Multiple Myeloma: Stages
What does stage of cancer mean?
The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to determine this. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.
What are the stages of multiple myeloma?
Different systems have been used to stage multiple myeloma. The most recent system is the Revised International Staging System (R-ISS).
Revised International Staging System
The R-ISS divides multiple myeloma into three stages. These are based mainly on the results of certain lab tests.
Stage I includes myelomas with all of the following:
Serum beta-2 microglobulin (B2M) is less than 3.5 mg/dL.
Serum albumin is at least 3.5 g/dL.
Serum lactate dehydrogenase (LDH) is normal.
The myeloma cells do not have any high-risk chromosome abnormalities.
Stage II includes all myelomas that do not fall into stage I or stage III.
Stage III includes myelomas with a serum B2M of at least 5.5 mg/dL, plus at least one of the following:
This older system is based on four factors:
These factors are used to divide multiple myeloma into three stages:
Stage I. X-rays and blood tests show that there are a small number of myeloma cells in your body. Most people with this stage do not have symptoms. Your healthcare provider may say that you have a low tumor burden at this stage.
Stage II. The myeloma cells have spread through the body a little bit. Your healthcare provider may say that you have an intermediate tumor burden at this stage.
Stage III. X-rays and blood tests show that many cancer cells are in your body. Your healthcare provider may say that you have a high tumor burden at this stage.
The Durie-Salmon system is not used as much now as it was in the past. If your healthcare provider uses this system, ask him or her to explain how it applies to you.
Along with the stage of a myeloma, other factors can also affect a person's outlook (prognosis). For instance, people who are younger tend to do better than those who are older. People who have better kidney function also tend to do better than those whose kidneys are more affected by the myeloma.
Talking with your healthcare provider
Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Make sure to ask any questions or talk about your concerns.