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Preparing for your appointment

By Mayo Clinic staff

In many cases, multiple myeloma is discovered as part of routine blood and urine tests during a medical checkup. To increase the odds of catching this and other serious conditions as early as possible, follow the recommended schedule for your age and sex for general physical examinations.

If you have symptoms that are common to multiple myeloma — such as back pain, weakness and fatigue, poor appetite and weight loss, or repeated infections — call your doctor. After your doctor sees you, you may be referred to a specialist in the diagnosis and treatment of cancer (oncologist).

Because appointments can be brief and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready and on what to expect from your doctor.

What you can do

  • Note any symptoms you're experiencing. If you've had signs and symptoms of illness or are just not feeling like yourself, write down those details before your appointment. Your doctor will also want to know when you first noticed these symptoms and whether they've changed over time.
  • List any other medical conditions with which you've been diagnosed. Your doctor will be especially interested to know if you've been diagnosed with any other plasma disorders, such as monoclonal gammopathy of undetermined significance (MGUS).
  • Make a list of your medications. Include any prescription or over-the-counter medications you're taking, as well as all vitamins, supplements and herbal remedies.
  • Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor.

Questions to ask your doctor at your initial appointment include:

  • What may be causing my symptoms or condition?
  • Are there any other possible causes?
  • What kinds of tests do I need?
  • What do you recommend for next steps in determining my diagnosis and treatment?
  • Are there any restrictions that I need to follow in the meantime?

Questions to consider if your doctor refers you to an oncologist include:

  • Do I have multiple myeloma?
  • What stage of myeloma do I have?
  • Does my myeloma have any high-risk features?
  • What are the goals of treatment in my case?
  • What treatment do you recommend?
  • What are the possible side effects of treatment?
  • If the first treatment isn't successful, what will we try next?
  • Am I a candidate for stem cell transplantation?
  • Do I need a medicine to strengthen my bones?
  • What is the outlook for my condition?

In addition to the questions, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Thinking about your answers ahead of time can help you make the most of your appointment. A doctor who sees you for possible multiple myeloma may ask:

  • What are your symptoms, if any?
  • When did you first begin experiencing symptoms?
  • How have your symptoms changed over time?
  • Do your symptoms include bone pain? Where?
  • Do your symptoms include nausea, lost appetite or weight loss?
  • Do your symptoms include weakness or fatigue?
  • Have you had repeated infections, such as pneumonia, sinusitis, bladder or kidney infections, skin infections, or shingles?
  • Have you noticed any changes in your bowel habits?
  • Have you been more thirsty or urinated more than usual?
  • What else concerns you?
  • Do you have any family history of plasma disorders such as MGUS?
  • Have you been diagnosed or treated for any other medical conditions?
  • Do you have a history of blood clots?
  • What medications are you taking?

What you can do in the meantime
While you wait for your appointment, check with your family members to find out if any relatives have been diagnosed with multiple myeloma or with plasma disorders such as MGUS.

Tests and diagnosis Complications
References
  1. Rajkumar SV, et al. Multiple myeloma and related disorders. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/145977116-5/856340478/1709/160.html#4-u1.0-B978-0-443-06694-8..50114-7_4940. Accessed June 12, 2009.
  2. Konrad CN, et al. Multiple myeloma: Diagnosis and treatment. American Family Physician. 2008;78:853.
  3. Rajkumar SV. Initial chemotherapy for patients with high risk multiple myeloma. http://www.uptodate.com/home/index.html. Accessed June 12, 2009.
  4. Rajkumar SV. Initial chemotherapy for symptomatic multiple myeloma in patients who are not candidates for transplantation. http://www.uptodate.com/home/index.html. Accessed June 12, 2009.
  5. Treatment of the complications of multiple myeloma. http://www.uptodate.com/home/index.html. Accessed June 12, 2009.
  6. Detailed guide: Multiple myeloma. Chemotherapy and other drugs. American Cancer Society. Accessed June 12, 2009.
  7. Multiple myeloma: Moving on after treatment. American Cancer Society. Accessed June 12, 2009.
  8. Richardson PG, et al. Management strategies for relapsed multiple myeloma: Therapy in practice. American Journal of Cancer. 2006;5:393.
  9. Detailed guide: Multiple myeloma. What are the risk factors for multiple myeloma? American Cancer Society. Accessed June 12, 2009.
  10. Multiple myeloma: What are some questions I can ask my doctor? American Cancer Society. Accessed June 12, 2009.
  11. Integrative medicine & complementary and alternative therapies as part of blood cancer care. The Leukemia & Lymphoma Society. http://www.leukemia-lymphoma.org/attachments/National/br_1150734030.pdf. Accessed June 12, 2009.
  12. Complementary and alternative methods for cancer management. American Cancer Society. http://www.cancer.org/docroot/ETO/content/ETO_5_1_Introduction.asp. Accessed June 12, 2009.
  13. Rajkumar SV (expert opinion). Mayo Clinic, Rochester, Minn. July 8, 2008.

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Aug. 15, 2009

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