Doctors sometimes find multiple myeloma after a routine blood test. More often, doctors suspect multiple myeloma after an x-ray for a broken bone. Usually though, patients go to the doctor because they are having other symptoms.

To find out whether such problems are from multiple myeloma or some other condition, your doctor may ask about your personal and family medical history and do a physical exam. In addition, your doctor may order some of the following tests and exams:

• Blood tests: The lab checks the level of blood cells and other substances. Myeloma causes a high level of plasma cells and calcium. Most people with myeloma have anemia. Myeloma also causes high levels of certain proteins. The lab checks for M protein, beta-2-microglobulin, and other proteins.
• Urine tests: The lab checks for Bence Jones protein, a type of M protein, in urine. The lab measures the amount of Bence Jones protein in urine collected over a 24-hour period.

If the lab finds a high level of Bence Jones protein in your urine sample, doctors will monitor your kidneys. Bence Jones protein can clog the kidneys and damage them.

• X-rays: You may have x-rays to check for broken or thinning bones.
• Biopsy: The doctor removes tissue to look for cancer cells. A biopsy is the only sure way to know whether myeloma cells are in the bone marrow. The doctor removes some bone marrow from your hipbone or another large bone. Local anesthesia helps reduce the discomfort. A pathologist uses a microscope to check the tissue for cancer cells.

  There are two ways the doctor can obtain bone marrow:

  • Bone marrow aspiration: The doctor uses a thin needle to remove samples of bone marrow.
  • Bone marrow biopsy: The doctor uses a thick needle to remove a small piece of bone and bone marrow.

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