Multiple myeloma often doesn’t have symptoms at first. This can make it difficult to diagnose in the early stages. Symptoms of multiple myeloma may include:
- Fractures: Myeloma cells produce substances called cytokines, which can trigger bone cells (osteoclasts) to destroy surrounding bone. When more than 30% of the bone has been destroyed, X-rays show a thinning of the bone (osteoporosis) or dark holes (lytic lesions). The weakened area of bone is more likely to break. This is called a pathological fracture.
- Bone pain, especially in the middle and/or lower back, rib cage or hips. The pain can be mild or severe depending on the extent of the multiple myeloma, the speed with which it has developed, and whether fracture or nerve compression has occurred. Typically, movement makes the pain much worse.
- Fatigue and/or shortness of breath: Myeloma can cause anemia for some patients which can lead to feeling short of breath with exertion or tiredness more than usual.
- Confusion: For some patients, bone involvement of myeloma can lead to high calcium levels in the blood and/or kidney failure. This can lead to confusion.
- Appetite changes: High calcium levels in the blood and/or kidney failure can also cause a decrease in appetite, weight loss and nausea.
- Infection: Because myeloma cells crowd out normal white blood cells, which fight infection, there is a risk of infection. Common myeloma infections include pneumonia, bladder or kidney infections, sinusitis and skin infections.