Late-Stage Multiple Myeloma

Medically Reviewed by Murtaza Cassoobhoy, MD on May 28, 2023
Written by Shishira Sreenivas
4 min read

Many doctors refer to late-stage multiple myeloma as stage III. This is the stage you’re most likely to be in when doctors diagnose you. It’s hard to find it early since it may start with no symptoms. By the time you do get them, the cancer may have spread to different parts of your body and be causing damage to organs, putting you in the late stages of the condition.

Because multiple myeloma starts when healthy plasma cells become abnormal and grow out of control, when you have stage III, your body may have a large number of these cells. You’ll also have at least one of the following:

  • High levels of calcium in your blood
  • Kidney damage
  • Large amount of monoclonal immunoglobulin (a type of protein) in your blood or urine
  • Low levels of protein molecules in your red blood cells that carry oxygen (hemoglobin)
  • Three or more areas of bone damage from cancer
     

Some people don’t have any complications from their multiple myeloma. You may find out about it if you have a blood or urine test for another condition. Having more than the normal number of proteins is a red flag.

But when you have late-stage multiple myeloma, your symptoms may show up as:

  • Being sick to your stomach
  • Bone pain in your back or ribs
  • Bruising or bleeding easily
  • Feeling very tired
  • Fevers
  • Frequent infections that are hard to treat
  • Losing a lot of weight
  • Not feeling like eating
  • Weakness in your arms and legs

As multiple myeloma speeds up the process of bone breakdown, large amounts of calcium may drain into your bloodstream. This is called hypercalcemia.

Symptoms can include:

If the calcium levels get too high in your blood, you may even slip into a coma. If this happens, you’ll need immediate medical attention.

Myeloma can also damage your nerves and cause a “pins and needles sensation.” This is known as peripheral neuropathy.

If you start to notice such symptoms, tell your doctor. They may take a detailed medical history and do a physical exam to diagnose you. If they suspect multiple myeloma, they may run more tests to be sure.

There’s no cure for multiple myeloma. However, doctors can tell you how many people with the same type and level of cancer in the overall population lived at least 5 years after their diagnosis. This is called the 5-year relative survival rate.

Current research puts the 5-year survival rate for stage III multiple myeloma at about 53%.

However, there are various factors other than stage that can influence your chance of survival. These include:

Kidney function. Creatinine is a substance that leaves your body as a waste product when you pee. A blood creatinine test shows how well your kidneys are doing their job of filtering out waste. If there’s too much creatinine in your blood, it may mean your kidneys are not working well.

Age. Being older when you’re diagnosed decreases your life expectancy.

Overall health. If you have other chronic conditions like diabetes or high blood pressure, especially if they’re not well-controlled, it may mean a worse survival outlook.

One study found that a common cause of death for people with multiple myeloma was worsening chronic disease other than their cancer.

Research shows that people with myeloma are 7 to 10 times more likely to get infections. Pneumonia causes 2 out of every 3 infection-related deaths.

The CDC recommends you get the influenza, shingles, and pneumococcal vaccines after a multiple myeloma diagnosis to give you the best protection against deadly infections. If you develop an infection that won’t clear up, tell your doctor right away.

More research is needed to understand exactly what causes death in people with multiple myeloma. However, improvement in technology, treatment plans, and therapies is helping people with multiple myeloma better control their symptoms and live longer.

If you have stage III multiple myeloma and you’re unsure about what staging means or what your survival rate looks like, ask your doctor to explain it to you.

The effects of multiple myeloma on your bone health, kidney function, and blood count can take a toll on your overall quality of life. The stress and anxiety that stem from getting a terminal stage III cancer diagnosis can also play a huge role in your emotional and mental health.

One study that looked at the quality of life of people living with the condition found that problems doing day-to-day activities caused the most stress. These include:

There are resources you can use to help you deal with the many challenges that come with living with myeloma.

Besides your doctor, you can reach out to other members in your cancer care health team. There are professionals who can help with supportive and complementary care as you manage your condition. Some medical centers may offer these serves for free or at a reduced rate for cancer patients.

You can try:

Palliative care doctors, social workers, and chaplains can also help you and your caregiver come to terms with your terminal cancer diagnosis. They can act as a bridge between you and your oncologist to help you communicate through all stages of your condition.