“I was diagnosed with stage 3 multiple myeloma,” one MyMyelomaTeam member wrote. “This has been a very emotional roller coaster.” Another member wrote, “I was diagnosed with stage 3 myeloma in 2018. I had failing kidneys and the outlook was not good. After some great medical care, I was able to achieve remission and later get a kidney transplant. … My message to everyone is that you should not give up hope.”

Stage 3 multiple myeloma is the most advanced stage of this type of blood cancer. People who are in stage 3 are the most likely to experience myeloma symptoms.

Read on for an overview of stage 3 myeloma, including tests, treatments, and prognosis (outlook) information.

Staging Systems for Myelomas

Multiple myeloma affects a type of white blood cell called plasma cells. In multiple myeloma, abnormal versions of these plasma cells multiply in the bone marrow. This may result in end-organ damage and bone lesions that cause bone pain and other symptoms. Bone lesions can also spread to other bones.

The International Staging System (ISS) and the Revised International Staging System (R-ISS) are two methods used to determine the stage of multiple myeloma. Both systems have three stages of multiple myeloma. Stage 1 is the least advanced and stage 3 is the most advanced. Stages are sometimes written with Roman numerals, such as stage I or stage III.

International Staging System

The ISS multiple myeloma criteria rely on measuring the levels of certain markers, such as a protein called beta-2 microglobulin, in the blood. According to the ISS, people with stage 3 myeloma have beta-2 microglobulin levels greater than 5.5 milligrams per liter of serum. Serum is the watery component left over after blood forms a clot.

Revised International Staging System

In August 2015, the International Myeloma Working Group published the R-ISS. The revised system includes a genetic risk check using a test called fluorescence in situ hybridization (FISH). It also looks at levels of lactate dehydrogenase (LDH), an enzyme that helps your body produce energy.

A stage 3 diagnosis of myeloma using the R-ISS means beta-2 microglobulin levels are 5.5 milligrams per liter of serum or higher. Additionally, either the FISH test must show a high risk of chromosome (genetic) abnormalities or the person must have high LDH levels in their blood.

Diagnosis of Stage 3 Multiple Myeloma

Many people don’t have any symptoms in the early stages of myeloma. Some individuals are diagnosed during a blood exam for other conditions. Age is the biggest risk factor for multiple myeloma, which is rare among those under age 45.

To diagnose and determine the stage of a person’s multiple myeloma, an oncologist (cancer specialist) or other doctor will run blood tests. This allows them to measure levels of beta-2 microglobulin, serum albumin, and calcium in the blood. They’ll also check for anemia (low red blood cell counts). Typically, the blood tests will be followed up with imaging tests, such as an X-ray, MRI, or positron emission tomography (PET) scan. These are used to view abnormalities and bone damage.

Treatment of Stage 3 Multiple Myeloma

The treatment plan for stage 3 multiple myeloma will include a combination of therapies to help increase survival rates. Treatment options include the following therapies:

• Antibodies
• CAR T-cell therapy
• Chemotherapy
• Immunotherapy
• Drugs that work in new and different ways
• Proteasome inhibitors
• Radiation therapy
• Stem cell transplants
• Steroids
• Surgery

Cancer treatment plans are typically personalized to treat a person’s specific symptoms and slow the progress of cancer while minimizing negative side effects. As new multiple myeloma treatments are approved, survival rates continue to improve for people with myeloma.

Outlook for Stage 3 Multiple Myeloma

In predicting a person’s disease prognosis, a doctor will consider several factors. These include the stage of the multiple myeloma, the person’s age, and overall health. The following factors are linked to better outcomes:

• An earlier cancer stage (stage 1 or stage 2)
• Younger age
• Lower serum beta-2 microglobulin levels, a sign of fewer cancer cells
• Lower LDH levels, suggesting there’s less tumor in the body
• Higher serum albumin levels
• Lower levels of creatinine, a waste product produced by the kidneys and used to determine renal (kidney) function
• Lack of abnormal findings on cytogenetics (chromosome changes)
• Lower plasma cell labeling index (PCLI), which shows how quickly myeloma cells are growing
• Better overall health and activity level, which are linked to a better prognosis

Many of the factors above are associated with earlier stages of multiple myeloma. However, people with stage 3 myeloma can have a positive outlook if they’re generally healthy and still have high kidney function. The tumor’s cytogenetics also play a role.

Myeloma survival can be affected by income, race, and location. One study found the following survival outcomes:

• People with lower incomes had a 38 percent five-year survival rate, compared to 60 percent for those with higher incomes.
• Rural residents had a 42 percent five-year survival rate, while urban residents had 58 percent.
• Black individuals had survival rates 1.25 times higher than white individuals in the study.

One possible reason the survival rates were lower among these study participants may have been that they had less access to early diagnosis and treatment.

Early detection can improve survival rates. That’s why it’s crucial for people with myeloma or their caregivers to consult an oncologist (a doctor who specializes in cancer) as soon as possible after a myeloma diagnosis. Taking action early may open the door to more treatment options and improve the chances of managing stage 3 myeloma.

Survival Rates for Multiple Myeloma

The American Cancer Society describes the outlook for cancers using a five-year relative survival rate. This term refers to the percentage of people with the same type and stage of cancer who are alive at the five-year mark after diagnosis, compared to those without that cancer type.

The five-year relative survival rate for people diagnosed with multiple myeloma is about 61 percent. The National Cancer Institute further breaks down the survival rates for this type of cancer by myeloma stage. For stage 3 myeloma, the five-year relative survival rate is 60.4 percent.

The survival rates are based on people who were diagnosed at least five years ago. As new treatments become available, survival rates keep improving. Doctors and researchers are always finding better ways to treat myeloma, giving patients more options than ever before. While survival statistics can be helpful, they don’t tell the whole story — many people are living longer and feeling better thanks to new treatments.

Talk With Others Who Understand

On MyMyelomaTeam, the social network for people with myeloma and their loved ones, more than 27,000 members come together to ask questions, give advice, and share their stories with others who understand life with myeloma.

Are you or someone you care for living with multiple myeloma? Share your experience in the comments below, or start a conversation by posting on your Activities page.