviscosity, can also be a sign of multiple myeloma and occurs from the excessive amount of proteins made by the cancerous plasma cells. With hyperviscosity, the blood is resistant to flow, and symptoms may include:

  • nose bleeds
  • blurred vision
  • numbing or tingling sensation in arms or legs
  • heart failure

Unexplained Weight Loss in Multiple Myeloma

While losing weight without effort may be welcomed by many, it can be a symptom of many types of cancer, including multiple myeloma.

Numbness and Tingling Sensations in Multiple Myeloma

When the bones of the spine are weakened or fractured by multiple myeloma, they can collapse onto nerve roots and compress them. This may cause a condition called radiculopathy, leading to symptoms like numbness, tingling, pain, and/or muscle weakness.

If the spinal cord is affected, a condition called spinal cord compression occurs, which is a medical emergency. In spinal cord compression, there is severe back pain, sensory disturbances or weakness of the legs, and/or loss of control of the bowel and bladder.

What Should I Do If I Have These Symptoms?

If you are experiencing any of the above symptoms, check in with your doctor. Multiple myeloma is a complex disease, and its symptoms mimic many other health conditions.

Sources:

American Cancer Society. (2015). Signs and Symptoms of Multiple Myeloma. 

Rajkumar SV et al. International myeloma working group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014 Nov;15(12):e538-48.

US National Library of Medicine. PubMed Health. About Multiple Myeloma.

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