Diagnosis

Sometimes multiple myeloma is diagnosed when your doctor detects it accidentally during a blood test for some other condition. It can also be diagnosed if your doctor suspects you could have multiple myeloma based on your signs and symptoms.

Tests and procedures used to diagnose multiple myeloma include:

• Blood tests. Laboratory analysis of your blood may reveal the M proteins produced by myeloma cells. Another abnormal protein produced by myeloma cells — called beta-2-microglobulin — may be detected in your blood and give your doctor clues about the aggressiveness of your myeloma.

  Additionally, blood tests to examine your kidney function, blood cell counts, calcium levels and uric acid levels can give your doctor clues about your diagnosis.

• Urine tests. Analysis of your urine may show M proteins, which are referred to as Bence Jones proteins when they're detected in urine.

• Examination of your bone marrow. Your doctor may remove a sample of bone marrow for laboratory testing. The sample is collected with a long needle inserted into a bone (bone marrow aspiration and biopsy).

  In the lab, the sample is examined for myeloma cells. Specialized tests, such as fluorescence in situ hybridization (FISH) can analyze myeloma cells to identify gene mutations.

• Imaging tests. Imaging tests may be recommended to detect bone problems associated with multiple myeloma. Tests may include an X-ray, MRI, CT or positron emission tomography (PET).

Assigning a stage and a risk category

If tests indicate you have multiple myeloma, your doctor will use the information gathered from the diagnostic tests to classify your disease as stage I, stage II or stage III. Stage I indicates a less aggressive disease, and stage III indicates the most aggressive disease.

Your multiple myeloma may also be assigned a risk category, which indicates the aggressiveness of your disease.

Your multiple myeloma stage and risk category help your doctor understand your prognosis and your treatment options.