FAQ (https://www.myeloma.org/myeloma-cancer-questions)

This multiple myeloma FAQ page answers some of the most commonly asked questions about this illness. Learn more about multiple myeloma, what causes it, and what you can do if you or a loved one is diagnosed with the disease.

Frequently Asked Questions About Multiple Myeloma
What is Multiple Myeloma?

 

General Information About Multiple Myeloma

Know more about the basics of multiple myeloma for a better understanding of your condition.

What is multiple myeloma?

Also known as plasma cell myeloma, multiple myeloma (https://www.myeloma.org/what-is-multiple-myeloma)  (https://www.myeloma.org/what-is-multiple-myeloma)is cancer that affects bone marrow plasma cells. These cells are responsible for making antibodies that help the body fight against bacteria and viruses. A malignant or cancerous plasma cell is called a myeloma cell. Myeloma is described as “multiple” because it frequently grows in several areas of the bone marrow.

While multiple myeloma is currently incurable, it is treatable. With advances in therapies, many patients can achieve remission and manage their disease for extended periods. (https://www.myeloma.org/newly-diagnosed/myeloma-life-expectancy) Early diagnosis and treatment by a myeloma specialist are recommended for the best outcomes.

How does multiple myeloma impact the body?

Multiple myeloma affects areas where the bone marrow is active in adults. These include the bones of the spine, skull, pelvis, rib cage, and areas around the shoulders and hips. This condition impacts the body by:

  • Causing bone breakdown.
  • Preventing new bone cell production.
  • Increasing the risk of fractures.
  • Releasing calcium into the blood (hypercalcemia).
  • Disrupting the production of new blood cells, leading to anemia, neutropenia, or thrombocytopenia.
  • Suppressing the immune response.
  • Reducing the number of normal antibodies.

Kidney disease is also identified as a serious complication of multiple myeloma, affecting 20% to 25% of newly diagnosed patients. Up to 50% of patients with active myeloma are also at risk of developing kidney disease.

What are the signs and symptoms of multiple myeloma?

In 70% of patients, the most common symptoms of multiple myeloma are: 

  • Back or bone pain
  • Fatigue
  • Recurrent or persistent infections

Other possible symptoms include:

  • Consistent or worsening tiredness.
  • Recurrent unexplained infections (such as pneumonia, sinus infection, or urinary tract infection).
  • Swollen arms, legs, hands, or feet.
  • Shortness of breath.

If you are experiencing any of these symptoms, it is important to consult your physician. 

What causes multiple myeloma?

The exact cause of multiple myeloma is unknown, but several potential risk factors (https://www.myeloma.org/newly-diagnosed/do-you-have-myeloma) have been identified, including:

  • Radiation exposure.
  • Immune system problems or infections.
  • HIV, hepatitis, and herpes viruses that may act as triggers.
  • Family history.

Although it's not proven, some theories suggest that exposure to toxic chemicals (benzene, dioxins, agricultural chemicals, solvents, fuels, and engine exhaust) may be linked to the development of myeloma.

Research is ongoing to better understand the genetic and environmental factors that may contribute to the development of myeloma. Some studies are investigating whether dietary and lifestyle factors play a role, especially in the progression from precursor conditions to active myeloma.

What determines a multiple myeloma prognosis?

A multiple myeloma prognosis is determined by both the number and specific properties of myeloma cells in a patient, which include: 

  • Growth rate of myeloma cells.
  • Production rate of monoclonal antibody proteins.
  • Production or non-production of various cytokines and chemicals that damage or significantly impair other tissues, organs, or bodily functions.
What are the types of multiple myeloma?

Multiple myeloma has different types and subtypes based on the immunoglobulin (protein) produced by the myeloma cell:

  • Heavy protein chains: G, A, D, E, and M
  • Light protein chains: Kappa (κ) and lambda (λ)

Find out more about the  (https://www.myeloma.org/types-of-myeloma)types of myeloma (https://www.myeloma.org/types-of-myeloma). (https://www.myeloma.org/types-of-myeloma)

 

What are the stages of multiple myeloma?

 

There are three stages of multiple myeloma (https://www.myeloma.org/what-are-mgus-smm-mm):

  1. Monoclonal gammopathy of undetermined significance (MGUS): The earliest precursor and disease state associated with the subsequent development of myeloma, with a low level of abnormal plasma cells and monoclonal protein (or M protein) found in the blood. There are several types of MGUS — multiple myeloma may develop from plasma cell type MGUS (comprising 85% of all MGUS cases). MGUS occurs in 3%-5% of the U.S. population, with higher rates among those aged 50 and older. Progression from MGUS to active myeloma occurs at a low rate of 1% per year. MGUS is a benign condition, and patients do not need to undergo treatment unless they choose to take part in a clinical trial. However, a hematologist should monitor patients with MGUS.
  2. Smoldering multiple myeloma (SMM): An asymptomatic precursor state of active myeloma, similar to MGUS but at an intermediate level. SMM patients have higher levels of monoclonal protein and abnormal plasma cells than MGUS, but no indications of end-organ damage based on the CRAB criteria (https://www.myeloma.org/newly-diagnosed/multiple-myeloma-diagnostic-criteria). The average risk progression from SMM to active myeloma is 10% per year. SMM patients should be observed by a hematologist-oncologist at regular intervals.
  3. Active multiple myeloma: Also known as symptomatic myeloma, active multiple myeloma is diagnosed when specific tests indicate the presence of end-organ damage (based on the CRAB criteria), which may include hypercalcemia, anemia, bone lesions, and/or kidney damage. A patient experiencing 10% or more clonal plasma cells in the bone marrow and at least one myeloma-defining event (MDE) is diagnosed with active myeloma.

Multiple myeloma is typically staged (https://www.myeloma.org/tests-staging) as Stage I, II, or III based on disease burden (amount of myeloma cells and M-protein). Stage I indicates lower disease burden, while Stage III indicates higher burden. Additionally, cytogenetic testing identifies risk level—standard risk or high-risk. High-risk features include t(4;14) deletion, 17p deletion, TP53 mutation, or 1q amplification. Your stage and risk level help your doctor predict treatment response and guide therapy selection.

The progression from MGUS to SMM to active myeloma involves increasing levels of abnormal plasma cells and monoclonal protein production. Careful monitoring and timely intervention are crucial to manage the disease course. (https://www.myeloma.org/phases-disease)

How is multiple myeloma staged?

The earlier staging system for multiple myeloma was the Durie-Salmon Staging System (https://www.myeloma.org/durie-salmon-staging). It shows the correlation between the amount of myeloma and the damage it has caused, such as bone disease or anemia.

Today, multiple myeloma is staged using the following:

  • International Staging System: Developed by the International Myeloma Working Group (IMWG), the I (https://www.myeloma.org/international-staging-system-iss-reivised-iss-r-iss)nternational Staging System (https://www.myeloma.org/international-staging-system-iss-reivised-iss-r-iss) is based on prognostic factors and predictors of survival, which include Serum β2 microglobulin (Sβ2M), serum albumin, platelet count, serum creatinine, and age.
  • Revised International Staging System for Multiple Myeloma: Published by the IMWG in August 2015, the R-ISS expanded upon the ISS by incorporating two additional prognostic markers assessed from bone marrow samples taken at the time of diagnosis:
    • Lactate dehydrogenase (LDH): An enzyme whose elevated levels can reflect more aggressive disease activity
    • Chromosomal abnormalities (cytogenetic abnormalities): Detected by fluorescence in situ hybridization (FISH), a technique that uses fluorescent chemical probes to bind to specific DNA sequences on chromosomes, revealing structural differences. The high-risk chromosomal abnormalities assessed are del(17p), t(4;14), and t(14;16).
  • A revised consensus framework for classifying high-risk multiple myeloma was released in June 2025 through a collaboration between the International Myeloma Working Group (IMWG) and the International Myeloma Society (IMS). The updated system reflects current research findings and recent advances in myeloma therapy, providing a more biologically based method for assessing disease risk.
    • The classification is intended to support treatment planning by helping clinicians determine the appropriate intensity and duration of therapy, as well as identify patients who may benefit from participation in clinical trials. 
    • Under this framework, patients are categorized into one of two risk groups: standard-risk or high-risk.

 

Who is at Risk for Multiple Myeloma?

Identifying Risk Factors for Multiple Myeloma

These multiple myeloma questions identify the likelihood of the condition among certain individuals.

Who is at risk of developing multiple myeloma?

Certain factors may increase a person's risk of developing multiple myeloma, including:

It is important to note that while these factors may increase the risk of developing multiple myeloma, not everyone will develop the disease. Additionally, individuals without these risk factors may still be diagnosed with multiple myeloma.  

The exact cause of multiple myeloma is not fully understood. Additional research is ongoing to better understand the underlying factors.   

How prevalent is multiple myeloma?

Multiple myeloma is the second most common blood cancer (https://pmc.ncbi.nlm.nih.gov/articles/PMC10818257/) in the world. According to the National Cancer Institute (NCI) SEER data, an estimated 36,000 new multiple myeloma cases are projected to be diagnosed in the United States in 2026, with myeloma representing 1.7% of all projected new U.S. cancer cases.

What tests will I need for myeloma diagnosis and monitoring?

Diagnosis involves blood tests (https://www.myeloma.org/multiple-myeloma-blood-tests) (https://www.myeloma.org/tests-staging)to detect M-proteins (https://www.myeloma.org/monoclonal-protein-tests) and measure kidney function (https://www.myeloma.org/myeloma-kidney-tests), calcium, and blood cell counts. Bone marrow biopsy and aspiration collect samples to identify myeloma cells and perform genetic testing (FISH test). Urine tests detect Bence Jones proteins.

Imaging tests (https://www.myeloma.org/multiple-myeloma-imaging-studies) including X-rays, MRI, CT, or PET scans show bone damage. Genomic testing determines your risk level. These tests are repeated during treatment to monitor disease response and guide therapeutic decisions.

What Should I Expect if I Have Multiple Myeloma?

Testing, Diagnosis, Medical Issues, and (https://www.myeloma.org/newly-diagnosed/do-you-have-myeloma)Other Information for the Newly Diagnosed (https://www.myeloma.org/newly-diagnosed/do-you-have-myeloma)

The following multiple myeloma questions and answers focus on providing helpful information for newly diagnosed individuals.

How is multiple myeloma diagnosed?

Multiple myeloma is typically diagnosed using a combination of the following methods:

Medical History and Physical Examination

Symptoms, medical history, and family history of cancer will be assessed, and a physical examination may be performed to check for signs of multiple myeloma or related complications. 

Tests to Assess Blood Cells

Complete blood count (https://www.myeloma.org/multiple-myeloma-blood-tests) (CBC) is used to identify the presence of MGUS, SMM, or multiple myeloma. A CBC also measures red blood cells, hemoglobin, hematocrit, white blood cells, neutrophils, and platelets.

Additionally, mass spectrometry (https://www.myeloma.org/multiple-myeloma/tests-staging/mrd-mass-spectrometry-testing) is conducted to detect and measure the amount of M-protein in the blood. Mass spectrometry is helpful in diagnosing and monitoring MGUS, SMM, and active myeloma. However, mass spectrometry has not yet been approved by the FDA and is currently only being conducted at a few reference laboratories.

Tests to Assess Kidney Function

The International Myeloma Working Group (IMWG) and National Comprehensive Cancer Network (NCCN) recommend kidney function tests (https://www.myeloma.org/myeloma-kidney-tests) for diagnosis and management of multiple myeloma, which include: 

  • Serum creatinine.
  • Estimated glomerular filtration rate.
  • Electrolyte measurements.
  • Free light chain assessment.
  • Urine electrophoresis of a sample from a 24-hour urine collection.

Tests to Assess Monoclonal Protein

This important group of blood and urine tests (https://www.myeloma.org/monoclonal-protein-tests) assesses the amount and activity of myeloma. These tests measure the monoclonal protein that myeloma cells secrete into the blood and/or urine. 

These blood and urine tests include Serum Quantitative Immunoglobulins (QIg), Serum Protein Electrophoresis, Urine Protein Electrophoresis, and serum Free Light Chain.

Bone Marrow Testing

Bone marrow tests (https://www.myeloma.org/bone-marrow-tests) (aspirate and biopsy) are performed routinely to diagnose multiple myeloma and are also used for monitoring during treatment:

  • Bone marrow aspiration uses a needle to collect a sample of fluid and cells from the bone marrow for examination under a microscope. 
  • Bone marrow biopsy uses a hollow-bore needle to collect a sample of bone tissue. If cancerous plasma cells are found, the pathologist estimates how much of the bone marrow is affected.

Imaging Tests

Because bone disease is a common symptom of multiple myeloma (with 70%-80% of patients found to have bone disease at diagnosis), imaging tests (https://www.myeloma.org/multiple-myeloma-imaging-studies) are crucial in assessing the status of a patient's bones and/or bone marrow at diagnosis and relapse. These tests include:

  • X-rays 
  • CT or CAT (computerized axial tomography) scans 
  • MRI (magnetic resonance imaging) scans 
  • PET (positron emission tomography) scans 
  • PET/CT scans 
  • Bone density testing 

Early diagnosis is important to guide appropriate treatment planning. The IMWG criteria for diagnosing myeloma (https://www.myeloma.org/international-myeloma-working-group-imwg-criteria-diagnosis-multiple-myeloma)  (https://www.myeloma.org/international-myeloma-working-group-imwg-criteria-diagnosis-multiple-myeloma)are based on these test results.

What do I need to know if I'm newly diagnosed with multiple myeloma?

The IMF has a database of essential information to help you understand your condition. If you are newly diagnosed with myeloma (https://www.myeloma.org/multiple-myeloma/multiple-myeloma-diagnosis), we recommend these resources to help you navigate these significant life changes:

Treatment for myeloma continues to evolve with new therapies and combination approaches. Recent updates from major hematology and oncology conferences show promise in improving outcomes for newly diagnosed patients. (https://www.myeloma.org/multiple-myeloma/multiple-myeloma-diagnosis) Modern treatment options are more targeted and often have better tolerability profiles. The goal of therapy has shifted toward achieving deeper responses and longer survival times. 

Work with a myeloma specialist who is aware of the latest treatment advances and clinical trial options available.

What are some medical problems that may be related to multiple myeloma?

Multiple myeloma can affect bones, red blood cells, and kidneys, as well as a patient's immune response, which may lead to chronic, sometimes even severe, infections. 

Urgent medical problems may also arise at diagnosis, which require medical attention before systemic therapy for myeloma begins:

  • Vertebral compression fractures 
  • Myeloma tumors (plasmacytomas) that can press on the spinal nerves 
  • Nerve damage in the spinal cord 
  • Infections 
  • Hypercalcemia from bone breakdown 
  • Kidney failure due to high levels of calcium and monoclonal protein in the blood 

Other possible medical problems include: 

  • Anemia due to myeloma cells interfering with red blood cell production.
  • Peripheral neuropathy (numbness, tingling, or pain in hands and feet).
  • Blood clots or venous thromboembolism.

Myeloma and its treatments can impact various organs and systems in the body. Learn more about possible myeloma-related complications (https://www.myeloma.org/medical-conditions) within and outside the bone marrow.

 

Is multiple myeloma curable?

While multiple myeloma has traditionally been considered incurable, advances in treatment and research are changing that outlook. Today, many patients achieve deep, long-lasting remissions and live longer, healthier lives than ever before. Researchers are actively exploring whether some patients who remain in complete remission, are minimal residual disease (MRD)-negative, and show no signs of active disease for many years could be considered cured (https://www.myeloma.org/newly-diagnosed/is-myeloma-curable). The question of sustained remissions equaling a cure is still being studied. Although a cure is not yet the standard outcome, ongoing innovations in immunotherapy, MRD testing, and cure-focused research (https://www.myeloma.org/black-swan-research-initiative) are bringing the myeloma community closer to that goal.

How long can I live with multiple myeloma?

Multiple myeloma life expectancy (https://www.myeloma.org/newly-diagnosed/myeloma-life-expectancy) varies from person to person based on factors such as age, overall health, disease stage, and individual risk factors. Recent studies show that the average survival for people with myeloma now exceeds 10 years, thanks to significant advances in treatment. While statistics cannot predict an individual's outcome, many patients today are living longer and maintaining a good quality of life with modern therapies, ongoing monitoring, and personalized care.

What should I ask my doctor immediately after a myeloma diagnosis?

Key questions include: 

  • What type of myeloma do I have? 
  • What is my stage and what does that mean? 
  • What is my chance of responding to treatment? What is the length of survival for myeloma?
  • Is there a cure? 
  • Are there factors in my case that are good or bad? 
  • What tests do I need before treatment decisions? 

The IMF recommends asking about your risk level (standard vs. high-risk), your baseline lab markers, and ensuring you have access to a specialized myeloma treatment center.

Can I work and maintain a normal lifestyle while undergoing myeloma treatment?

Yes, many people living with myeloma can work and maintain relatively normal lifestyles, especially with modern treatment advances. The ability to continue working depends on your specific treatment regimen, (https://www.myeloma.org/working-while-living-with-multiple-myeloma) side effects, and overall health. Some patients work full-time during treatment while others adjust their schedules. Your healthcare team can help manage side effects and plan treatment schedules to minimize disruption. With optimal treatment, many patients live 20+ years after diagnosis, allowing for extended periods of normal functioning.

What are my treatment options and how are they administered?

Treatment options vary based on your myeloma type (https://www.myeloma.org/multiple-myeloma-treatment), stage, age, and overall health. Common approaches include drug therapy (combinations of targeted drugs, immunomodulatory agents, proteasome inhibitors), stem cell transplants, and CAR-T cell therapy. Medications can be administered by injection— either intravenously or subcutaneously— or orally. Some medications may be taken at home. Your treatment plan should be individualized to your situation. Discuss with your doctor how treatments will be given, their potential side effects, and how they'll monitor treatment effectiveness.

What happens if my myeloma becomes resistant to my current treatment?

If your myeloma stops responding to treatment (https://www.myeloma.org/treatment/relapse-definition) (becomes refractory), your hematologist/oncologist will develop an alternative treatment plan. Multiple effective therapies exist for treatment-resistant myeloma, including different drug combinations, higher doses, or clinical trials testing new therapies. Regular monitoring through blood tests and imaging helps detect progression early, so your team can adjust treatment promptly. 

The goal is to find a treatment regimen that works specifically for you.

How do I know if my treatment is working?

Your doctor monitors treatment effectiveness (https://www.myeloma.org/multiple-myeloma-treatment) through regular tests (https://www.myeloma.org/multiple-myeloma-tests) measuring M-protein levels, kidney function, calcium, and blood cell counts. They also use imaging tests (X-rays, MRI, or PET scans) to assess if bone lesions or fractures are present.  

Lab results help determine if you've achieved remission (complete or partial) or stable disease. Blood tests are typically done more frequently at the start of treatment and then at regular intervals. Discuss with your team what response goals are realistic for your situation.

What treatment decisions should I consider when making my treatment plan?

Important treatment preferences to discuss with your team include: your desired aggressiveness of treatment, preference for outpatient vs. inpatient settings, whether you want to take medications at home, tolerance for side effects, importance of quality of life vs. quantity of life, interest in clinical trials, out-of-pocket costs, and desire to maintain an active lifestyle. 

The IMF's Myeloma Treatment Discussion Tool (https://www.myeloma.org/resource-library/tip-card-myeloma-treatment-discussion-tool) helps patients communicate their values and preferences to their healthcare team.

What to Avoid if You Have Multiple Myeloma

Additional questions to ask about multiple myeloma include possible dietary and lifestyle changes, which we answer below.

What foods should I avoid if I have multiple myeloma?

The “Hazardous Five” refers to five key additives that are considered “the worst of the worst.” In the blog, “You Are What You Don't Eat,” (https://www.myeloma.org/blog/dr-duries/you-are-what-you-dont-eat) multiple myeloma patients are advised to avoid foods that contain these additives at all costs:

  • Red dye #3
  • Titanium dioxide
  • Brominated vegetable oil
  • Potassium bromate
  • Propyl paraben
Should I avoid physical activity if I have multiple myeloma?

Your attending myeloma clinician may recommend a consultation with a physical or occupational therapist to assess your physical activity level and assistance needs. Common questions to discuss with your healthcare providers when considering your physical activity level include:  

  • How do you move in and out of bed?  
  • How long can you tolerate exercise? For example, can you comfortably ride a stationary bike for 10 minutes?  
  • Are you experiencing any pain in certain parts of your body? 

For healthcare providers, an exercise prescription should consist of the four components of the FITT Principle:  

  • Frequency: The number of sessions per week
  • Intensity: How hard the person is exercising
  • Time: The duration of the exercise session
  • Type: The activity mode 

Before starting any exercise program, healthcare providers should assess a patient's overall fitness and safety level. Patients should also be educated about when to modify or abstain from their exercise regimens. As always, discuss your planned physical activities (https://www.myeloma.org/cancer-exercise-guidelines)  (https://www.myeloma.org/cancer-exercise-guidelines)with your healthcare provider.

 

What is the IMF's Role in the Fight Against Multiple Myeloma?

Learn about the IMF's efforts in research, education, support, and advocacy for people living with multiple myeloma.

What is the IMF doing to help prevent and cure multiple myeloma?

The IMF is dedicated to finding a cure for myeloma and preventing its onset through various research initiatives: 

Through these robust research programs, the IMF is making significant strides and bringing hope for improved outcomes, prevention strategies, and ultimately a cure for this disease.  (https://www.myeloma.org/newly-diagnosed/is-myeloma-curable)

Additionally, the IMF promotes health equity worldwide through the Global Myeloma Action Network (https://www.myeloma.org/take-action/global-myeloma-action-network-gman) and the M-Power Project, (https://mpower.myeloma.org/?_gl=1%2A1wryroo%2A_ga%2AMTc4ODI1Mzg1OC4xNjk0NjIxNzA5%2A_ga_2EJEFWRS4D%2AMTcxNzYxODA5Mi40NTEuMS4xNzE3NjI1Njc3LjE0LjAuMTY0OTcwNzI1OQ..) which aim to reduce healthcare disparities that can contribute to myeloma development in underrepresented communities. 

How can the IMF help with my multiple myeloma diagnosis?

The IMF can help you in many ways after a myeloma diagnosis: 

Can the IMF InfoLine help with referrals to myeloma specialists and treatment centers/facilities?

The IMF InfoLine is staffed by trained specialists who can provide information about myeloma treatment centers and specialists in your area. While they cannot directly refer you to a specific doctor, they can guide you on factors to consider when choosing a myeloma specialist and treatment facility.  

The InfoLine team aims to empower you with knowledge to have informed discussions with your healthcare providers. You may call 1-800-452-CURE (2873) in the U.S./Canada, or worldwide at 1-818-487-7455. You may also email your inquiries to [email protected] (mailto:[email protected]).

How does the IMF utilize corporate support or funds?

The IMF utilizes corporate and foundation support to advance its mission of accelerating the prevention and cure of myeloma and improving the quality of life for patients and families. Corporate gifts and foundation grants provide critical seed funding to accelerate the path to a cure. This funding can expedite the discovery of innovative treatments and expand IMF programming to support those affected by this incurable disease. 

The IMF guides corporate giving strategies to align with companies' goals, target audiences, and marketing objectives. By partnering with the IMF, corporations make a wise investment in the future while providing value for their organization. Corporate and foundation funding allows the IMF to continue its vital research initiatives, educational resources, support services, and advocacy efforts for the myeloma community worldwide. 

Know more about what the IMF does in the latest IMF Annual Report. (https://issuu.com/international-myeloma-foundation/docs/annual-report-2025?fr=sMTM5YjkxMDM3NjQ)

 

 

Does the IMF provide financial assistance to patients and their families?

Unfortunately, the IMF is not able to provide direct monetary assistance to patients, but we do have information about financial resources that may be available to you.

You can view a list of co-pay assistance programs   (https://www.myeloma.org/online-resources/drug-reimbursement-information-assistance)or contact the IMF InfoLine at 1-800-452-CURE (2873) in the U.S./Canada, or globally at 1-818-487-7455. Phone lines are open Monday through Friday, 9 a.m. to 4 p.m. (PST). You may also email your inquiries to [email protected] (mailto:[email protected]). 
 

Join Our Cause

The IMF does valuable work in providing comprehensive support to patients with multiple myeloma. You can help join our fight against this disease by making a donation (https://www.myeloma.org/donate) or being an advocate (https://www.myeloma.org/take-action/advocacy). Contact our team for more information.


 


The International Myeloma Foundation medical and editorial content team

Comprised of leading medical researchers, hematologists, oncologists, oncology-certified nurses, medical editors, and medical journalists, our team has extensive knowledge of the multiple myeloma treatment and care landscape. 

Additionally, the content on this page is medically reviewed by myeloma physicians and healthcare professionals.

Last Medical Content Review: July 30, 2026

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