Hypercalcemia Associated with Cancer

Stewart, Andrew F.

doi:10.1056/nejmcp042806

Cited by 842 publications

(777 citation statements)

References 38 publications

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“…case-control studies, but it is less of a problem when pre-diagnostic calcium levels are available, as in this analysis. Moreover, hypercalcemia of malignancy usually presents with advanced disease [35], and such patients would probably have been diagnosed with breast cancer at baseline and would, thus, have been excluded. To further exclude cases where hypercalcemia might have been caused by undiagnosed breast cancer, the analyses were repeated excluding cases with breast cancer occurring within two years following baseline.…”

Section: Discussionmentioning

confidence: 99%

Serum calcium and breast cancer risk: results from a prospective cohort study of 7,847 women

Almquist

Manjer

Bondeson

et al. 2007

Cancer Causes Control

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Experimental and epidemiological studies suggest that calcium-regulating hormonesparathyroid hormone (PTH) and vitamin D -may be associated with breast cancer risk.No prospective cohort study has investigated the association between pre-diagnostic calcium levels and subsequent risk of breast cancer. We have examined this in a cohort of 7847 women where serum calcium levels and established risk factors for breast cancer had been assessed at baseline. During a mean follow-up of 17.8 years, 437 incident breast cancer cases were diagnosed. Incidence of breast cancer was calculated in different quartiles of serum calcium levels and a Cox's proportional hazards analysis was used to obtain corresponding relative risks (RR), with a 95% confidence interval (CI), adjusted for potential confounders.In premenopausal women, serum calcium levels were inversely associated with breast cancer risk in a dose-response manner. The adjusted RR (95% CI) of breast cancer was in the 2 nd calcium quartile 0.91 (0.65-1.30), in the 3 rd quartile 0.89 (0.60-1.31), and in the 4 th quartile 0. 56 (0.32-0.98), as compared to the 1 st calcium quartile. In postmenopausal overweight women (BMI>25), breast cancer risk was higher in calcium quartiles 2 to 4 as compared to the 1 st quartile. Our findings may have implications for primary prevention of breast cancer and for the management of asymptomatic primary hyperparathyroidism.

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Section: Discussionmentioning

confidence: 99%

Serum calcium and breast cancer risk: results from a prospective cohort study of 7,847 women

Almquist

Manjer

Bondeson

et al. 2007

Cancer Causes Control

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“…Hypercalcemia is defined as an increase in the serum calcium level above the upper limit of normal for a given reference value used in a laboratory (6). The differential diagnosis of hypercalcemia includes multiple pathologic entities but is focused primarily on primary hyperparathyroidism and hypercalcemia of malignancy given the highest prevalence of these etiologies (6) accounting for more than 90% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Hypercalcemia associated with cancer can be classified into four types: 1) local osteolytic hypercalcemia, results from the marked increase of osteoclastic bone resorption in areas surrounding the malignant cells within the marrow space, 2) humoral hypercalcemia of malignancy (HHM) which is caused by systemic secretion of PTHrP, and causes increased bone resorption and enhances calcium renal retention 3) 1,25-dihydroxyvitamin D secretion by some lymphomas and 4) ectopic secretion of authentic PTH, a rare cause of hypercalcemia (6)(7)(8)(9). HHM is the most common cause associated with cancer (6-9,10).…”

Section: Case Reportmentioning

confidence: 99%

“…General measures include exclusion of all calcium intake and hydrosaline replenishment (3), patients with hypercalcemia are dehydrated by default due to poor oral intake secondary to nausea, vomiting, altered mental status, and hypercalcemia-induced nephrogenic diabetes insipidus (6). Once the non-pharmacological measures of the treatment of hypercalcemia are taken, and even simultaneously, pharmacological measures can be implemented (3).…”

Section: Case Reportmentioning

confidence: 99%

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The coexistence of hypercalcemia and hypoglycemia in a patient with a renal tumor and B cell lymphoma

Soutelo¹,

Moldes²,

Frisone³

et al. 2017

Arch. Endocrinol. Metab.

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SUMMARYParaneoplastic syndromes are a heterogeneous group of malignant diseases caused by events which involve endocrine, immune and metabolic aspects and whose symptoms vary according to the substance produced and the primary tumor. Hypercalcemia is a frequent complication in cancer patients. Prognosis of cancer patients with hypercalcemia is usually poor. A factor called parathyroid hormone related peptide, whose actions are similar to those of the parathyroid hormone, is thought to be the most common cause of malignancy associated hypercalcemia. Non-islet hypoglycemic cell tumor consists of a rare syndrome characterized by the presence of a solid tumor and severe fasting hypoglycemia determined by an insulin-independent pathway. We report a case of a 59-year-oldman with a renal tumor and a T-cell rich large B cell lymphoma who was hospitalized due to severe hypercalcemia and hypoglycemia. The laboratory examination reported hypercalcemia with inhibited PTH and hypoglycemia with inhibited insulin secretion, arriving to the conclusion of tumoral peptide production. He received denosumab and corticoid therapy. The patient died one month later despite initial improvement after medical treatment. While a single paraneoplastic manifestation may be expected in most tumors, the coexistence of two or more of them is rare, except in hepatocellular carcinomas, and it has not yet been described in renal tumors. Arch Endocrinol Metab. 2017;61(1):98-102

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“…Malignancy-associated hypercalcemia (MAH), one of the most serious and common complications of malignancy at the advanced stage and with a prevalence around 3%~30% in all cancer patients, is not univocally correlated with the occurrence of bone metastasis (Grill et al, 2000;Stewart et al, 2005). However, the incidence of hypercalcemia in China is far below the number (Xie et al, 2006;Shi et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Analysis on Survival and Prognostic Factors for Cancer Patients with Malignancy-associated Hypercalcemia

Zhang

Hu²,

Cao³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Objective: To explore the incidence, clinical characteristics, diagnosis and treatment strategies, prognosis of patients with malignancy-associated hypercalcemia (MAH). Methods: The data of 115 patients with MAH who were treated at the Medical Oncology Department of Chinese PLA General Hospital from Jan., 2001 to Dec., 2010 was retrospectively reviewed. Survival analysis was performed using the Kaplan-Meier method and the Cox proportional hazard model with statistic software SPSS 18.0. Results: The patients had blood calcium levels ranging from 2.77 to 4.87 mmol/L. Except for 9 cases who died or were discharged within 5 days after admission, all other patients recovered to normal blood calcium level after treatment with bisphosphonates or intravenous hydration and diuretics; their survival after occurrence of MAH was from 1 day to 4,051 days, and the median survival time was only 50 days. In the log-rank test, the male, renal metastasis, central nervous system symptoms and hypercalcemia occurring over 140 days after cancer diagnosis were predictors of poor survival (P=0.002, P=0.046, P=0.000, P=0.009). In the COX analysis, being male, central nervous system symptoms and hypercalcemia lasting over 140 days after cancer diagnosis were independent prognostic factors for survival time (RR=2.131, P=0.027; RR=3.054, P=0.002; RR=2.403, P=0.001). According to these factors, a score system was established to predict the patient prognosis and adjust the treatment. Conclusion: Cancer patients with MAH have an extremely poor median survival. Some independent factors indicate poor prognosis, including male gender, central nervous system symptoms and hypercalcemia lasting over 140 days after cancer diagnosis. The prognostic score can serve as a reference for MAH prognosis and treatment, worthy of further investigation.

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Hypercalcemia Associated with Cancer

Cited by 842 publications

References 38 publications

Serum calcium and breast cancer risk: results from a prospective cohort study of 7,847 women

Serum calcium and breast cancer risk: results from a prospective cohort study of 7,847 women

The coexistence of hypercalcemia and hypoglycemia in a patient with a renal tumor and B cell lymphoma

Analysis on Survival and Prognostic Factors for Cancer Patients with Malignancy-associated Hypercalcemia

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