What does ‘risk’ mean? 

You may hear ‘risk’ used in different ways when talking about cancer.

‘Risk’ can mean the likelihood that something might happen. A ‘risk factor’ is something that increases the chance of developing a condition. Examples include being over a certain age or having a family history of cancer.1

For myeloma specifically, ‘risk’ is also the word given to describe the results of some tests you will have. These tests look for changes in your genes and the results can help doctors understand how you might respond to treatment.2

How is risk status assessed in multiple myeloma? 

Doctors use established staging systems to measure someone’s risk status and see how advanced their myeloma is. The systems used are called the International Staging System (ISS) and Revised International Staging System (R-ISS):2,3

  • ISS uses the results from two blood tests
  • R-ISS uses the results from three blood tests and one genetic test 

The staging systems calculate a stage of either 1, 2 or 3. A higher number stage means the myeloma is more advanced.2,3 

Does risk status affect which treatment is given?

There are a few different things to think about when choosing which treatment to have for myeloma. These include whether the person has had myeloma before, whether they have any other health conditions, and how healthy and fit the person is. The results of the blood tests and any other tests or scans will also come into play.4

Risk status is a factor that affects treatment. People with newly diagnosed, high-risk multiple myeloma may be given more aggressive medications compared to someone with lower risk multiple myeloma. It’s likely that treatment for high-risk myeloma will be started as soon as possible.5

Questions that might be useful for discussions with your healthcare team 

Risk status may be complicated to talk about and understand. There are lots of scientific words to describe the results of the tests that are used to calculate risk status. 

You may wish to talk to your healthcare team about risk status and factors that contribute to risk. The following questions might help you better understand your risk status and how it might affect your treatment:6

  • Can you explain my blood test results?
  • What is my risk status and what stage is my myeloma?
  • What are the preferred treatment options for my level of risk?

References

  1. Macmillan. Causes and risk factors. Available from: https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/causes-and-risk-factors [Accessed June 2025].
  2. Cancer Research UK. Stages of myeloma. Available from: https://www.cancerresearchuk.org/about-cancer/myeloma/stages [Accessed June 2025].
  3. Macmillan. Staging of myeloma. Available from: https://www.macmillan.org.uk/cancer-information-and-support/myeloma/stages [Accessed June 2025].
  4. Cancer Research UK. Treatment options for myeloma. Available from: https://www.cancerresearchuk.org/about-cancer/myeloma/treatment/treatment-decisions [Accessed June 2025].
  5. WebMD. Treating high-risk multiple myeloma. Available from: https://www.webmd.com/cancer/multiple-myeloma/treating-high-risk-multiple-myeloma [Accessed June 2025].
  6. Multiple Myeloma Research Foundation. Questions to ask your doctor about multiple myeloma. Available from: https://themmrf.org/wp-content/uploads/2023/09/Questions-to-Ask-Your-Doctor-Fast-Facts-in-Myeloma.pdf [Accessed June 2025].