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Horm Metab Res 2010; 42(3): 153-164
DOI: 10.1055/s-0029-1241821
Review

© Georg Thieme Verlag KG Stuttgart · New York

Hypercalcemia in Cancer Patients: Pathobiology and Management

L. Santarpia1 , 2 , C. A. Koch3 , N. J. Sarlis4
  • 1Translational Research Unit, Department of Oncology Hospital of Prato and Istituto Toscana Tumori, Florence, Italy
  • 2Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas – M. D. Anderson Cancer Center, Houston, Texas, USA
  • 3Division of Endocrinology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
  • 4Department of Medical Affairs – Oncology, Sanofi-Aventis U.S., Bridgewater, New Jersey, USA
Further Information

Publication History

received 15.06.2009

accepted 07.10.2009

Publication Date:
03 December 2009 (online)

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Abstract

Hypercalcemia is the most common life-threatening metabolic disorder associated with cancer, occurring in approximately 10–30% of all patients with neoplastic disease, although it occurs much less often in the pediatric setting. Hypercalcemia can emerge in hematologic malignancies, particularly multiple myeloma, as well as assorted solid tumors, primarily lung and breast cancers, and can even dominate the clinical picture in select patients. Early diagnosis and treatment with fluids and drugs that lower calcium levels in the blood can improve symptoms in a few days, ameliorate the quality of life of these patients, and avoid delays in the implementation of further anticancer treatments. Occasionally, the symptoms of hypercalcemia can appear gradually, and may be non-specific, resembling symptoms of many cancers and other comorbidities, especially in the elderly, thus resulting in an underestimated incidence of hypercalcemia in cancer patients. Of note, there is an increasing number of antineoplastic compounds that can interfere with calcium metabolism. Taking into consideration both the severity of hypercalcemia and the tumor status, health care providers should determine and apply appropriate treatment measures. We provide a comprehensive subjective synthesis of peer-reviewed evidence on the pathophysiology and treatment of hypercalcemia in cancer patients.

Key words

cancer - hypercalcemia - malignancy - therapy

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Correspondence

L. SantarpiaMD, PhD 

Translational Research Unit

Department of Oncology

Hospital of Prato and Istituto

Toscana Tumori

Florence

Italy

Piazza dell' Ospedale

59100 Prato

Italy

Phone: +39 0574 434766

Fax: +39 0574 29798

Email: lsantarp@mdanderson.org