HYPERCALCEMIA – Basics
Occurs in what percentage of cancer patients.
Occurs in ~20–30% of cancer patients.
Name 3 symptoms a patient may present with
First-line therapy for all symptomatic hypercalcemia
What is IV normal saline hydration?
Most common presenting symptom.
What is back pain?
This emergency is most associated with what type of cancers?
What is inter-abdominal?
Three cancers most commonly associated with this emergency.
What are breast, lung, and multiple myeloma?
Mechanism of hypercalcemia seen with bone metastases.
What is osteolysis from cytokine-induced bone resorption
Class of drugs that inhibit osteoclasts and are the mainstay of therapy.
Immediate medication to start upon suspicion.
What is dex?
Two cancers most commonly associated with MBO.
What are ovarian and colorectal cancer?
What does hypercalcemia usually indicates about prognosis
What is advanced disease / poor prognosis?
Two non standard labs helpful in determining cause of hypercalcemia.
What are PTH and PTHrP?
Drug used for rapid but short-term calcium reduction.
What is calcitonin?
Imaging modality of choice.
What is MRI?
Classic symptom triad.
What is:
Define corrected calcium.
What is
Corrected Ca = total Ca + 0.8 × (4 – albumin)
In addition to advanced disease, high tumor burden, and bone mets, this common reason for hospitalization (for any patient) is a risk for hypercalcemia
What is dehydration?
Targeted therapy used in bisphosphonate-refractory cases.
What is denosumab?
Common cancers causing spinal cord compression.
What are lung, breast, prostate cancers?
Pharmacologic agent used to reduce GI secretions in MBO.
What is octreotide?
The most common mechanism of hypercalcemia in malignancy mimics this hormone
What is PTH
Name the three mechanisms of malignancy-related hypercalcemia.
What are:
We would be able to use denosumab first line in patients with this issue
What is renal insufficiency?
Most important predictor of neurologic recovery.
What is pretreatment neurologic status?
Primary goal of treatment in advanced MBO.
What is symptom palliation and quality of life maintenance?