Referral to a specialist for symptoms of myeloma

Your GP should arrange for you to see a specialist if you have symptoms or abnormal blood test results that could be due to myeloma.

Depending on your symptoms and other factors (such as blood test results), this might be an urgent referral.

You will see a specialist as soon as possible. Ask your GP when this is likely to be.

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

Your GP might arrange for you to have some tests first. This will help them decide if you need to see a specialist.

UK guidelines

There are guidelines for GPs to help them decide who needs a referral. These vary slightly between the different UK nations. Your GP will use these guidelines as well as their own experience and judgement.

Usually doctors use blood and urine tests to look for abnormal proteins (monoclonal protein). These proteins might also be called M-protein or paraprotein. 

England and Wales

You should have a full blood count and other blood tests if you are aged 60 or over and have one of these symptoms:

• bone pain that doesn’t get better
• an unexplained bone break (fracture)

You should have special blood and urine tests within 2 days if you are aged 60 or over and have:

• high calcium level or low white blood cells, and
• other signs or symptoms that might be due to myeloma

You should have special blood and urine tests within 2 days if you are any age and your blood and urine tests suggest that you could have myeloma. 

Your GP will look at the results of your urine tests, blood tests, or other tests such as bone X-rays. If the results suggest you could have myeloma then your GP will make an urgent referral to a haematologist.

Scotland

The Scottish guidelines are for all blood cancers, not just myeloma.

You should have an urgent referral to a specialist if:

• your blood test shows you have acute leukaemia or chronic myeloid leukaemia
• you have swollen lymph nodes that are larger than 2cm and have either been swollen for more than 6 weeks or are getting bigger
• you have an enlarged liver or spleen , but you don’t have any known liver disease
• you have bone pain together with anaemia or an abnormal paraprotein 
• a bone x-ray suggests you may have myeloma

You might have an urgent referral to a specialist if you also have any of the following signs or symptoms:

• extreme tiredness (fatigue)
• heavy sweating at night
• weight loss
• itching
• infections that keep coming back
• bone pain
• bruising
• weeing a lot and feeling very thirsty due to high calcium levels in your blood

Northern Ireland

The Northern Ireland guidelines are for all blood cancers, not just myeloma.

Your GP should refer you immediately to a specialist if:

• your blood test results show you have acute leukaemia
• your GP thinks you have myeloma and you have signs of spinal cord compression or kidney failure

Your GP should refer you urgently to a specialist if you have an unexplained, enlarged spleen that doesn’t get smaller.

Your GP should do further tests and consider referring you to a specialist if you have some of the symptoms listed below. The urgency of the referral depends on how severe your symptoms are and your test results. Symptoms include:

• extreme tiredness (fatigue)
• heavy sweating at night
• high temperature (fever)
• losing a lot of weight
• itching all over the whole body
• feel breathless
• bruising
• bleeding
• infection keep coming back
• bone pain
• tummy (abdominal) pain
• swollen lymph nodes
• enlarged spleen
• pain after drinking alcohol

If swollen lymph nodes are your only symptom, you do not need to see a specialist.

Other symptoms

Your GP will consider any other symptoms that you are having, so do mention these. They might also take into account whether you have any risk factors that affect your chances of developing myeloma.

If you're still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to explain why they don’t think you need a referral.

Contact your GP again if your symptoms don't get better or you notice any new or unusual symptoms. 

What should you do if you don’t get an appointment?

If your GP has referred you, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral

Waiting times

Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK.