Diagnosed with SMM, SPB, or MGUS?

Learn how you can stall the development of full-blown Multiple Myeloma with evidence-based nutritional and supplementation therapies.

Click the orange button to the right to learn more.

Pre-Myeloma- SPB, MGUS, SMM

Share Button

Pre-Myeloma- Single Bone Plasmacytoma, Monoclonal Gammopathy of Undetermined Significance (MGUS) and Smoldering Multiple Myeloma (SMM) Defined- Symptoms, Causes, Diagnostics-

Pre-myeloma is a diagnostic term. This blog post is designed to outline the basics of the pre- myeloma aka pre-MM blood disorders of:

  • Single Plasmacytoma of Bone-SPB
  • Monoclonal Gammopathy of Undetmiuned Significance-MGUS
  • Smoldering Multiple Myeloma- SMM.

My experience as a cancer survivor and cancer coach is that the more  someone understands about their diagnosis, the more in control they will feel, and the better their decision-making will be. The more in control you feel, the better your decision-making,  the greater your quality and length of life.

Have you been given a diagnosis of pre-myeloma– a single plasmacytoma, MGUS or SMM? Are you experiencing any symptoms? Do you want to learn more about evidence-based, non-toxic therapies? Scroll down the page, post a comment or a question and I will reply to you ASAP.

multiple myeloma in bone marrow

The first thing that you must understand about a diagnosis of a single plasmacytoma, MGUS or SMM is that they are NOT cancer. Yes, these diagnoses increase your risks of a full myeloma diagnosis but they are blood disorders or pre-cancer stages.

The second thing that you should understand about your blood disorder is that you do not have to “watch and wait.”

You can reduce your risk of a myeloma diagnosis.

Yes, regular diagnostic testing to keep an eye on your monoclonal proteins is a good idea but there are steps you can take to reduce your risks of a full-blown diagnosis of multiple myeloma.

The third thing that I think pre-MM patients should understand is if their SPB. MGUS or SMM progresses to full-blown MM, they will be at an early stage of MM. Early stage or MM stage 1 is very different from the average newly diagnosed MM patient (NDMM).

According to research, 95% of NDMM patients are stage 2 or 3. Many present with bone or kidney involvement. The stage 1 MM NDMM patients is different and therefore has a much better (longer) prognosis.

In my experience, the standard-of-care treatment plan for the average NDMM patient much too much toxicity. In other words, induction chemotherapy, an autologous stem cell transplant both followed by low-dose maintenance therapy- all three are the SOC for NDMM, is a lot of chemo. A lot of toxicity.

It is up to the patient of course, but consider a treatment plan that is less toxicity, less chemotherapy.

To learn more about the evidence-based therapies you can follow to manage your pre-Myeloma and prevent full-blown Myeloma from developing, please watch the short video below:


Each area of interest below is linked to specific information for you to pursue if you choose to.

Consider Pre-Myeloma therapies such as:

  1. non-toxic, cytotoxic/apoptotic supplements,
  2. foods that starve pre-myeloma
  3. evidence-based mind-body therapies,
  4. detoxification therapies,
  5. Non-conventional bone health therapies
  6. Cannabis/CBD/THC oil

Thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading

Multiple Myeloma

Multiple Myeloma Complications

Multiple myeloma can cause problems including:

  • Bone problems. Your bones can become weaker, leading to fractures.
  • Blood problems. You might get anemia, which means your body doesn’t have enough red blood cells. This can make you tired and pale and cause heart problems. You might also have too few platelets, which makes it harder for your blood to clot.
  • Infections. When you have myeloma, your body produces a lot of weak antibodies that crowd out healthy ones, making it harder for you to fight infection. A lack of white blood cells can also weaken your immune system.
  • Kidney damage. Myeloma can clog your kidneys so they don’t filter the way they should. This might lead to kidney failure.

Smouldering Multiple Myeloma

“Smouldering myeloma is a disease which is characterised by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein (M protein).[1]


Smouldering myeloma is characterised by:[2]

  • Serum paraprotein >30 g/L AND/OR
  • Clonal plasma cells >10% and <60% on bone marrow biopsy AND
  • No evidence of end organ damage that can be attributed to plasma cell disorder AND
  • No myeloma-defining event (>60% plasma cells in bone marrow OR Involved/Uninvolved light chain ratio >100)


Smouldering myeloma with an increasingly abnormal serum free light chain (FLC) ratio is associated with a higher risk for progression to active multiple myeloma.[3]

If you do not want to “watch and wait” to see if your MGUS progresses to Multiple Myeloma scroll down the page, post a question or a comment and I will reply to you ASAP…”

Monoclonal gammopathy of undetermined significance

“MGUS, is a condition in which a paraprotein is found in the blood during standard laboratory blood tests. It resembles multiple myeloma and similar diseases, but the levels of antibody are lower,[1] the number of plasma cells (white blood cells that secrete antibodies) in the bone marrow is lower, it has no symptoms or major problems…”


MGUS is a common, age-related medical condition characterized by an accumulation of bone marrow plasma cells derived from a single abnormal clone. Patients may be diagnosed with MGUS if they fulfill the following four criteria:[4]

  1. A monoclonal paraprotein band lesser than 30 g/L (< 3g/dL);
  2. Plasma cells less than 10% on bone marrow examination;
  3. No evidence of bone lesions, anemiahypercalcemia, or renal insufficiency related to the paraprotein, and
  4. No evidence of another B-cell proliferative disorder.


At the Mayo Clinic, MGUS transformed into multiple myeloma or similar lymphoproliferative disorder at the rate of about 1-2% a year, or 17%, 34%, and 39% at 10, 20, and 25 years, respectively, of follow-up—among surviving patients…”

Single Plasmacytoma of Bone

“Plasmacytoma refers to plasma cell tumor growing within soft tissue or within the axial skeleton…Solitary Plasma of the Bone (SPB) and extramedullary plasmacytomas are mostly treated with radiotherapy, but surgery is used in some cases of extramedullary plasmacytoma.


Serum protein electrophoresis of an individual with polyclonal antibodies (top) and an individual with a large paraprotein (bottom).

The diagnosis of plasmacytoma uses a diverse range of interdisciplinary techniques including serum protein electrophoresisbone marrow biopsy, urine analysis for Bence Jones protein and complete blood countplain film radiographyMRI and PET-CT.[10][11]


Most cases of SPB progress to multiple myeloma within 2–4 years of diagnosis, but the overall median survival for SPB is 7–12 years. 30–50% of extramedullary plasmacytoma cases progress to multiple myeloma with a median time of 1.5–2.5 years. 15–45% of SPB and 50–65% of extramedullary plasmacytoma are disease free after 10 years.[3]”

Leave a Comment:

James mullen says a few months ago

Already been diagnosed with MM had chemo and stem cell

James mullen says a few months ago

Already been diagnosed with MM had chemo and stem cell currently going through second phase of pills

    David Emerson says a few months ago

    Hi James-

    I’m sorry to read of your MM diagnosis. Do you have a question?

    David Emerson

Sharon Lewis says a few months ago

I have myeloma. Had stem cell transplant a year ago next week.
My paraprotiens have started rising a small amount. I’m on maintenance treatment which they have increased. I also started on injections twice a week. I would really like some advice on supplements and diet please. I do exercise bone pain in my hip and rib’s but not bad enough to take pain relief. I don’t suffer with fatigue. I try and stay active and positive.. I’m 53 I’m struggling to gain weight
Please can you help. Thank you

    David Emerson says a few months ago

    Hi Sharon-

    I replied to your question directly via email. If you don’t see my reply in your inbox please check your spam folder.


    David Emerson

Deirdre Mc Nally says a few months ago

Hi I have Mgus and Smouldering Myeloma. My lambda/Kappa ratio recently is 0.14 what does it mean when it is low.

    David Emerson says a few months ago

    Hi Deirdre-

    The range for a normal K/L ratio is 0.26 to 1.65. In order for your ratio to be below the normal range, either your kappa or lambda value is a bit off. The amount of being “off” is so small that I think that you are low risk aka doing okay.

    David Emerson

Kathryn Sleet says a few months ago

Hi I have Monoclonal Gammapathy but fear it’s now Multipal Myeloma. I’m afraid I don’t have long to live. Im so scared. What would you recommend me to do but wait for the Dr to tell me that I only have a few months to live. I’m so scared. I watched my dad die of Colon Cancer at 49.Im only 62. I so wanted to grow old with my husband.

    David Emerson says a few months ago

    Hi Kathryn-

    Take a deep breath. While I understand that a diagnosis of either MGUS or MM is frightening, the evidence is on your side. If you have MGUS, you do not have cancer. You have a blood disorder that is considered to be a form of pre-cancer.

    If your MGUS advances to full MM, you are stage 1 and your prognosis is for more than 10 years. According to research, 94% of all newly diagnosed MM patients are advanced at stage 2 or 3. You are stage 1. You are much better off.

    While you may feel fatigue, bone or nerve pain, these are common symptoms.

    If you would like to take matters into your own hands and improve your prognosis (regardless of stage), get your heart rate up a bit each day, eat a health diet daily, get more sleep and find a myeloma specialist. An oncologist who specializes in treating MM.

    Hang in there,

    David Emerson

Marianne White says 6 months ago

I have had MGUS for 20 years. I Fe rusty I was diagnosed with bone cancer. I am still on no treatment as I have no pain. So far all I have is fatigue.

    David Emerson says 6 months ago

    Hi Marianne-

    You are doing well. I am not sure what you meant by ” I Fe rusty was diagnosed with bone cancer” but great also that you have no pain. Fatigue is a common symptom of MGUS- possibly anemia aka reduced red blood cells.

    David Emerson

Priscilla says 7 months ago

Is there certain foods or products i can use. When it comes to watch and wait.

    David Emerson says 7 months ago

    Hi Priscilla-

    I replied directly to your question with an email. Please check your spam folder if you don’t see my reply.

    Hang in there,

    David Emerson

jo says 7 years ago

I am diagnosted in july 2015 with MGUS and a huge retroperitoneal liposarcoma. I had radiotherapy and in nov 2015 I had surgery for the liposarcoma. In nov 2016 I had a recurrence of the liposarcoma so I had to undergo a second operation. Now I have to do my CT scan to control the disease.
What can I do as alternative treatment?

    David Emerson says 7 years ago

    Hi Jo-

    Do you know your monoclonal protein (m-spike) levels at diagnosis and now? In other words, my understanding is that it is your m-spike that is this issue. It is your m-spike that dictates the severity of your situation.

    David Emerson

Roberto says 7 years ago

I would like to know the diet (including supplements) and lifestyle changes that I should implement to prevent my MGUS from progressing to Multiple Myeloma.

    David Emerson says 7 years ago

    Hi Roberto-

    I am sorry to read of your MGUS diagnosis. I am a long-term MM survivor and Cancer Coach. I have researched and created an MGUS Cancer Coaching program for MGUS/SMM patients. The program is comprised of six guides encompassing evidence-based, anti-MGUS nutrition, supplementation, detox/exercise, Online Support, Cannabis and mind-body therapies. The program is inexpensive, straightforward and evidence-based.

    Are you experiencing any symptoms such as bone pain, anemia or kidney involvement?

    Let me know. Thanks.

    David Emerson
    MM survivor
    Cancer Coach
    Director PeopleBeatingCancer

Add Your Reply