Multiple Myeloma: Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 10/2016


People with multiple myeloma may experience a number of different symptoms and signs. Sometimes, people with multiple myeloma do not have any of these changes. For people with myeloma who have no symptoms, their cancer may be discovered by a blood or urine test that is performed for a different reason, such as for an annual physical. Or, the cause of a symptom may be another medical condition that is not cancer.

  • Anemia is a low level of red blood cells. This happens when myeloma plasma cells suppress or crowd out healthy red blood cells.

  • Fatigue is usually caused by anemia or other factors associated with myeloma, such as abnormal cytokine production. It occurs in most people with myeloma.

  • Bone pain is a common symptom. Myeloma cells grow in the bone marrow and cortical bone, causing local bone damage or generalized thinning of the bone, called osteoporosis. This makes the bone more likely to break. The back or ribs are the most common sites of bone pain, but any bone can be affected. The pain is usually worse when someone moves and at night. If cancer is in the spine, the vertebrae (the individual bones that make up the spine) can collapse, which is known as a compression fracture. In advanced multiple myeloma, a patient may lose inches from his or her height due to compressed vertebrae over the course of their illness.

  • Pain, numbness, and weakness can sometimes happen when collapsed vertebrae press against the spinal cord or pinch a nerve coming out of the spine.

  • Excess M protein may lead to kidney damage or failure, an important issue to be aware of.

  • Hypercalcemia is a high level of calcium in the blood that can arise as a result of bone breakdown. It can cause drowsiness, constipation, and kidney damage.

  • Symptoms of weight loss, nausea, thirst, muscle weakness, and mental confusion are related to kidney failure, hypercalcemia, or other imbalances in blood chemicals.

  • Fever and infections, especially of the upper respiratory tract and lungs, may arise as a result of the lower immunity that people with myeloma have. This makes it harder to fight infection.

  • Blood clots, nosebleeds, bleeding gums, bruising, hazy vision caused by hyperviscosity, which is thickened blood, and low platelets are other symptoms of multiple myeloma.

If you are concerned about any changes you experience, please talk with your health care team. The health care team may ask how long and how often you have been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If multiple myeloma is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may be called palliative care or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose another section to read in this guide.