One of the first things that doctors attempt to do when a patient is diagnosed with multiple myeloma is determine the staging of the condition. So-called multiple myeloma staging involves looking at indicators of the disease to determine how far the condition has progressed and how much it has already affected the patient's marrow and bones. Based on this information, the physician can then chart a course of treatment and have a better sense for the patient's prognosis.
To help them with multiple myeloma staging, physicians look at the major indicators of this type of cancer. They are bone lesions or pain, reduced kidney function, elevated levels of calcium in the blood and anemia. Patients without apparent symptoms have inactive multiple myeloma, also called smoldering multiple myeloma. If a physician determines this during the course of multiple myeloma staging, he or she will still keep a close eye on the patient going forward. The physician might also suggest some medications to protect the patient from the potential side effects of the condition, such as medicines to strengthen bones or inoculations against certain types of infections.
If the patient matches the symptoms of multiple myeloma, then he or she is considered to have an active case. A patient who demonstrates higher levels of protein in his or her urine or blood or shows organ damage in particular could then require immediate treatment. Other symptoms that physicians can observe during multiple myeloma staging include repeated infections and amyloidosis, an abnormal buildup of proteins in certain organs.
The name of the traditional multiple myeloma staging system is called the Durie-Salmon system. It allows physicians to know which of three stages an active case of multiple myeloma has reached. Each of the three stages in this system is also broken down into two subcategories, based on whether the disease has affected the patient's kidneys.
Another multiple myeloma staging system, which is newer and has become more common, is called the International Staging System. Based on levels of certain proteins in the blood, this system also breaks down cases into three stages. Stage I myeloma is diagnosed when a patient has near-normal red blood cells, normal calcium levels, very low levels of the blood proteins and no bone damage, among other symptoms. With Stage II myeloma, the patient's body contains more cancer cells. Stage III myeloma patients display bone damage, anemia, many cancer cells in the body and higher levels of blood protein, among other symptoms.