Managing myeloma symptoms
Myeloma can cause symptoms if it affects the bones, kidneys, blood or nerves. Symptom control is important for everyone diagnosed with myeloma.
Symptoms of myeloma
Not everyone diagnosed with myeloma has symptoms, and some people may only have mild symptoms. But symptom control is often an important part of myeloma treatment.
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).
You will see your cancer doctor regularly for blood tests and scans, and to talk about how the myeloma is affecting you. Always tell your doctor and nurse about any problems you may have. There are different ways to manage symptoms.
Myeloma and bone problems
If myeloma damages the bone, this can cause:
- pain
- nerve damage, called spinal cord compression if the bones of the spine are affected
- high blood calcium levels.
There are different ways of managing and treating these problems. Some of them are less common, but need urgent treatment if you develop symptoms. Find out more in our information bone problems and myeloma.
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 (nausea)
- feeling thirsty
- feeling drowsy
- feeling confused
- feeling unwell
- feeling constipated
- passing urine (pee) often.
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 treatment. We have more information about managing fatigue.
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. It is important to 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.
Kidney Care UK has more information about dialysis or kidney problems.
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 infection to be aware of. Your doctor may give you drugs to help prevent an infection. These are called prophylactic drugs. They may also recommend you have vaccines such as the flu or coronavirus vaccination, if you have not already.
Immunoglobulin treatment
If you are getting a lot of infections, you may have regular immunoglobulins treatment. You have this as a drip into a vein or an injection under the skin (subcutaneously).
Most people feel fine when having treatment, but sometimes it can cause an allergic reaction. This is most likely to happen during or after the first treatment. Your cancer team will explain your treatment and what to expect.
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. It can make you feel tired and breathless.
Your doctor may suggest that you have a blood transfusion. The blood goes 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. You usually have it 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.
You may also 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 ends. But it can 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.
If you have a poor appetite, try to eat little amounts as often as possible. Keep snacks with you, such as nuts, grated cheese or dried fruit.
It is important to try to eat well during your treatment. If you are having problems, ask your specialist 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. Speak to your specialist nurse or doctor for more advice.
Related pages
Blood clots
Myeloma, and some treatments for it, can increase your risk of developing a blood clot.
Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:
- throbbing pain or swelling in a leg or an arm
- reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
- suddenly feeling breathless or coughing.
Always call 999 if you have:
- chest pain
- difficulty breathing.
A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating 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
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.
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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 informationproductionteam@macmillan.org.uk
Hughes D, Yong K, Ramasamy K, et al. Diagnosis and management of smouldering myeloma: A British Society for Haematology Good Practice Paper. Br J Haematol. 2024;204(4):1193-1206. Available from: www.doi.org/10.1111/bjh.19333
Sive J, Cuthill K, Hunter H, et al. Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Br J Haematol.2021;193(2):245-268. Available from: www.doi.org/10.1111/bjh.17410
Reviewer
Senior Clinical Research Fellow and Honorary Consultant in Molecular Diagnostics and Leukaemia
Date reviewed
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