Multiple Myeloma: Insights Into a Challenging Diagnostic Journey

IntroductionMultiple myeloma (MM), an incurable plasma cell malignancy, is one of the most challenging cancers to diagnose. Diagnostic delays are associated with increased complications and worse outcomes. Existing knowledge of MM diagnostic pathways largely relies on secondary data that fails to capture important details of MM patients' diagnostic journeys. The aim of this study was to explore patients' journeys from initial symptom onset to MM diagnosis and to identify barriers and facilitators to timely diagnostic resolution.MethodsWe conducted a qualitative descriptive study using semi-structured interviews with adults diagnosed with MM within the past 10 years from the United States. Interviews, conducted in English or Spanish, were analyzed using reflexive thematic analysis guided by the Model of Pathways to Treatment.ResultsWe interviewed 34 participants living with MM (38.2% Black, 35.3% White, 20.6% Hispanic, 5.9% Asian). Facilitators of timely diagnosis included recognition of health changes by patients or others, persistent advocacy, and routine primary care engagement. Barriers included misattribution of symptoms by patients and providers, prolonged conservative management, and limited awareness of MM among patients.ConclusionsMM diagnosis is frequently delayed due to non-specific symptoms, misattribution, and limited disease awareness. Regular primary care engagement and advocacy facilitate earlier diagnosis. Interventions targeting public awareness, increased primary care knowledge of MM signs and appropriate testing, and improved access to care may help reduce diagnostic delays.