Signs and symptoms

Signs and symptoms of myeloma are sometimes referred to as myeloma-defining events. They may be vague and similar to those of other conditions, which is why it can take quite some time for myeloma to be diagnosed for many people. 

CRAB symptoms

The most common myeloma-defining events are often described using the acronym CRAB, which stands for: 

Calcium elevation (increased calcium in your blood, also called hypercalcaemia) 

Calcium is a mineral normally found in bones. It helps keep our bones strong and is involved with many other bodily functions, such as muscle movement, nerve conduction and blood flow. 

When bones are damaged by myeloma cells, they can release calcium into the bloodstream. This can lead to higher levels of calcium in your blood, known as hypercalcaemia. Symptoms of hypercalcaemia include confusion, constipation and thirst.

To read more about calcium elevation in myeloma see our living well page Myeloma bone disease

Renal insufficiency (reduced kidney function) 

Your kidneys’ main function is to cleanse blood of toxins and turn the waste into urine. Sometimes, when myeloma cells produce high levels of light chains, these can block the filtration mechanism of the kidneys. This can affect your kidneys’ ability to function at full capacity. Myeloma treatments such as chemotherapy can also cause stress on your kidneys.

Anaemia (low red blood cell count) 

Red blood cells are produced in the bone marrow and are responsible for carrying oxygen around the body. When there are high levels of myeloma cells in your bone marrow, they can take up too much space and not leave enough room for healthy levels of red blood cells to be produced. This results in anaemia, which can cause symptoms including fatigue, shortness of breath and dizziness

Bone involvement 

The bones of our skeleton are maintained by a process called remodelling. This means our bones are constantly being broken down and rebuilt at an even pace. Myeloma cells release a chemicals that can upset this process, resulting in bone being broken down faster than it can be rebuilt. Signs that myeloma has affected your bones include pain, fractures, osteoporosis (bone weakening), and destructive tumours, which are called lytic lesions. 

To read more about how myeloma affects the bones see our living well page Myeloma bone disease

I had no symptoms of myeloma at all until I injured my shoulder while playing basketball. Scans revealed a plasmacytoma, which had caused weakness in my bones. From there, I was diagnosed with non-secretory myeloma.

– Geoff, Victoria

The onset of CRAB symptoms is often the reason for starting myeloma treatment. 

The signs and symptoms you have at diagnosis may change with each relapse. It’s important to report any new symptoms to your treating team.

Other signs and symptoms

Recurrent infections 

Myeloma cells can affect your immune system’s normal function, increasing your risk of developing infections. Often, people have experienced repeated infections just before being diagnosed with myeloma. 

To read more about infection and myeloma, see living well page on Infection prevention.

Fatigue 

Myeloma cells put pressure on many functions of the body, which in turn causes fatigue. Fatigue is one of the most common symptoms of myeloma. It can be persistent and difficult to relieve with sleep or rest. 

To read more about myeloma fatigue and management strategies see living well page on Fatigue

The fatigue can be overwhelming at times. It’s hard for my family and friends to comprehend just how tired I can feel. I try to pace myself and plan my activities on the days that I have the most energy.

– Jan, Western Australia

Peripheral neuropathy 

Myeloma cells can cause direct damage to your nerves, causing a problem called peripheral neuropathy. This can cause changes in sensation, such as tingling, numbness, pain or a burning feeling, most commonly felt in your hands and feet. Some treatments for myeloma can also cause peripheral neuropathy. 

To read more about peripheral neuropathy and management strategies see our Managing peripheral neuropathy booklet.

Hyperviscosity

In some people, high levels of myeloma cells (paraprotein) can cause their blood to thicken, which is called hyperviscosity. This results in sluggish blood flow which can cause symptoms including headaches, blurred vision and high blood pressure.