Symptoms of myeloma

In the early stages, myeloma may not cause any symptoms. Some people may only have mild symptoms. Myeloma can cause symptoms if it affects areas of the body such as the bones, kidneys, blood or nerves. Symptom control is important for everyone diagnosed with myeloma.

You will see your doctor regularly for blood tests and x-rays, and to talk to you about how the myeloma is affecting you. Always tell your doctor and nurse about any problems you may have. There are different ways that symptoms can be managed.

Myeloma may cause problems such as:

  • bone problems and bone pain
  • high calcium levels in the blood (hypercalcaemia)
  • pressure on the spine (spinal cord compression), causing leg weakness or numbness, bladder problems or bowel problems
  • infection
  • tiredness (fatigue)
  • anaemia (low number of red blood cells)
  • kidney problems
  • numb or tingling hands or feet (peripheral neuropathy)
  • eating problems
  • blood clots
  • high levels of paraprotein in blood affecting blood flow (hyperviscosity syndrome).

Myeloma and bone problems

Myeloma cells can damage bones and cause bone problems. Areas of bone may get thinner and weaker, and may sometimes break (fracture).

The most common symptom of myeloma is bone pain. Treatments for bone pain may include:

  • painkillers
  • bisphosphonates
  • radiotherapy
  • surgery, including vertebroplasty.

We have more information about managing or treating bone problems

Spinal cord compression

Myeloma can develop in the bones of the spine. Sometimes this can weaken the bone and put pressure on the spinal cord. This is called spinal cord compression.

Hypercalcaemia (high levels of calcium in the blood)

Bone damage can cause calcium to be released from the bones into the blood. High levels of calcium in the blood is called hypercalcaemia. Symptoms of hypercalcaemia can include:

  • feeling sick
  • feeling thirsty
  • feeling drowsy or confused
  • constipation
  • passing urine (pee) often.

Kidney problems

The paraprotein and light chains produced in myeloma can damage the kidneys. Calcium may also leak out of damaged bones and build up in the blood. This can also cause kidney problems.

Kidney problems can cause symptoms such as:

  • passing less urine (pee) than usual
  • tiredness
  • reduced appetite
  • feeling sick (nausea) or being sick (vomiting).

Not everyone has symptoms. But you will have regular blood tests to check for kidney problems.

You can help protect your kidneys by drinking plenty of fluids. Try to drink at least 3 litres (5 pints) each day. Always check with your doctor or nurse before taking painkillers called anti-inflammatory drugs, such as ibuprofen. These can cause kidney problems.

If your kidneys are affected, you may have fluids through a drip (infusion). This helps your body to flush the waste products out of your kidneys into your urine. Treatment for myeloma usually reduces the amount of paraprotein in the blood. This helps with kidney problems.

Sometimes kidney damage is severe, and the kidneys stop working altogether. This is called kidney failure or renal failure. If you have kidney failure, blood is not filtered properly and you do not produce any urine. Excess fluid and waste products, which are usually passed as urine, begin to build up in the body. If this happens, you may need to have your blood artificially filtered. This is called kidney dialysis.

Some people who need kidney dialysis only have it for a short period of time. Other people need long-term dialysis.

You can contact our cancer support specialists on 0808 808 00 00 to talk about dialysis. You may also find our Online Community a helpful place to get support.

Tiredness (fatigue)

Many people with myeloma feel tired and have less energy to do the things they normally do. This may be caused by anaemia, or it may be a side effect of myeloma treatment. We have more information about managing fatigue.

Infection

Myeloma, and some treatments for it, can affect your ability to fight infections. Your doctor or nurse will talk to you about infections and possible signs of an infections to be aware of. Your doctor may give you drugs to help prevent an infection (prophylactic drugs). They may also recommend you have vaccines such as the flu or coronavirus vaccination, if you have not already.

Immunoglobulin infusion

If you are getting a lot of infections, your doctor may give you a regular infusion (drip) of immunoglobulins. You have this into a vein. It can help to improve your immune system. Most people feel fine when having an immunoglobulin infusion, but sometimes it can cause an allergic reaction. This is most likely to happen during or after the first infusion.

To reduce the chance of a reaction, the first infusion is given slowly.

Anaemia (low number of red blood cells)

Myeloma or its treatment can reduce the number of red blood cells in your blood. This is called anaemia. This can make you feel tired and breathless.

Your doctor may suggest that you have a blood transfusion. The blood is given into a vein in your arm. Some people have a drug called erythropoietin (EPO) instead of a blood transfusion. This drug encourages your bone marrow to make more red blood cells. It is usually given as an injection under the skin (subcutaneously).

Numb or tingling hands or feet (peripheral neuropathy)

Myeloma and its treatment can affect the nerves in your hands or feet. This can cause tingling, numbness, or a feeling like pins and needles. This is called peripheral neuropathy. You may find it hard to fasten buttons or do other fiddly tasks. Your doctor or nurse will tell you if you are having a treatment that may cause this side effect.

Tell your doctor or nurse if this happens. If it is caused by your treatment, they may need to lower the dose. Or your doctor may talk to you about whether you could have a different treatment. Usually, peripheral neuropathy gets better when treatment is over, but it can sometimes be permanent.

Eating problems and feeling sick

Myeloma, and some treatments for it, can cause sickness and loss of appetite

There are several treatments to help prevent and control sickness. Your doctor can prescribe anti-sickness (anti-emetic) drugs for you. Let them know if your anti-sickness drugs are not helping as there are different types you can take.

It is important to try to eat well during your treatment. If you are having problems eating or losing weight, ask your nurse for advice. You can also ask to see a dietitian.

You can add extra energy and protein to your diet with everyday foods or by using food supplements. We have information on how to build up your diet

Blood clots

Myeloma, and some treatments for it, can increase your risk of developing a blood clot. Symptoms of a blood clot include:

  • pain, redness or swelling in a leg or an arm
  • breathlessness
  • chest pain.

Blood clots can be very serious. Tell your doctor straight away if you have any of these symptoms. Most blood clots can be successfully treated with drugs that thin the blood.

Sometimes doctors may give you drugs to reduce the risk of a blood clot.

Your doctor or nurse can give you more information about blood clots. We also have more information on blood clots.

Hyperviscosity syndrome

Rarely, myeloma causes a very high level of paraprotein in the blood. This means the blood can become thicker than normal. This is called hyperviscosity syndrome. It can cause symptoms such as:

  • headaches
  • blurred vision
  • abnormal bleeding
  • confusion
  • dizziness.

You may need a plasma exchange (plasmapheresis). This is a procedure that removes the abnormal paraprotein from the blood.

About our information

  • References

    Below is a sample of the sources used in our myeloma information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    National Institute for Health and Care Excellence (NICE). Myeloma: diagnosis and management. NICE guideline [NG35]. Published: 10 February 2016 Last updated: 25 October 2018. Available from: https://www.nice.org.uk/guidance/ng35/chapter/recommendations Accessed: 19/07/22

    Jonathan Sive et al., on behalf of the British Society of Haematology. British Journal of Haematology. Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Published: 21 March 2021 Available from: https://onlinelibrary.wiley.com/doi/10.1111/bjh.17410 Accessed: 19/07/22

    M.A. Dimopoulos et al. Annals of oncology. European Society for Medical Oncology (ESMO). Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Volume 32, ISSUE 3, P309-322, March 01, 2021. Available from: https://www.annalsofoncology.org/article/S0923-7534(20)43169-2/fulltext Accessed: 19/07/22


  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

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