Your GP will ask you questions about your symptoms, check your medical history and examine you. S/he may also do a blood test (see below).

If s/he thinks you may have myeloma, s/he will send you to see a specialist doctor (a haematologist) at a nearby hospital. There are NHS cancer referral guidelines to help GPs decide who may need to see a specialist, and how quickly.

Here are the tests you may have:

Blood test
This is to see whether your blood contains any abnormal protein (called paraprotein). This is found in the blood of some people with myeloma.

If the test shows a very low level of paraprotein, you don’t have myeloma – you have a condition called MGUS (monoclonal gammopathy of unknown significance). Your doctor will arrange to check your blood every so often and, if the paraprotein level rises in the future, s/he will organise more tests to look for signs of myeloma.

If your blood test shows a higher level of paraprotein, you will need to have these tests:

Urine sample
Your urine is tested to see whether it contains a paraprotein called the Bence Jones protein.

Bone marrow test
The aim is to see whether your bone marrow contains any abnormal plasma cells. The doctor usually takes some bone marrow from the back of the pelvis. Most patients have a local anaesthetic for this, but it can be done with a sedative injection. The injection makes you feel sleepy and relaxed, and you are unlikely to remember the test afterwards.

The doctor uses a fine needle to take the bone marrow sample. It may be a bit painful for a little while afterwards, but taking normal painkillers should help.

X-rays
If you have myeloma your doctor will want to see X-rays of your head, neck, back, pelvis, arms and legs, to find out whether the cancer has damaged your bones.