Symptoms - Multiple myeloma

Multiple myeloma may not cause any symptoms in the early stages, but eventually leads to a wide range of problems. It's often diagnosed after a routine blood test or, sometimes, a urine test.

See a GP if you have any of the symptoms of multiple myeloma. While they're unlikely to be caused by cancer, it's best to be sure by getting a proper diagnosis.

Bone pain

Multiple myeloma can cause pain in affected bones – usually the back, ribs or hips.

The pain is frequently a persistent dull ache, which may be made worse by movement.

Bone fractures and spinal cord compression

Multiple myeloma can weaken the bones and make them more likely to break (fracture). The spine and long bones (arms and legs) are most often affected.

Fractures of the spine can cause the sections of the spine to collapse, leading to pain and, occasionally, compression of the spinal cord (the main column of nerves running down the back).

Compression of the spinal cord can cause:

• pins and needles
• numbness and weakness in the legs and feet
• problems controlling your bladder and bowels

You should seek immediate medical help if you have symptoms of spinal cord compression. It's an emergency and needs immediate investigation and treatment.

Anaemia

Multiple myeloma can affect the production of blood cells in the bone marrow, which can lead to a lack of red blood cells (anaemia). This can also occur as a side effect of myeloma treatment.

If you have anaemia, you may feel very tired, weak and breathless.

Repeated infections

People with multiple myeloma are particularly vulnerable to infection because the condition interferes with the immune system, the body's natural defence against infection and illness.

You may find you get frequent infections that last for a long time.

Raised calcium levels in the blood

A high level of calcium in the blood (hypercalcaemia) can develop in people with multiple myeloma because too much calcium is released from affected bones into the bloodstream.

Symptoms of hypercalcaemia can include:

• extreme thirst
• feeling sick
• stomach pain
• needing to urinate frequently
• constipation
• confusion and drowsiness

You should seek immediate medical help if you have symptoms of hypercalcaemia, as they need quick investigation and treatment.

Unusual bleeding

Some people with multiple myeloma have bruising and unusual bleeding (haemorrhage), such as frequent nosebleeds, bleeding gums and heavy periods.

This is because the cancer cells in your bone marrow can stop blood-clotting cells called platelets from being made.

Thickened blood

In some people, multiple myeloma can cause the blood to become thicker than normal. This is due to the excess proteins that myeloma cells often produce.

This is known as hyperviscosity and can cause problems such as:

• blurred vision
• headaches
• dizziness
• bleeding from the gums or nose
• shortness of breath

Kidney problems

Kidney damage can occur in people with multiple myeloma. Eventually, the kidneys may stop working properly.

This is known as kidney or renal impairment, or kidney or renal failure.

Signs of kidney failure can include:

• weight loss and poor appetite
• swollen ankles, feet or hands
• tiredness and a lack of energy
• shortness of breath
• itchy skin
• feeling sick
• hiccups that won't go away

You should seek immediate medical help if you have symptoms of kidney failure. It's an emergency and needs quick investigation and treatment.