Introduction

A diagnosis of myeloma is not always straightforward. One of the most difficult aspects is that patients present with their own unique profile. Some patients present completely asymptomatically while others suffer from life-threatening complications that require emergency attention.

Many patients go to their GP with non-specific symptoms such as lower back pain, repeated infection and tiredness. Although these symptoms are characteristic of myeloma they commonly occur in a wide range of other disorders and conditions, making a diagnosis difficult. Over a third of patients visit their GP at least three times before getting a diagnosis.

Myeloma may also be detected coincidently when blood tests are taken to monitor other conditions or may be revealed when tests are performed to determine the cause of, for example, anaemia, generalised bone pain or lower back ache. For 1 in 3 patients, a diagnosis is made following their admittance to A&E with symptoms associated with hypercalcaemia, renal failure or spinal cord compression.

Receiving a diagnosis of myeloma affects people differently. It is common for patients to describe feelings of shock, numbness, fear, loss of control, anger and disbelief but also a sense of relief when the diagnosis has been made.

Patients who are diagnosed late are more likely to have more severe symptoms, complications and impaired quality of life. For family members and partners, too, the impact can be substantial.

Nurses play a pivotal role in ensuring that myeloma patients receive the optimal psychological and practical support necessary to deal with all that a diagnosis brings. By having a clear understanding of how myeloma presents, nurses can initiate appropriate interventions which help create a greater sense of assurance, wellbeing and overall quality of life for patients. This also includes providing them with access to the right information at the right time, in the right format.

This module describes the common presenting symptoms, the diagnostic procedures used and the criteria needed to make a definitive diagnosis. A more detailed explanation of the symptoms and complications of myeloma are found in Module 8.