Understanding the Stages of Multiple Myeloma
Before deciding on treatment options, your doctor will need to know the extent, or stage, of the multiple myeloma. Your doctor will look at the results of blood tests, X-rays, and bone marrow tests to determine the stage of the cancer.
Your doctor may also schedule a positron emission tomography (PET) scan to help determine your stage. This test scans your entire body, so it is more helpful than a series of several different X-rays. The PET scan shows which parts of your body are using glucose. Glucose use is a sign of active, quickly dividing cells, such as multiple myeloma cells. For this test, you get injected with a small amount of radioactive glucose. Then you lie still on a table that is pushed into the PET scanner, which rotates around you, taking pictures. Some people are sensitive to the radioactive glucose and may have nausea, headache, or vomiting.
The most commonly used system to stage multiple myeloma is called the Durie-Salmon system. There are 3 different clinical stages of multiple myeloma. Stage I indicates the smallest amount of tumor, and stage III indicates the largest amount of tumor.
Stage I. Most people with this stage do not have symptoms, and they do not have elevated levels of M proteins. Your doctor may say that you have a “low tumor burden” at this stage.
Stage II. The myeloma cells have spread through the body a little bit. Your doctor may say that you have an “intermediate tumor burden” at this stage.
Stage III. Many cancer cells are present in the body. There are high levels of M protein and calcium in the blood, and many bones are affected. Your doctor may say that you have a “high tumor burden” at this stage.
Your doctor may give you more staging information based on how well your kidneys are functioning.