Multiple Myeloma Stages / Staging
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Video: Cancer StagingDr. Timothy McCay explains what the stages of cancer mean and how this information is determined. He also discusses why determining the stage of cancer is critical to treatment planning.
Dr. Timothy McCay explains what the stages of cancer mean and how this information is determined. He also discusses why determining the stage of cancer is critical to treatment planning.
Stages of Multiple Myeloma
To determine which multiple myeloma treatments will be best suited to you, your Cancer Treatment Centers of America (CTCA) care team will learn the stage (extent) of the disease. The rate the cancer is growing and whether or not there is evidence of kidney problems or other serious symptoms may also influence treatment choices.
Most cancers are staged based on the size and spread of tumors. To stage multiple myeloma, we look at blood cell counts, the amount of protein found in the blood and urine, the calcium level in the blood and other diagnostic test results.
How Is Multiple Myeloma Staged?
There are currently two ways of staging multiple myeloma, both of which divide myeloma into three stages indicated by Roman numerals I-III. These two multiple myeloma staging systems differ in the factors that are evaluated:
- The Durie-Salmon System considers the levels of monoclonal immunoglobulin, calcium and hemoglobin in the blood as well as the number of bone lesions (indicating the severity of bone damage). This multiple myeloma staging system is becoming less common.
- The International Staging System for Multiple Myeloma relies on two main factors to stage multiple myeloma: the levels of albumin and beta-2-microglobulin in the blood.
Stage Grouping for Multiple Myeloma
The multiple myeloma stages currently used to identify the extent of the disease in the body include:
- Stage I Multiple Myeloma: The tests indicate there are a relatively small number of myeloma cells. The levels of beta-2 microglobulin may be slightly higher than normal and the levels of albumin (a water soluble protein) may have decreased.
- Stage II Multiple Myeloma: This intermediate stage of multiple myeloma is determined if the levels tested fall between the standards set for stage I and stage III.
- Stage III Multiple Myeloma: The number of myeloma cells is considered high. The most advanced stage of multiple myeloma is characterized by high levels of beta-2 microglobulin and low levels of albumin.
Smoldering myeloma (also called asymptomatic myeloma), a slow-growing type of multiple myeloma, is characterized by increased plasma cells in the bone marrow and the presence of monoclonal proteins, without the presence of symptoms.
Smoldering myeloma typically uses a "watch and wait" approach, which holds off on treatment until the disease progresses, with close monitoring of diagnostic tests.
Treatment Planning for Multiple Myeloma
The multiple myeloma staging process will help you and your doctors determine your treatment options. We’ll work closely with you to answer your questions about the staging process and plan treatment that’s tailored to your needs, lifestyle and personal preferences.
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