Symptoms of Multiple Myeloma: What You Need to Know

Multiple myeloma is a type of blood cancer that arises from the abnormal proliferation of plasma cells in the bone marrow. These malignant cells crowd out healthy blood cells and produce abnormal proteins that can damage organs, especially the kidneys and bones. Recognizing the early signs of this disease is crucial for timely diagnosis and effective treatment.

Common Physical Symptoms of Multiple Myeloma

One of the most prevalent symptoms of multiple myeloma is bone pain, often localized in the lower back, pelvis, ribs, or skull. This discomfort occurs because cancerous plasma cells accumulate in the bone marrow, weakening the surrounding bone structure. Over time, this can lead to osteolytic lesions—areas where bone tissue has been eroded—and significantly increase the risk of pathological fractures, even with minimal trauma.

In advanced cases, patients may experience spinal compression due to vertebral collapse, which can cause numbness, weakness, or tingling in the limbs. Persistent, unexplained bone pain—especially at night or when resting—should prompt medical evaluation.

Blood-Related Complications

Anemia and Fatigue

As myeloma cells take over the bone marrow, they interfere with the production of normal red blood cells, leading to anemia. This results in fatigue, weakness, shortness of breath, and pale skin. Many patients initially seek medical help for these nonspecific symptoms, not realizing they could signal an underlying blood disorder.

Bleeding Tendencies

Multiple myeloma can also impair platelet function, increasing the risk of easy bruising, nosebleeds, or prolonged bleeding from minor cuts. This occurs due to reduced platelet counts or dysfunctional clotting mechanisms influenced by abnormal proteins in the bloodstream.

Metabolic and Systemic Effects

Elevated Calcium Levels (Hypercalcemia)

Bone destruction releases calcium into the bloodstream, leading to hypercalcemia. Symptoms include excessive thirst, frequent urination, constipation, confusion, and in severe cases, cardiac arrhythmias or coma. Monitoring calcium levels is essential during diagnosis and treatment.

High Blood Viscosity (Hyperviscosity Syndrome)

The overproduction of monoclonal proteins (M-proteins) by malignant plasma cells thickens the blood, causing hyperviscosity syndrome. This can impair circulation, particularly in small blood vessels, leading to headaches, blurred vision, dizziness, and even stroke-like symptoms. In some cases, it affects the retina, resulting in visual disturbances.

Kidney Dysfunction and Organ Impact

Renal impairment is another hallmark of multiple myeloma. The excess light chains produced by cancer cells—known as Bence Jones proteins—can clog the kidney tubules, leading to impaired filtration and, eventually, kidney failure. Patients may present with swelling in the legs, fatigue, or changes in urine output long before a myeloma diagnosis is considered.

Interestingly, some individuals are first diagnosed with anemia or kidney problems during routine checkups. Further investigation often reveals a very high erythrocyte sedimentation rate (ESR) and elevated serum globulin levels—key clues pointing toward a plasma cell disorder.

Diagnostic Pathways and Confirmation

When multiple myeloma is suspected, doctors typically order blood and urine tests to detect M-proteins, assess kidney function, and evaluate blood cell counts. Imaging studies like X-rays, MRI, or PET scans help identify bone lesions. However, the definitive diagnosis comes from a bone marrow biopsy, which confirms the presence of clonal plasma cells exceeding 10–30% of total marrow cells.

Early detection improves prognosis and allows for timely interventions such as chemotherapy, targeted therapy, stem cell transplantation, or supportive care to manage complications.

Conclusion

Multiple myeloma presents with a wide range of symptoms that can mimic other conditions, making awareness critical. Bone pain, unexplained fatigue, kidney issues, and abnormal blood work should not be ignored. If you or a loved one experiences persistent, unusual symptoms, consult a healthcare provider for a comprehensive evaluation. With advances in treatment, many patients now live longer, healthier lives when the disease is caught early.