You will be usually be seen by a haematologist (a doctor who specialises in treating blood disorders). The haematologist may examine you and ask you questions about your general health.
You will usually have blood and urine tests. Your haematologist may also advise you to have other tests to check for myeloma or lymphoma. These tests may include x-rays, scans and, occasionally, a bone marrow test. The bone marrow is where blood cells are made and develop until they’re ready to go into the blood.
Not everyone will need to have these tests and your haematologist will advise you on which are appropriate for you.
You have a blood test called serum protein electrophoresis to diagnose MGUS. This test is also used to check on MGUS. This test measures the type and amount of paraprotein produced by the plasma cells.
You will also have a test to check the number of different types of blood cells (full blood count). This is to make sure your bone marrow is working well
Your doctor may arrange blood tests to check how well your liver and kidneys are working. You may also have your calcium levels checked, as these can be raised in myeloma.
You will be asked to give samples of your urine, which will be checked for paraproteins.
Some people may have x-rays taken of different bones in the body. This is to check for damage to the bones, which can be caused by myeloma.
CT scan (computerised tomography)
A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. It is used to find out if lymph nodes, or organs such as the liver or spleen, are enlarged. The scan takes 10-30 minutes and is painless. It uses a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with.
You will be asked not to eat or drink for at least four hours before the scan. You may be given a drink or injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It’s important to let your doctor know if you are allergic to iodine or have asthma, because you could have a more serious reaction to the injection.
Bone marrow sample
In some situations, the haematologist may recommend that a sample of bone marrow is taken (biopsy) to be examined under a microscope.
A doctor or nurse takes a small sample of bone marrow from the back of the hip bone (pelvis). Before the bone marrow sample is taken, you’ll be given a local anaesthetic injection to numb the area. You may also be offered a short-acting sedative to reduce any pain or discomfort during the test.
You’ll be asked to lie on your side. The doctor or nurse then passes a needle through the skin into the bone and draws a small sample of liquid marrow into a syringe (bone marrow aspirate). It can feel uncomfortable for a few seconds when the liquid marrow is drawn into the syringe. After this, they take a small core of marrow from the bone (a trephine biopsy). A small plaster or dressing is placed over the skin.
You may feel bruised after having a sample of bone marrow taken, and have an ache for a few days. This can be eased with mild painkillers.
The test is usually done as an outpatient and takes about 15-20 minutes.