A narrative review of progress in diagnosis and treatment of small cell lung cancer patients with hyponatremia

Abstract

Small cell lung cancer (SCLC) is one of the malignant cancers of lung tumors, and hyponatremia, defined as serum sodium concentration (Na + ) lower than 135 mmol/L, is the most common complication of solid tumors, with an incidence of up to 18.9% and a negative impact on quality of life in SCLC. As a prognostic index of SCLC, timely monitoring and correcting of hyponatremia is of great clinical significance for prolonging the survival period of patients. In the explore of new drugs for small cell lung cancer, it is necessary to include hyponatremia as an evaluation index in clinical studies. As the occurrence of hyponatremia is sometimes unavoidable owing to SCLC specific neurological characteristics, early monitoring to detect the presence of hyponatremia and timely correction are helpful to improve the prognosis of patients. There are many predisposing factors for hyponatremia, including heterotopia of antidiuretic hormone (ADH), use of platinum-based chemotherapy drugs, and intracranial metastasis, among others. Patients with small cell lung cancer are usually asymptomatic in the early stage, while it is of great significance to find a suitable clinical index to judge whether it is a malignant inducement or not.In the clinical setting, due to different electrolyte levels and therapeutic scheduling for the primary disease, an individualized plan is often made, mainly comprising water restriction, infusion, and medications. This review includes related clinical studies and describes the common symptoms and predisposing factors of hyponatremia in patients with SCLC, and their impact on quality of life and prognosis.

Syndrome of Inappropriate Antidiuretic Hormone Secretion as the Initial Presentation in a Patient with Stage I Small-cell Lung Cancer

“…However, the plasma ADH level (3.4 pg/dL) just before surgery was too low compared with other reports of ectopic ADH-producing SCLC ( 6 , 7 , 13 ). Furthermore, the resected tumor cells were negative for ADH on an immunohistochemical examination.…”

Hyponatraemia and the syndrome of inappropriate antidiuresis (SIAD) in cancer

“…The evidence is compelling that hyponatraemia is common in malignancy and has negative effects on performance, survival and duration of hospital stay. There are little data from randomised, prospective trials that treatment of hyponatraemia improves outcomes, but there is enough evidence from the data available to strongly suggest symptomatic ( Petereit et al 2013 , Bilgetekin et al 2021 , Ren & Yang 2021 ) and survival benefit ( Tiseo et al 2014 , Yang et al 2017 , Wu et al 2020 , Bartalis et al 2021 , Sandfeld-Paulsen et al 2021 ). Unpublished data from our own hospital (Murphy B., unpublished audit) suggest that other than renal medicine, where hyponatraemia is actively within-house, the lowest rate of endocrine referral is from patients who develop hyponatraemia on oncology/haematology services.…”

In pursuit of new anti-malarial candidates: novel synthesized and characterized pyrano-benzodioxepin analogues attenuated Plasmodium berghei replication in malaria-infected mice

“…It is also vitally important to maintain proper acidity in the body, passively balancing out the positive ions of the blood, tissue, and organs. Increased chloride concentration, when compared to the control, may be an indication of overactivity of the parathyroid glands (Wu et al, 2020;Chawla et al, 2011). Bicarbonate acts as a buffer in maintaining homeostasis in the body and maintaining a normal acidity level.…”