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Signs and symptoms of multiple myeloma

This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on June 24, 2022.

Multiple myeloma is a relatively rare cancer that develops in bone marrow. As cancerous plasma cells accumulate in the marrow, they crowd out healthy blood cells. This may cause symptoms such as infection, anemia, bruising and bleeding.

Myeloma cells also increase the activity of cells called osteoclasts (which break down bone) and decrease the activity of osteoblasts (which form new bone), causing the bones to dissolve at a faster rate than they’re formed. This may damage and weaken the bones, causing pain, lesions and other symptoms.

Symptoms of multiple myeloma

Initial multiple myeloma symptoms may be mild or even undetectable. A precursor stage is known as smoldering multiple myeloma (SMM). It may continue to worsen until the cancer is discovered. Though SMM is typically slow-growing, patients may need frequent testing to monitor its progression.

As abnormal plasma cells grow, divide and take over the bone marrow, the likelihood of developing symptoms increases. Not only do abnormal plasma cells crowd out healthy bone marrow cells, damaging the bone, but they also release antibodies, M protein and other proteins into the blood, thickening it.

Many people show symptoms of bone damage, bone loss and bone fracture. Multiple myeloma may also lead to kidney damage and injury and dysregulated blood levels of antibodies and proteins.

Multiple myeloma symptoms vary for each person. Some common signs include:

  • Pain in the bones of the back or ribs
  • Bones that fracture easily
  • Fatigue and weakness
  • Shortness of breath
  • Dizziness
  • Unexplained weight loss
  • Frequent infections and fevers
  • Frequent need to urinate and extreme thirst

The bone damage associated with multiple myeloma occurs mostly in the rib cage, spine and pelvis, increasing the risk of spinal cord compression, which causes pain, numbness or weakness in the limbs and requires immediate treatment. It may come on gradually or suddenly.

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Show references
  • National Cancer Institute: Surveillance, Epidemiology and End Results Program. Cancer Stat Facts: Myeloma.
    https://seer.cancer.gov/statfacts/html/mulmy.html
  • American Cancer Society. Key Statistics About Multiple Myeloma.
    https://www.cancer.org/cancer/multiple-myeloma/about/key-statistics.html
  • National Cancer Institute (2020, December 11). Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Patient Version.
    https://www.cancer.gov/types/myeloma/patient/myeloma-treatment-pdq
  • National Cancer Institute. Smoldering myeloma.
    https://www.cancer.gov/publications/dictionaries/cancer-terms/def/smoldering-myeloma
  • American Cancer Society (2018, February 28). Clinical Signs and Symptoms of Multiple myeloma.
    https://www.cancer.org/cancer/multiple-myeloma/detection-diagnosis-staging/signs-symptoms.html
  • American Society of Clinical Oncology. Amyloidosis: Symptoms and Signs.
    https://www.cancer.net/cancer-types/amyloidosis/symptoms-and-signs
  • U.S. National Library of Medicine (2021, February 8). Hypercalcemia.
    https://medlineplus.gov/ency/article/000365.htm
  • National Institute of Diabetes and Digestive and Kidney Diseases (2018, January). What is Kidney Failure?
    https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/what-is-kidney-failure
  • National Center For Advancing Translational Sciences (2016, March 9). Multiple Myeloma.
    https://rarediseases.info.nih.gov/diseases/7108/multiple-myeloma#diseaseSymptomsSection