How is multiple myeloma diagnosed?
If you have signs or symptoms of blood cancer, you need tests to find the specific condition. An accurate and timely multiple myeloma diagnosis is the first step to the best possible treatment.
Testing also helps your care team classify and stage the cancer. This information guides treatment decisions and gives you a clearer understanding of your outlook. At Penn Medicine, specialists use advanced testing and a team-based approach to provide a precise diagnosis as quickly as possible.
During a physical exam, our nurses and hematologists ask about:
- Symptoms
- How long they've been happening
- Personal and family history of cancer
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
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.
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).