This is the earliest stage of multiple myeloma, where individuals may be symptom-free and show no signs of bone damage. At this stage, your oncologist may suggest “watchful waiting,” where the condition is closely monitored. Your cancer doctor may also recommend therapies aimed at slowing the growth of blood cancer cells. Regular testing every three months is typically advised to monitor the development of tumors in your bones and signs of kidney problems.
Stages of Multiple Myeloma
After a diagnosis of multiple myeloma, your oncologist will assess how advanced your blood cancer is, a process known as staging. Staging is essential for creating an effective treatment plan, as multiple myeloma responds differently to treatments based on how advanced it is.
Tests for Staging Multiple Myeloma
When determining the stage of your multiple myeloma, your doctor will likely request a number of blood tests. These may include checking serum albumin and beta-2 microglobulin (β2-M) levels. Albumin is a protein that carries various substances in the bloodstream; low levels can indicate issues with your liver or kidneys.
Your oncologist may also measure the level of Beta-2 Microglobulin (β2-M), which cancer cells, such as myeloma cells, can shed into the bloodstream. High levels of β2-M suggest the presence of cancer.
Another important test may be the serum lactate dehydrogenase (LDH) level. LDH is a protein found in nearly all body tissues, including the kidneys, and rises in the bloodstream when tissue damage occurs. This makes LDH a reliable biomarker, or indicator, of tissue damage.
Additionally, your doctor may order other blood tests to evaluate kidney function and examine your platelet levels, which are essential for blood clotting.
Imaging studies are also a key part of staging, providing detailed pictures of your bones. These tests, such as computed tomography (CT) and magnetic resonance imaging (MRI), are quick and painless, typically completed in under an hour.
Stages of Multiple Myeloma
There are four stages of multiple myeloma, although the numbers only go up to three. The first stage is usually prior to starting treatment.
Smoldering
Stage I
In Stage I, your β2-M will be less than 3.5 mg/L, and your serum albumin should be 3.5 g/dL or higher. If you remain symptom-free, your oncologist might continue with watchful waiting and monitoring. However, treatment may be suggested if you begin to experience symptoms.
Your lab results may change as you enter Stage I. The impact of multiple myeloma on your kidneys may prevent them from clearing calcium from your bloodstream, leading to elevated serum calcium levels above 2.75 mmol/L (normal range is 2.2 to 2.7 mmol/L).
Additionally, multiple myeloma can prevent the kidneys from clearing creatinine — a waste product produced by your muscles — from your bloodstream. Higher-than-normal creatine levels indicate Stage I.
Multiple myeloma can also disrupt the normal blood production in your bone marrow, potentially leading to anemia, which occurs when there is not enough hemoglobin to deliver oxygen to your body cells or carry away carbon dioxide. You may have Stage I multiple myeloma if your hemoglobin level is below 10 g/dL.
Finally, myeloma may cause bone damage, known as lytic lesions, and can also cause osteoporosis (thinning of the bones) or compression fractures of the spine, in which the vertebrae collapse.
Stage II
In Stage II of multiple myeloma, the blood cancer begins to spread, resulting in various symptoms. You enter Stage II when your β2-M level is between 3.5 mg/L and 5.5 mg/dL or when your albumin drops less than 3.5 g/dL.
Stage III
In Stage III multiple myeloma, the blood cancer affects several areas of your body, leading to complex symptoms. You enter Stage III when your β2-M is greater than 5.5 mg/L.
Because multiple myeloma spreads through the bloodstream, it can quickly impact different parts of the body, making this form of cancer difficult to treat. Staging helps your oncologist develop the best multiple myeloma treatment plan for your stage.
Blood Cancer Doctors Specializing in Multiple Myeloma in the Syracuse Area
At Hematology-Oncology Associates of CNY, we are committed to providing expert, patient-centered cancer care for multiple myeloma. Our team ensures each patient receives a personalized treatment plan based on the latest advancements in cancer care.
Our cancer centers provide care for patients in Central New York, including the Syracuse area, Onondaga County, Cayuga County, Cortland County, Herkimer County, Jefferson County (including Watertown), Madison County (including Oneida), Oneida County (including Utica and Verona), and Oswego County (including Fulton and Oswego).
