Once it is confirmed that you have multiple myeloma, further exams are needed to determine the stage of the cancer. This is an important step; it helps your doctor to choose the most appropriate treatment to fight the disease. In general, the stage of cancer depends on the tumor size and degree of spread.
There are several methods to describe the multiple myeloma stages, but the classification system mostly used is the Durie–Salmon. Durie-Salmon Myeloma Staging System is based on 3 stages: stage I, stage II and stage III.
Stage I – the cancer is considered as a “stage 1 myeloma” when the following criteria are met:
- low number of cancer cells
- slightly low hemoglobin level
- blood calcium levels can be normal
- X-ray has revealed only 1 area of bone damage
- Blood and urine test has revealed small amount of monoclonal immunoglobulin.
Stage II – at stage 2, the cancer can present the same characteristics as stage 1, the only difference is that the number of myeloma cells has increased.
Stage III – in this last stage, the cancer has become more aggressive, and your chance to survive has decreased considerably. The cancer is considered as a “stage 3 myeloma” when the following conditions are present:
- large amount of myeloma cells
- hemoglobin level is below 8.5 g/dL
- blood calcium level is above 12 mg/dL
- three or more areas of bone are affected
- Large amount of monoclonal immunoglobulin in blood or urine.