Why does malignancy cause hypercalcaemia?
The pathophysiology of hypercalcemia of malignancy is mainly through three mechanisms: excessive secretion of parathyroid hormone-related protein (PTHrP), bony metastasis with the release of osteoclast activating factors, and production of 1,25-dihydroxy vitamin D (calcitriol).
Does malignancy cause hypercalcemia?
The most common cancers associated with hypercalcemia in the United States are breast, renal, and lung cancer and multiple myeloma . Malignancy is usually evident clinically by the time it causes hypercalcemia, and patients with hypercalcemia of malignancy often have a poor prognosis.
How is hypercalcaemia of malignancy treated?
Thus, patients with hypercalcemia will generally need to be managed with urgency, and hypercalcemia of malignancy in many cases represents an oncologic emergency. The treatment options for hypercalcemia include IV hydration, calcitonin, bisphosphonates, denosumab, gallium nitrate, prednisone, and hemodialysis.
What are common signs and symptoms of hypercalcemia of malignancy?
If you do have symptoms, they may includes:
- Loss of appetite.
- Nausea and vomiting.
- Constipation and abdominal (belly) pain.
- The need to drink more fluids and urinate more.
- Tiredness, weakness, or muscle pain.
- Confusion, disorientation, and difficulty thinking.
What is the first line treatment for hypercalcemia?
Intravenous bisphosphonates are the treatment of first choice for the initial management of hypercalcaemia, followed by continued oral, or repeated intravenous bisphosphonates to prevent relapse.
How long can a person live with hypercalcemia?
Unfortunately, cancer-related hypercalcemia has a poor prognosis, as it is most often associated with disseminated disease. Eighty percent of patients will die within a year, and there is a median survival of 3 to 4 months.
Can hypercalcemia be cured?
Treatment is aimed at the cause of hypercalcemia whenever possible. People with primary hyperparathyroidism (PHPT) may need surgery to remove the abnormal parathyroid gland. This will cure the hypercalcemia. People with mild hypercalcemia may be able to monitor the condition closely over time without treatment.
What is the most common cause of hypercalcemia?
The most common causes of hypercalcemia are primary hyper-parathyroidism and malignancy. Some other important causes of hypercalcemia are medications and familial hypocalciuric hypercalcemia.
What is high calcium of malignancy?
Hypercalcemia means there is too much calcium in the blood. It is the most common life-threatening complication of cancer in adults. Hypercalcemia develops in 10% to 20% of adults with cancer, but it rarely develops in children. When it develops in people with cancer, it may be called hypercalcemia of malignancy (HCM).
What is the best treatment for high calcium levels?
In some cases, your doctor might recommend:
- Calcitonin (Miacalcin). This hormone from salmon controls calcium levels in the blood. …
- Calcimimetics. This type of drug can help control overactive parathyroid glands. …
- Bisphosphonates. …
- Denosumab (Prolia, Xgeva). …
- Prednisone. …
- IV fluids and diuretics.