Symptoms of Multiple Myeloma and Its Common Sites of Spread

Multiple myeloma is a type of blood cancer that primarily affects plasma cells in the bone marrow. One of its most significant characteristics is the destruction of bone tissue, which can lead to various skeletal complications. These include lytic bone lesions, widespread osteoporosis, and pathological fractures—fractures that occur with minimal or no trauma due to weakened bones. Bone pain, especially in the back, ribs, or hips, is often one of the earliest signs and tends to worsen with movement.

Kidney Involvement in Multiple Myeloma

Renal impairment is a common complication in patients with multiple myeloma. The abnormal proteins produced by malignant plasma cells can accumulate in the kidneys, leading to kidney dysfunction or even renal failure. Symptoms may include hematuria (blood in urine), persistent lower back pain, and in some cases, the detection of an abdominal mass. When large amounts of blood are present, clots can form and trigger renal colic—a severe, cramping pain in the flank or lower abdomen.

Patients may also experience painful urination, difficulty emptying the bladder, or complete urinary retention. The back pain associated with kidney involvement is typically a constant, dull ache caused by tumor growth increasing pressure on the renal capsule or invading surrounding tissues. Early detection and management of kidney issues are crucial to improving long-term outcomes.

Pulmonary Manifestations and Respiratory Symptoms

While less common than bone or kidney involvement, lung metastases can occur in advanced stages of multiple myeloma. When cancer cells spread to the lungs, individuals may develop shortness of breath, a persistent cough, increased sputum production, and occasionally coughing up blood (hemoptysis). Chest discomfort or sharp chest pain may also be present, particularly during breathing.

Progressive Systemic Effects

As the disease progresses, patients might experience additional symptoms such as dull back pain, shoulder pain, and fluid accumulation around the lungs—known as pleural effusion. This buildup of fluid can further restrict lung expansion, worsening breathing difficulties and contributing to fatigue and reduced physical endurance.

Liver Involvement and Gastrointestinal Symptoms

Hepatic metastasis, though relatively rare, can significantly impact a patient's health. When multiple myeloma spreads to the liver, it may cause pain in the upper right abdomen, jaundice (yellowing of the skin and eyes), and signs of impaired liver function. Digestive disturbances such as indigestion, nausea, and vomiting are frequently reported.

Other systemic effects include profound fatigue, unintended weight loss, episodes of fever, and peripheral edema due to fluid retention. In more severe cases, ascites—an abnormal accumulation of fluid in the abdominal cavity—may develop, causing bloating and discomfort.

Additional Warning Signs

Some patients also exhibit bleeding tendencies, such as frequent nosebleeds or subcutaneous bruising, resulting from low platelet counts or dysfunctional clotting mechanisms. These symptoms underscore the systemic nature of multiple myeloma and highlight the importance of comprehensive monitoring and multidisciplinary care.

Recognizing these diverse symptoms early can lead to timely diagnosis and more effective treatment strategies, ultimately enhancing quality of life and survival rates for individuals living with this complex hematologic malignancy.