The staging and prognosis of myeloma

Staging

The tests conducted to diagnose myeloma help your specialist work out how far the cancer has progressed. This is known as staging, and it helps your health care team recommend the best treatment for you.

The R-ISS divides myeloma into stages I, II and III based on the results of various blood tests that check:

• levels of beta-2 microglobulin (ß2M)—a protein produced by myeloma cells that indicates the extent of disease.
• levels of albumin—a protein produced by the liver that indicates overall health.
• levels of lactate dehydrogenase (LDH)—an enzyme released into the blood when cells are damaged or destroyed.
• genetic information—the presence of one or more specific chromosomal abnormalities may identify people at highest risk of the disease progressing[DR1] .

Prognosis

Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor, but it is not possible for any doctor to predict the exact course of the disease. Instead, your doctor can give you an idea about the general prognosis for people with the same type and stage of cancer.

To come up with a prognosis, your doctor will consider:

• test results;
• the type of myeloma you have;
• the rate and extent of tumour growth; and
• other factors such as age, fitness and medical history.

These details will also help your doctor advise you on the best treatment options.

Treatment for myeloma can help control the disease, manage the symptoms and improve quality of life, but cannot cure it.

If the myeloma is under control (also called a plateau phase), people usually return to a state of good health. The good health may last for months or a few years.

For some people, the disease can be controlled for much longer periods. If the disease becomes active again (relapses), further treatment will be needed.