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Blood Health 2020

Why myeloma is so difficult to diagnose

iStock / Getty Images Plus / Drazen Zigic

Laura Kirby

Chief Executive, Myeloma UK

“The blood cancer, myeloma, is one of the most difficult cancers to diagnose, with more than half of patients having to wait more than five months for the correct diagnosis,” says Myeloma UK Chief Executive, Laura Kerby.


“One of the main challenges is for the GP to suspect that their patient may have myeloma. It is a relatively rare cancer and, when you look at the common symptoms, which include bone pain, fatigue, persistent infections and nosebleeds, it is hard to see how they are connected.

“However, when you stop and think about where blood is made, what it is and what it does, it becomes easier to join the dots.”

Blood is essential to life

Blood is a toolkit of cells essential to life. There are three types of cells in your blood; red blood cells, white blood cells and platelets.

Red blood cells carry oxygen around the body so, low levels of red blood cells mean your body finds it harder to work and you will be fatigued.

It is critical that we raise awareness of myeloma – still an incurable cancer – and make people aware of the symptoms.

White blood cells work as part of the immune system; without them our bodies can’t fight infection.

Platelets are the cells that stop bleeding when a blood vessel is damaged, for instance when you get a cut. Low levels of platelets make you bleed more easily, which can lead to abnormal bruising or nosebleeds.

These different cells all play an important role in keeping us healthy.

We have blood in our bones

Bones are not just scaffolding to hold our bodies together. Although bone is made up of minerals and is hard, it is a living tissue that is continually maintained and has many functions including blood cell production.

In fact, most blood cells are made in the bone marrow, the spongy centre of our bones. The bone marrow maintains a delicate balance, ensuring that our bodies have the right levels of the various cells in our blood.

When the balance is disrupted it can impact the production of all these cells. This causes a wide range of symptoms.

Myeloma disrupts blood at the source

Myeloma is a blood cancer arising from faulty plasma cells – a type of white blood cells – in the bone marrow.

As myeloma cells multiply and grow, they overcrowd the bone marrow, disrupting the delicate balance and stopping the bones from maintaining themselves and suppressing the production of blood cells.

This can cause damage to the bones and the level of platelets, red and white blood cells to fall. As result, myeloma has multiple symptoms including bone pain, fatigue, infections, bruising and nosebleeds.

Although these symptoms seem unconnected, it is blood that connects them all. Myeloma affects blood at its source, impacting all blood cells.

The importance of early diagnosis

“It is critical that we raise awareness of myeloma – still an incurable cancer – and make people aware of the symptoms,” concludes Kerby.

“Our Myeloma Early Diagnosis Programme brings together leading experts to discuss where delays might happen and where improvements can be made.

We strive to reduce time to diagnosis, reduce complications and to increase awareness of the early signs and symptoms of myeloma, by educating GPs and other healthcare professionals.

The longer patients wait for diagnosis, the higher the chances of having complications. If patients have any concerns or symptoms it is vital that they visit their GP to get checked.

Diagnosing myeloma early means that patients start treatment sooner, which helps prevent permanent damage, lengthens survival and preserves quality of life.”

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