Multiple myeloma is diagnosed through a combination of clinical evaluations, laboratory tests, imaging studies, and sometimes biopsy. The diagnostic process typically involves the following steps:
Medical History and Physical Examination:
- Symptoms: Physicians take a detailed history to identify symptoms such as bone pain, fatigue, frequent infections, weight loss, and weakness.
- Physical Exam: This includes checking for signs of anemia, bone tenderness, and any other physical abnormalities.
Laboratory Tests:
- Blood Tests: These tests measure various substances in the blood to identify abnormalities commonly associated with multiple myeloma:
- Complete Blood Count (CBC) to check for anemia, low white blood cell count, and low platelet count.
- Blood chemistry tests to measure calcium levels, kidney function (creatinine levels), and other electrolytes.
- Serum protein electrophoresis (SPEP) to detect abnormal monoclonal proteins (M proteins).
- Immunofixation electrophoresis (IFE) and Free Light Chain (FLC) assay to identify specific types of M proteins and light chains.
Urine Tests:
- Urine Protein Electrophoresis (UPEP) and Immunofixation: These tests are used to detect Bence Jones proteins, which are free light chains of immunoglobulins often found in the urine of multiple myeloma patients.
Bone Marrow Examination:
- Bone Marrow Aspiration and Biopsy: A sample of bone marrow is taken (usually from the hip bone) and examined under a microscope to identify the presence of abnormal plasma cells. The percentage of plasma cells in the bone marrow is a critical diagnostic criterion.
Imaging Studies:
- X-rays: Often called a skeletal survey, X-rays of various bones can reveal lytic lesions, which are areas of bone damage caused by myeloma cells.
- MRI (Magnetic Resonance Imaging): This can provide detailed images of bone marrow and is useful for detecting bone lesions and spinal cord compression.
- CT (Computed Tomography) Scans: These are used to identify bone damage and soft tissue masses.
- PET (Positron Emission Tomography) Scans: Combined with CT, PET scans can show areas of active disease.
Early and accurate diagnosis of multiple myeloma is crucial for effective treatment and management of the disease. The diagnostic path can vary based on the individual's specific circumstances and symptoms. Individuals experiencing multiple myeloma cancer symptoms can obtain a prompt and accurate diagnosis from the GW Cancer Center Thoracic Oncology Program’s multidisciplinary team of medical and radiation oncologists, surgeons, pathologists, and advanced practice providers.
