The blood cancer, myeloma is a slow cancer to diagnose with the average patient waiting nearly 100 days between the onset of symptoms and myeloma diagnosis. This is in part because many of the symptoms for myeloma, such as back pain or tiredness, are not limited to myeloma and are also associated with a wide range of other conditions. Therefore, patients often visit the GP multiple times to rule out other, more common causes of these symptoms before investigations for myeloma are triggered. Earlier diagnosis is a high priority for patients since it can both improve survival and allow for better control of symptoms.
In an effort to enable the earlier recognition of myeloma symptoms, Dr Karthik Ramasamy (Oxford University Hospitals and Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine) with collaborators from Amgen Ltd and Aetion, studied the electronic health records from GP surgeries of >2500 patients with newly diagnosed myeloma. They looked back in time before each patient’s diagnosis and identified the common early clinical features of a subsequent myeloma diagnosis.
The team discovered that bone pain, mainly affecting the back, was a symptom approximately 7 months before diagnosis in nearly half of all patients with myeloma. Clinical investigations for myeloma using the four recommended laboratory and imaging tests (blood tests to assess calcium levels, kidney function (serum creatine) and anaemia (haemoglobin), and imaging to identify bone lesions), were only used in 18.9% of patients.
This work provides more information about the occurrence and timing of clinical features and recommended testing prior to a myeloma diagnosis. This can be used to increase awareness to promote earlier recognition and testing of myeloma in primary care.
Their research is published in the journal BMJ Open.
Image credit: The Authors 2021 CC BY-NC 4.0