Multiple Myeloma Diagnosis and Stages

If you have signs or symptoms of blood cancer, you need tests to diagnose the specific condition. Accurate and timely multiple myeloma diagnosis is the first step to the best possible treatment.

Tests for multiple myeloma will also help your health care team classify and stage the cancer. That information will help you understand your multiple myeloma prognosis (outlook).

Tests for Multiple Myeloma Diagnosis

Our specialists use a variety of tools to gather complex information about multiple myeloma for accurate diagnosis, including:

  • Physical exam
  • Blood tests
  • Bone marrow biopsy
  • Imaging tests

Physical Exam

During a physical exam, our nurses and hematologists ask about:

  • Symptoms
  • How long they've been happening
  • Personal and family history of cancer

Multiple Myeloma Blood Tests

Blood tests are essential to accurate diagnosis of this complex disease. They can help your hematologist identify and measure many things to indicate type and stage of disease, including:

  • Albumin, a protein in the blood which, when low, can identify more aggressive disease
  • Beta-2-microglobulin, a protein made by myeloma cells
  • Calcium, which is in higher levels in the blood when bone is breaking down
  • Complete blood count, levels of red cells, white cells and platelets
  • Genetic abnormalities of the cancer, which helps guide treatment decisions
  • Lactate dehydrogenase (LDH), which indicates tissue damage and active myeloma
  • Kidney function tests
  • M protein in the blood, a hallmark of multiple myeloma

Bone Marrow Biopsy

Your team may order a bone marrow biopsy to check the cells in the bone marrow, where multiple myeloma starts. For a bone marrow biopsy, a specialist uses a long, thin need to take a small sample of bone marrow. The sample usually comes from the hip bone. Most patients receive local anesthesia to prevent pain at the needle site, sometimes with a sedative to help them relax.

Our pathologists examine the cells under a microscope to identify myeloma cells and determine how many are present. Our pathologists also perform tests to identify certain characteristics in cells to help determine the best treatment options.

Imaging Tests

Your hematologist may order imaging tests to look for cancer in the body or to identify damage to bones or organs. Imaging tests include X-rays, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound and positron emission tomography (PET).

Understanding the Results of Multiple Myeloma Diagnostic Testing

After testing, our multiple myeloma team which consists of hematologists, oncologists and pathologists meet to discuss your results. This meeting ensures that we have all of the information we need for an accurate diagnosis.

Then our physicians and nurse practitioners meet with you, taking time to educate you about the diagnosis, including:

  • Test results
  • Classification and stage of multiple myeloma
  • Next steps for treatment
  • Prognosis
  • Questions you or your loved ones have

What Is Multiple Myeloma Staging?

If tests indicate you have multiple myeloma, our hematologists (blood cancer experts) determine the stage of cancer. The stage ranges from stage I to III.

Test results could indicate that you have a condition that has not yet developed into multiple myeloma but could progress:

  • Monoclonal gammopathy of undetermined significance (MGUS): There is a small amount of M protein (an antibody released by multiple myeloma cells) in the blood. But there are no other signs of multiple myeloma diagnosis (for example, a tumor or symptoms).
  • Solitary (isolated) plasmacytoma: There is a single myeloma tumor somewhere in the body. But there are no signs of anemia, kidney damage or further disease.
  • Smoldering (asymptomatic) multiple myeloma: Low levels of M protein are present in the blood, but there are few to no symptoms.

Depending on classification and stage, your team may suggest multiple myeloma treatment. Or they may recommend active surveillance, a "watch and wait" strategy to monitor you closely until symptoms appear or change.

Getting a Second Opinion on Your Diagnosis

If you already have a blood cancer diagnosis, you may want to meet with a specialist for a second opinion.

Penn Medicine has hematologists, pathologists and nurses who specialize in only multiple myeloma. We can confirm the diagnosis, clarify the type and stage, and provide additional information to guide treatment decisions. We review your existing medical records and determine what additional, advanced testing you may need.

Talking with us can help you make sure you choose the most effective treatments for your unique case.

Multiple Myeloma Diagnosis: The Penn Medicine Advantage

The Multiple Myeloma Research Foundation (MMRF) recommends that patients find specialists who diagnose and treat many patients with the disease. This will help you get the most accurate understanding of your unique situation and lead to the best outcomes. At the Penn Medicine Blood Cancer Program, you'll find:

  • Expertise in multiple myeloma: Our fellowship-trained hematologists, pathologists and nurses specialize in multiple myeloma. They are equipped with advanced technology to accurately diagnose and stage multiple myeloma for the best outcomes.
  • Guidance through the process: When you contact our team for multiple myeloma diagnosis, you work closely with a nurse navigator who specializes in blood cancer. She makes sure you quickly get the testing and consultation appointments you need. After your appointments, our team takes time to make sure you understand your results and what they mean.
  • In-house labs and tests: All multiple myeloma testing is performed in our on-site lab. You get faster results and start treatment quickly.
  • Well-established research program: Penn has a robust multiple myeloma research program. Our scientists frequently participate in multiple myeloma clinical trials to find better ways to detect it and treat the disease.

Make an Appointment

Please call 800-789-7366 or request a callback.