Multiple myeloma is a type of blood cancer that affects plasma cells. Plasma cells are white blood cells that help your body fight infections. In multiple myeloma, cancerous plasma cells (called multiple myeloma cells) crowd out normal cells in the bone marrow. This results in loss of function of the normal bone marrow cells.

Doctors assign each case of multiple myeloma a stage. The stages of multiple myeloma tell you how advanced the cancer is and how much it has spread within the body. Doctors use staging information to guide treatment decisions and to estimate a person’s prognosis (outlook).

What Is Stage 2 Multiple Myeloma?

Cancers are staged according to many criteria specific to each type. Oncologists (cancer specialists) use blood tests and other diagnostic tools to determine the state of multiple myeloma.

Historically, two staging systems were used for multiple myeloma: the Durie-Salmon Staging System and the International Staging System (ISS). In 2005, the ISS replaced the Durie-Salmon Staging System, due to its relative simplicity and the need for fewer tests. In 2015, the ISS was further refined into the Revised International Staging System (R-ISS), incorporating additional factors that better reflect the severity of the disease.

Revised International Staging System

The R-ISS categorizes multiple myeloma into three stages, with higher stages indicating more advanced and severe disease. For example, stage 2 multiple myeloma represents more progression than stage 1. Stages are often written using Roman numerals, such as “stage II” instead of “stage 2.”

The R-ISS evaluates levels of three proteins in the blood: albumin, beta-2 microglobulin, and lactate dehydrogenase (LDH). Lower albumin levels and higher levels of beta-2 microglobulin and LDH are signs of more advanced disease. Additionally, the R-ISS looks at cytogenetic tests that check for genetic abnormalities in the myeloma cells, which can affect how the disease progresses.

Stage 2 Multiple Myeloma

The R-ISS defines stage 2 multiple myeloma when test results fall between those of stage 1 and stage 3. In other words, stage 2 is diagnosed when a person shows a mix of factors seen in both stage 1 and stage 3.

Stage 1 multiple myeloma is diagnosed when all of the following are present:

• Beta-2 microglobulin level less than 3.5 milligrams per liter
• Albumin level equal to or greater than 3.5 grams per deciliter
• Normal LDH levels
• No high-risk genetic abnormalities

Stage 3 multiple myeloma is diagnosed when a person has a beta-2 microglobulin level of 5.5 milligrams per liter or higher, along with high-risk genetic abnormalities or high LDH levels.

If you have any questions about your multiple myeloma stage, ask your doctor to explain your test results and how your stage is determined. You can also ask how your myeloma stage affects treatment options and outlook.

Signs and Symptoms of Stage 2 Multiple Myeloma

Sometimes, a doctor may detect signs of myeloma through blood tests before noticeable symptoms develop. As myeloma progresses, especially in more advanced stages, it becomes more likely to cause symptoms, such as:

• Bone pain
• Fatigue (extreme tiredness)
• Hypercalcemia (high levels of calcium in the blood)
• Anemia (low levels of red blood cells)
• Thrombocytopenia (low platelet counts)
• Decreased kidney function
• Bone lesions (bone damage)
• Frequent infections

If you’re experiencing bone pain or any other symptoms of multiple myeloma, talk to your doctor.

Treatments for Stage 2 Multiple Myeloma

Most types of active multiple myeloma, including stage 2, are treated similarly. People with myeloma typically receive a combination of different drugs, which may include chemotherapies, biological therapy, or monoclonal antibodies. Other options may include:

• Chimeric antigen receptor (CAR) T-cell therapy for those who relapse (have their cancer return) after treatment
• Radiation therapy
• Bone marrow transplant
• Surgery

People with stage 2 myeloma may require more aggressive treatment options than those with stage 1. More intensive treatments can lead to side effects, such as fatigue, nausea, infections, or neuropathy (nerve damage). It's important to let your health care provider know if you experience any side effects, as they can help manage or reduce these symptoms.

Many people with multiple myeloma also use supportive treatments. These are therapies that don’t aim to kill cancer cells. Rather, supportive treatments help improve myeloma symptoms. For example, people with stage 2 myeloma may use bisphosphonate drugs to relieve bone pain and strengthen bones.

Can Stage 2 Myeloma Be Cured?

Stage 2 multiple myeloma isn’t generally considered curable. However, following a treatment plan may help your cancer care team manage the disease and keep it under control. After treatment, regular monitoring is essential to check for signs of the disease returning.

Outlook and Survival for Stage 2 Multiple Myeloma

Between 2014 and 2020, the overall five-year relative survival rate for multiple myeloma was 61.1 percent. That means that 61.1 percent of people diagnosed with multiple myeloma were alive five years after their diagnosis. With ongoing advancements in cancer treatments, the outlook for people diagnosed today is likely even better than these past figures suggest.

Stage 2 Multiple Myeloma Life Expectancy

Survival statistics for multiple myeloma can vary depending on the R-ISS stage at diagnosis:

• About 82 percent of people with stage 1 disease live for five years or more after diagnosis.
• Approximately 62 percent of people with stage 2 disease live at least five years after diagnosis.
• About 40 percent of people with stage 3 disease live for five years or more.

The median survival time after a multiple myeloma diagnosis is:

• 62 months for stage 1
• 44 months for stage 2
• 29 months for stage 3

Generally, a person with a later stage of cancer will have a poorer prognosis than someone with an earlier stage. However, predicting the prognosis for stage 2 multiple myeloma can be more complex because it involves a combination of factors from both stage 1 and stage 3.

For instance, if a person with stage 2 multiple myeloma has three factors from stage 3 and only one factor from stage 1, they are likely to have a poorer prognosis than someone who only has one stage 3 factor.

In addition to the characteristics used in the R-ISS, other risk factors influence the prognosis of stage 2 multiple myeloma, including:

• Age
• Overall health
• Kidney function

Younger people diagnosed with multiple myeloma generally have longer life expectancies. Those in good overall health tend to have better outcomes.

Kidney function can be affected by the abnormal proteins produced by the cancerous plasma cells and by high calcium levels. People with multiple myeloma and impaired kidney function have an average survival of 20 months compared to 40 months for those with healthy kidneys.

Race and Multiple Myeloma Survival

Some research suggests that racial differences may affect myeloma treatment options and survival outcomes. For example, one study in the journal Blood Advances found that African-American and Hispanic people with myeloma may not receive access to newer treatments until later stages of the disease. Another study in Scientific Reports analyzing data from 53,527 people indicated that death rates among non-Hispanic Black people with myeloma were higher than those of other races.

A third study in Clinical Lymphoma Myeloma and Leukemia, which reviewed data from 410,086 individuals, found that Black participants with myeloma had higher or similar survival rates compared to white participants.

Researchers continue to explore the impact of racial or ethnic differences on multiple myeloma survival.

The Importance of Self-Advocacy

Maintaining open, honest communication with your oncology and hematology teams is key to managing your care. Advocating for yourself means asking questions about your treatment plan, exploring additional options like newer therapies, and informing your doctor about any side effects or concerns during treatment. Remember, seeking a second opinion is always an option — it can provide peace of mind, offer alternative approaches, or confirm your current plan. Taking an active role helps to ensure you’re getting the best possible care for your situation.

As new multiple myeloma treatments are approved and applied, the outlook and survival for people living with the disease should continue to improve. Ongoing cancer research, including numerous clinical trials, aims to develop more effective treatments for multiple myeloma.

Talk With Others Who Understand

On MyMyelomaTeam — the social network for people with myeloma and their loved ones — more than 26,000 members come together to ask questions, give advice, and share their stories with others who understand life with myeloma.

Are you living with stage 2 multiple myeloma? Share your experience in the comments below, or start a conversation by posting to your Activities feed.