Once you have been diagnosed with multiple myeloma, your doctor will most likely order tests to help determine the stage of your disease.
Determining the stage of your cancer, referred to as staging, is the process of finding out how advanced your myeloma is. This information, along with a thorough assessment of your myeloma symptoms, is very important in providing a prognosis for your condition and determining the best treatment method.
Myeloma Stage Overview
There are two systems used to determine myeloma stage. The first, known as the Durie-Salmon staging system, was commonly used in the past and is based on the amount of monoclonal immunoglobulin (a type of abnormal protein produced in people with myeloma) in the blood or urine, the amount of calcium in the blood, the severity of bone damage seen on X-rays, and the amount of hemoglobin in the blood.
The second one, which is now used most often, is the International Staging System (ISS). "The ISS uses only two parameters: beta-2microglobulin and albumin," says Guido Tricot, MD, PhD, director of the Utah Blood and Marrow Transplant and Myeloma Program at the Huntsman Cancer Institute in Salt Lake City.
The ISS is the result of a collaboration of more than 20 international research institutions.
Myeloma Stage: I, II, III
The more advanced a person's multiple myeloma is, the higher the myeloma stage. Myeloma stage is determined by the amount of disease that is present in your body. There are three stages used to classify multiple myeloma:
- Stage I. A relatively small number of myeloma cells are present and there is minimal bone damage.
- Stage II. A moderate number of myeloma cells are present.
- Stage III. A large number of myeloma cells are present, and the cancer is probably causing problems with your bones and kidneys.
Why Knowing Your Myeloma Stage is Important
If you have myeloma, it is important to determine the stage of your disease so your doctor can develop an appropriate treatment plan. Your myeloma stage, symptoms, and the results of your other tests, all play a part in allowing your doctor to come up with an effective course for treating your multiple myeloma.
For example, if your myeloma is in an early and slow-progressing stage you may not require immediate treatment. Instead, your doctor will closely monitor your disease and hold off treatment until symptoms develop and the disease progresses. If your disease is more advanced, however, you and your doctor may decide on a more aggressive treatment plan.
Another important reason for staging myeloma is to help your doctor determine your prognosis, or likely outcome. People who have less advanced disease are likely to have better survival and outcomes than those with more advanced disease. However, as treatments get better, your myeloma stage will become less important in determining your outcome.
"If you treat patients aggressively, then staging does not have as big of an impact on the outcome," says Dr. Tricot. And that's good news, no matter what stage you are in.
Last Updated: 1/26/2009