Multiple Myeloma: Insights Into a Challenging Diagnostic Journey
10 affiliations
- 1School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 2The Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 3Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 4School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 5School of Medicine, Duke University, Durham, NC, USA
- 6Duke Cancer Center, Duke University, Durham, NC, USA
- 7Multiple Myeloma Community Advisory Board, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- 8Clinical Genomics and Therapeutics, Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, AZ, USA
- 9School of Nursing, Duke University, Durham, NC, USA
- 10School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
Abstract
Introduction: Multiple 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.
Methods: We 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.
Results: We 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.
Conclusions: MM 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.
Related
- Diagnostic Tissue Re-Evaluation Supporting the Observation of a ¹¹C-Methionine PET-Negative Residual Paraskeletal Mass in Multiple Myeloma
- Multiple Myeloma Presenting as a Pancoast-Like Tumor: A Diagnostic Challenge.
- Epithelioid Angiosarcoma Masquerading as Multiple Myeloma: A Diagnostic Pitfall
- Diagnostic Delay in Gaucher Disease and the Role of Gastroenterology in the Diagnostic Journey: A Real-World Cohort Study
- Challenging the loss of complexity theory: Insights from isometric force output in chronic obstructive pulmonary disease
BibTeX
@article{leblanc2026multiple,
title = {{Multiple Myeloma: Insights Into a Challenging Diagnostic Journey}},
author = {Matthew R. LeBlanc and Melissa Luna and Kalin Bennington and Staci Keene and Allison O. Taylor and Susana Barroso and Thomas Goode and Tony Newberne and Valarie Traynham and Sascha A. Tuchman and Samuel M. Rubinstein and Eben I. Lichtman and Joseph Mikhael and Atinuke G. Oyinbo and Saif Al-Amin and Osborn O. Ansah and Mark A. Fiala and Lisa N. Mansfield},
journal = {Journal of Primary Care \& Community Health},
year = {2026},
month = sep,
doi = {10.1177/21501319261492515},
url = {https://doi.org/10.1177/21501319261492515},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Multiple Myeloma: Insights Into a Challenging Diagnostic Journey
AU - Matthew R. LeBlanc
AU - Melissa Luna
AU - Kalin Bennington
AU - Staci Keene
AU - Allison O. Taylor
AU - Susana Barroso
AU - Thomas Goode
AU - Tony Newberne
AU - Valarie Traynham
AU - Sascha A. Tuchman
AU - Samuel M. Rubinstein
AU - Eben I. Lichtman
AU - Joseph Mikhael
AU - Atinuke G. Oyinbo
AU - Saif Al-Amin
AU - Osborn O. Ansah
AU - Mark A. Fiala
AU - Lisa N. Mansfield
PY - 2026
DA - 2026/09/28
JO - Journal of Primary Care & Community Health
DO - 10.1177/21501319261492515
UR - https://doi.org/10.1177/21501319261492515
AB - Introduction: Multiple 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. Methods: We 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. Results: We 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. Conclusions: MM 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.
SN - 2150-1319
SN - 2150-1327
ER -