Cancer Keys: The two tests that will diagnose at least 90% of myeloma patients
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Welcome to Cancer Keys, a regular bite-sized learning column brought to you by GatewayC in collaboration with Cancer Research UK.
If you are suspicious of myeloma following blood results, there are two pertinent investigations that can be ordered in primary care to give a strong case for referral:
1. Serum protein electrophoresis test
2. Bence-Jones protein urine test
If you test for serum protein electrophoresis alone, you will identify only 2/3 of patients.
Most patients with untreated myeloma have a monoclonal immunoglobulin peak in serum, urine, or both. A combination of serum protein electrophoresis and Bence-Jones protein urine test will diagnose up to 95% of patients with myeloma without any form of imaging. NICE NG12 guidelines suggest making a suspected cancer referral for patients whose investigation results indicate myeloma.