What Are the Signs and Symptoms of Multiple Myeloma?

This content has been reviewed and approved by

Kenneth C. Anderson, MD
Chief, Division of Hematologic Neoplasia

Dana-Farber Cancer Institute

At first, multiple myeloma may not cause any symptoms. If the disease progresses (or worsens), too many of the abnormal plasma cells, or myeloma cells, can crowd the bone marrow and prevent it from making enough healthy blood cells. These include not only white blood cells, but also red blood cells and platelets. Without enough of these cells, you might feel fatigued, develop infections more often, or bruise and bleed more easily than before. The myeloma cells also can collect on the bones, causing growths to form and weakening the bones.

Each individual may experience symptoms differently. Several symptoms can result:

• Bone pain
• Fractures in bones
• Weakness
• Fatigue
• Weight loss
• Repeated infections
• Nausea
• Vomiting
• Constipation
• Problems with urination
• Weakness or numbness in legs
• Back pain
• Rib pain

Symptoms of Complications

Sometimes, symptoms can occur as a result of the complications of multiple myeloma. For example, bone damage can lead to a condition in which there is too much calcium in the blood, called hypercalcemia. This can cause problems throughout the body. Symptoms may include:

• Loss of appetite
• Nausea or vomiting
• Excessive thirst
• Frequent urination
• Constipation
• Fatigue or weakness
• Mental confusion or trouble thinking

The M proteins made by myeloma cells have no function to play in the body. Over time, they can build up and cause the blood to thicken, a condition known as hyperviscosity syndrome (HVS). Signs and symptoms of this condition may include:

• Feeling very tired
• Headache
• Nosebleeds
• Vision changes, such as blurred vision or bulging eyes
• Dizziness
• Pain, tingling, or numbness in the hands, feet, fingers, toes, or other parts of the body
• Trouble walking
• Confusion
• Pain or a feeling of fullness below the ribs on the left side

Clearly, there is a wide range of symptoms that may lead your doctor to suspect multiple myeloma. Also, keep in mind that most of these symptoms also can be associated with other bone or blood disorders, or other medical problems. Your doctor is the best source of information about what any unusual symptoms might mean.