Diagnosis of myeloma

Tests for myeloma may include blood, urine and bone marrow tests, and x-rays or scans of the bones.

About diagnosing myeloma

Myeloma is usually diagnosed by a doctor who specialises in blood conditions (haematologist) or a cancer doctor.

Your specialist doctor will ask about your symptoms and your general health. They will examine you and arrange more tests.

You will have different blood tests to diagnose myeloma. Blood tests are also an important way to monitor myeloma and how it is responding to treatment. We have more information about blood tests for myeloma.

Urine test

You may be asked to give urine samples to test for Bence Jones protein. These tests can also show how well your kidneys are working. You may need to take a container home and collect your urine over 24 hours. The nurses will explain more about how to do this test.

X-rays

You will have x-rays to check for any damage to the bones from the myeloma cells (lytic lesions). You usually have x-rays of the bones that contain bone marrow. This is called a skeletal survey. It can take about 30-45 minutes. Although x-rays are not painful, lying on a hard surface can be uncomfortable. Ask your doctor or nurse about taking painkillers before the test. Let the person doing the x-ray know if you need a painkiller during the x-rays.

Bone marrow test

If there is a paraprotein in your blood or urine, a doctor or nurse will take a sample (biopsy) of bone marrow. They usually take it from the back of your hipbone (pelvis). The sample is sent to a laboratory to be checked for myeloma cells.

Cytogenetic test

Cells in contain chromosomes, which are made up of genes. Genes carry the instructions cells need to work properly. You may have a test on the cells taken from the bone marrow sample to look for changes in the chromosomes of the myeloma cells. These tests are called cytogenetic tests. A test called fluorescence in situ hybridisation (FISH) may be used to look for any cytogenetic changes. The results help the doctors understand how the myeloma may behave and to plan the most effective treatment.