Multiple Myeloma

Diagnosing Multiple Myeloma  

Hearing you have multiple myeloma is never easy. But getting a diagnosis is the first step toward feeling better. Many patients lived with symptoms for months before they had an answer. Now you have one, plus a path forward. 

What is the first step in a multiple myeloma diagnosis?  

A myeloma diagnosis often begins with routine bloodwork. A complete blood count (CBC) can flag abnormal white blood cell levels. If your results are out of the normal range, your doctor will refer you to a specialist for more testing. Often, that is when Siteman comes in. 

What are the symptoms of multiple myeloma? 

Multiple myeloma can affect many parts of the body at once. You may notice one or more of these signs: 

• Fragile or brittle bones 
• Pain in the bones 
• Fatigue and weakness 
• Increased bruising and bleeding 
• Unexplained fevers 
• Recurring infections 
• Difficulty breathing 

Are there any specific symptoms and signs of multiple myeloma? 

Most myeloma symptoms, like pain, fatigue, and fever, aren’t specific enough to point to one condition. But hypercalcemia and amyloidosis are specific findings that prompt your doctor to investigate further.  

Hypercalcemia means too much calcium in your blood. It does not automatically mean myeloma, but it is a red flag your doctor will investigate with further testing. 

What are symptoms of hypercalcemia?  
 

• Increased thirst and need to use the bathroom 
• Loss of appetite, nausea, or vomiting 
• Changes in the bathroom (constipation or diarrhea) 
• Muscle weakness  
• Problems thinking and confusion 

Amyloidosis is a condition where abnormal proteins, called amyeloids, build up in your organs and tissues, interfering with how they work.

What are signs of amyloidosis? 

• Purple spots appearing on their skin 
• A swollen tongue 
• Tingling or numbness in the feet and legs 
• Swelling in the hands and feet 

Why Choose Siteman for Your Multiple Myeloma Diagnosis? 

At Siteman, your diagnosis is the foundation of everything we do. Our myeloma specialists build your treatment plan around a precise understanding of your specific disease. 

We need to know exactly what kind of myeloma you have, where it is, and how it is affecting your body. We go beyond evaluating your past records. Advanced screening and imaging give us a current picture, so your care is based on where you are today. 

Your WashU Medicine physicians are specialists in myeloma, not just generalists in oncology. They will get your diagnosis correct the first time and build a treatment plan around your specific case. 

We know your time matters. Whenever possible, we schedule multiple tests and appointments on the same day, so you make fewer trips for your care. 

What to expect during a diagnosis 

A myeloma diagnosis requires specialized tests that primary care physicians do not perform. You can come to Siteman directly without a referral for these.  

For an accurate myeloma diagnosis, we order these tests: 

• Lab work and blood tests 
• Internal tests, like bone biopsies
• Imaging and scans, like PET, CT, and X-ray 

Lab work

For many people, the first hint of myeloma shows up during a routine visit. After a physical exam and review of your medical history, your doctor may order blood and urine tests to look for signs of the disease. 

If these tests show you have an issue with your white blood cells, you will need more advanced tests. This is when you may be referred to Siteman, or you can decide if you want to come here. You don’t need a referral to make an appointment with us.

Advanced and internal tests 

A bone marrow biopsy is a key step in confirming a myeloma diagnosis. Your doctor collects a small sample of bone marrow — usually from the hip — and examines it for myeloma cells. You will receive local anesthesia to stay comfortable for this procedure. 

Imaging and Scans 

Imaging helps us see the full picture. PET and CT scans identify myeloma cells, tumors, and affected areas throughout your body. Because myeloma can damage bones, your physician may also order X-rays. 

Staging multiple myeloma 

Staging tells us how far the myeloma has spread. There are three stages — Stage 1 is the earliest, Stage 3 is the most advanced. 

Your Siteman team reviews all of your test results alongside your overall health to determine your stage. That staging directly shapes your treatment plan.