Multiple Myeloma: Symptoms and Signs

Aprobado por la Junta Editorial de Cancer.Net, 07/2022

ON THIS PAGE: You will find out more about the changes and medical problems that can be a sign of multiple myeloma. Use the menu to see other pages.

What are the symptoms and signs of multiple myeloma?

People with multiple myeloma may experience a number of different symptoms and signs. Symptoms are changes that you can feel in your body. Signs are changes in something measured, like taking your blood pressure or doing a lab test. Together, symptoms and signs can help describe a medical problem. Sometimes, people with multiple myeloma do not have any of the symptoms and signs described below. 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 exam. Or, the cause of a symptom or sign may be a 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 bone, causing local bone damage or generalized thinning of the bone, which is 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 person may lose inches from their 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.

  • Too much M protein may lead to kidney damage or failure, an important issue to be aware of. Kidney damage in its early stages often does not cause any symptoms and may only be diagnosed through blood and urine tests. When the kidneys begin to fail, symptoms include itching, weakness, fatigue, shortness of breath, muscle cramps, nausea, appetite loss, trouble sleeping, urination changes, anemia, and swelling of the legs, feet, or ankles.

  • 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, cloudy 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. Your clinicians will try to understand what is causing your symptom(s). They may do an exam and order tests to understand the cause of the problem, which is called a diagnosis.

If multiple myeloma is diagnosed, relieving symptoms remains an important part of cancer care and treatment. Managing symptoms may also be called "palliative and supportive care," which is not the same as hospice care given at the end of life. This type of care focuses on managing symptoms and supporting people who face serious illnesses, such as cancer. You can receive palliative and supportive care at any time during cancer treatment. Learn more in this guide’s section on Coping with Treatment.

Be sure to talk with your health care team about the 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 a different section to read in this guide.