What is myeloma?
Myeloma is a type of blood cancer. Around 5,900 people in the UK are diagnosed with myeloma each year.
Myeloma develops from white blood cells called plasma cells. Plasma cells make antibodies that travel in the blood to help fight infection. Antibodies are also called immunoglobulins.
Normally, plasma cells are made in a controlled way. With myeloma, the process is out of control. Lots of abnormal (cancerous) plasma cells are made. These are called myeloma cells.
Abnormal immunoglobulins in myeloma
Myeloma cells usually make abnormal immunoglobulins that do not fight infection well. You might hear other terms for myeloma immunoglobulins such as:
- paraprotein
- M protein.
We have more information about immunoglobulins and myeloma.
In the video below, Charlotte Pawlyn, a haematology doctor specialising in myeloma, talks about the signs and symptoms of myeloma and how it is treated.
Types of myeloma
Myeloma is usually named after the abnormal immunoglobulin that the myeloma cells make.
The most common type of myeloma makes abnormal immunoglobulin G and is called IgG myeloma. Find out more about types of myeloma.
Related pages
Booklets and resources
Symptoms of myeloma
Myeloma may not cause any symptoms in its early stages. It is sometimes found during a routine blood test.
Symptoms of myeloma can include:
- constant bone pain in 1 area (such as in the back, ribs, hip or pelvis)
- an increased risk of infection or having infections one after the other (recurrent infections), that need antibiotics
- having a low number of red blood cells (anaemia) and bruising and bleeding more easily
- feeling extremely tired (fatigue)
- tingling or numbness in the hands or feet, though this is rare.
Myeloma may also cause symptoms if it affects:
- the bones - this can cause bone thinning, fractures or high levels of calcium in the blood, called hypercalcaemia
- the kidneys – this can cause tiredness, confusion or passing less pee (urine) than usual.
These symptoms can be caused by other conditions. But it is important to get them checked by your GP.
Related pages
Causes and risk factors of myeloma
Doctors do not know the exact causes of myeloma. But there are risk factors that can increase your chance of developing it.
It is more common in people over the age of 60. Most cases of myeloma are linked to a plasma cell condition called MGUS (monoclonal gammopathy of unknown significance).
We have more information about the causes and risk factors of myeloma.
Diagnosis of myeloma
Myeloma can be diagnosed in different ways.
Some people may see their GP about symptoms. Your GP may arrange for some blood tests or scans. If necessary, they then refer you to a specialist at the hospital for more tests and treatment.
Some people are diagnosed with myeloma after going into hospital with more severe symptoms such as:
- being very unwell with an infection
- bone problems such as severe pain or a break in the bone (fracture)
- spinal cord compression
- kidney problems.
At the hospital
You will usually see a doctor who specialises in blood conditions (haematologist). They ask about your general health and any previous medical problems. Then they examine you and arrange more tests. These may include some of the following.
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Blood tests
Blood tests are an important way to diagnose and monitor myeloma. You will have blood tests to find out more about the myeloma and how it is affecting you.
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Urine tests
You may be asked to collect samples of your urine (pee). This is to test for the Bence Jones protein in your pee and to test how well your kidneys are working. Sometimes you need to take a container home and collect your pee over 24 hours. Your doctor or nurse will explain more about how to do this test.
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Bone marrow biopsy
A bone marrow biopsy is a test to collect a sample of cells from the bone marrow where blood cells are made. The sample is sent to a laboratory to be checked for myeloma cells.
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Cytogenetic tests
Your doctor may talk to you about doing further tests on your bone marrow sample. These are called cytogenetic tests. One type of cytogenetic test is called a FISH test (fluorescence in situ hybridisation test).
Cytogenetic tests check for changes in the chromosomes of the myeloma cells. Chromosomes are made up of genes. Genes carry the instructions cells need to work properly.
Knowing about chromosome changes can help doctors to understand how the myeloma may behave and respond to treatment. They might describe the myeloma as high risk or low risk.
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Scans and x-rays
You may also have scans, such as a whole-body MRI, CT scan or PET-CT scans. An MRI scan is often used as well as a CT scan. Other forms of imaging can be used to check the bones.
Sometimes x-ray of the bones are done if an MRI and CT are not suitable. This is called a skeletal survey x-ray.
Waiting for test results can be a difficult time, we have more information that can help.
Related pages
Staging myeloma
Staging describes how advanced the myeloma is and how effective treatment might be. To find out what stage the myeloma is, doctors use the results of blood tests. Sometimes they also use other test results and look at the effect the myeloma is having on your body.
We have more information about staging of myeloma.
Treatment for myeloma
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Your cancer doctor or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions and before you agree (consent) to any treatment.
Myeloma cannot usually be cured, but it is treatable. Treatment can be very effective and is used to:
- stop the myeloma developing further
- control symptoms
- improve your quality of life.
Your treatment plan will depend on a number of things, including your general health and whether you have symptoms.
Myeloma with no symptoms is called smouldering or asymptomatic myeloma. If the myeloma is not causing symptoms, you do not usually need treatment straight away.
Myeloma with symptoms is sometimes called active or symptomatic myeloma. If the myeloma begins to cause symptoms, you will usually start treatment with cancer drugs.
You can find out how each of the following treatments is used in our information about treatment for myeloma. You may have some treatments as part of a clinical trial.
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Active monitoring
Active monitoring means you do not have treatment until it is needed. It is also called active surveillance or watch and wait.
This may be used for myeloma that is not causing symptoms. You have regular tests. If these show the myeloma is progressing or you develop symptoms, your doctor will talk to you about starting treatment.
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Cancer drug treatment
Myeloma is usually treated with a combination of different cancer drugs. This often includes targeted therapy drugs and a steroid. You may also have these drugs with chemotherapy. Find out more in our information about myeloma cancer drugs.
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Treating myeloma symptoms
Symptom control is important for everyone diagnosed with myeloma. Not everyone has symptoms, and some people may only have mild symptoms. But myeloma can affect the bones, kidneys, blood or nerves. There are different ways these problems can be managed. Find out more about managing myeloma symptoms.
Response to myeloma treatment
Treatment for myeloma is usually very effective and most people have a good response. You will have tests during treatment to check this.
If myeloma cannot be detected with the tests, this is called complete response or complete remission. We have more information about levels of response to myeloma treatment.
There may be long periods of time when you do not need any more treatment and have no myeloma symptoms.
Treating myeloma relapse
After a time, myeloma usually comes back and needs further treatment. This is called relapsed or recurrent myeloma.
Myeloma can relapse a number of times. The time between remission and relapse is different for everyone. For some people, this may be many years later.
Your cancer doctor and nurse will talk to you about the different treatment options.
You may have the same treatment as before or a different one. Your doctor or nurse may talk to you about a clinical trial.
After myeloma treatment
If you are having treatment or are in remission, you usually have regular follow-up appointments at the hospital. Or you may have follow-up appointments with your GP. This is sometimes called a shared care agreement.
If you have myeloma that is not yet causing symptoms (smouldering myeloma), you will also have follow-up appointments every few months.
If you have any problems, or notice any new symptoms between appointments, tell your doctor or specialist nurse as soon as possible.
Related pages
Living with myeloma
With treatment, many people are now living longer and better lives. There may be long periods when the myeloma is under control. But coping with myeloma can feel difficult. It can affect you physically and emotionally. Find out more about the ways you can look after yourself in our guide to living with treatment.
Getting support
Everyone has their own way of dealing with illness and the different emotions they experience. It is important to know where to get support or information if you need it.
To find support:
- Ask your GP or someone from your cancer team for advice about support in your area.
- Search cancercaremap.org to find cancer support services near you.
- Use our local services search to find cancer support services near you.
- Call the Macmillan Support Line free on 0808 808 00 00 or talk to us online - our cancer information and support specialists can offer guidance and help you find what you need.
- Visit our myeloma forum to talk to people who have been affected by myeloma, share your experience, and ask your questions.
The HOPE programme is a free 6 session self-management course designed to help you develop techniques and strategies when living with or after cancer. Topics include goal setting, fatigue management, and wellbeing.
You can sign up for the online HOPE programme. Or to find out more about face-to-face programmes in your area, email ServiceOpsSupport@macmillan.org.uk
Related pages
Other organisations who offer information and support
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Anthony Nolan
Anthony Nolan offers information and support for people with blood cancer or a blood disorder who need a stem cell transplant. Runs a stem cell register of potential donors. Offers telephone support, grants, online community and support days.
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Blood Cancer UK
Blood Cancer UK offers information and support for people all types of blood cancer. Provides information and support online, by phone, by email, and through support groups and buddy systems. Also has a clinical trials support service.
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Kidney Care UK
Kidney Care UK offers advice, support and financial assistance to people with kidney problems. Has leaflets and booklets, including information about having dialysis.
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Myeloma UK
Myeloma UK offers information and support to people affected by myeloma. Helps improve treatments through research, education and awareness.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our myeloma information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Hughes D, Yong K, Ramasamy K, et al. Diagnosis and management of smouldering myeloma: A British Society for Haematology Good Practice Paper. Br J Haematol. 2024;204(4):1193-1206. Available from: www.doi.org/10.1111/bjh.19333
Sive J, Cuthill K, Hunter H, et al. Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Br J Haematol.2021;193(2):245-268. Available from: www.doi.org/10.1111/bjh.17410
Reviewer
Senior Clinical Research Fellow and Honorary Consultant in Molecular Diagnostics and Leukaemia
Date reviewed
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