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Hypercalcemia (PDQ®): Supportive care - Health Professional Information [NCI] - Management



Hypercalcemia generally develops as a late complication of malignancy; its appearance has grave prognostic significance. It remains unclear, however, whether death is associated with hypercalcemic crisis (uncontrolled or recurrent progressive hypercalcemia) or with advanced disease. Currently available hypocalcemic agents have little effect in decreasing the mortality rate among patients with hypercalcemia of malignancy. Although there is some disagreement among investigators who have evaluated survival among patients with cancer-related hypercalcemia,[59,60,61,62] it has been observed that 50% of patients with hypercalcemia die within 1 month and 75% within 3 months after starting hypocalcemic treatment. In the same study, patients with hypercalcemia who responded to specific antineoplastic treatment were found to have a slightly greater survival advantage over nonresponders. Other prognostic variables shown to correlate with longer survival included serum albumin concentration (direct correlation), serum calcium concentrations after treatment (inverse correlation), and age (inverse correlation).[5] In contrast with their modest effect on survival, marked but differential response rates were observed after hypocalcemic treatments as a factor of symptom type. The most substantial improvements occurred in renal- and central nervous system–related symptoms (nausea, vomiting, and constipation). Symptoms of anorexia, malaise, and fatigue improved, but less completely.[5]


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Last Updated: February 25, 2014
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