15 NCCN Guidelines for Patients ® : Multiple Myeloma, 2019 2 Testing for myeloma General health tests | Blood tests Treatment planning starts with testing. This chapter describes the tests that are used to confirm (diagnose) myeloma and plan treatment. This information can help you use the Treatment guide in Part 4. It may also help you know what to expect during testing. Not every person with myeloma will receive every test listed. General health tests Medical history Your medical history includes all health events in your life and any medicines you’ve taken. You will be asked about any illnesses, injuries, and health problems you’ve had. Some health problems run in families. So, your doctor may also ask about the health of your blood relatives. Myeloma may cause symptoms. It’s important that your doctor knows if you have them. Symptoms may result from a shortage of healthy blood cells. Or, they may result from myeloma cells collecting in certain parts of the body or the damage to the bones. But, some patients may have few or no symptoms at all. A medical history is needed for treatment planning. See Guide 1 on page 16 for a full list of the tests that are recommended before treatment for myeloma. It is important to make a list of old and new medicines while at home to bring to your doctor’s office. Physical exam Doctors often perform a physical exam along with taking a medical history. A physical exam is a review of your body for signs of disease. During this exam, your doctor will listen to your lungs, heart, and gut. Parts of your body will likely be felt to see if organs are of normal size, are soft or hard, or cause pain when touched. Blood tests Doctors test blood to look for signs of myeloma in the bloodstream. Blood tests are done along with other initial tests to help confirm (diagnose) myeloma. Blood is made of red blood cells, white blood cells, and platelets. It also has many proteins and other chemicals. Different types of blood tests are used to look for and measure different substances in the blood. These tests help doctors learn more about the myeloma and your health. Some blood tests are used to assess the extent or amount of myeloma in your body. This is referred to as the tumor burden. Other tests are used to check the health of your bones, kidneys, and other organs. Blood tests may be repeated sometimes to check how well cancer treatment is working and to check for side effects. For a blood test, your doctor will insert a needle into your vein to remove a sample of blood. The blood sample will then be sent to a lab for testing. The blood tests that are used for myeloma are described next. CBC with differential A CBC ( c omplete b lood c ount) is a test that measures the number of blood cells in a blood sample. It includes the number of white blood cells, red blood cells, and platelets. The CBC should include a differential. The differential measures the different types of white blood cells in the sample. As myeloma cells take over the bone marrow, too few normal blood cells are made.