Hypercalcemia - Causes, Symptoms & Treatment

Hypercalcemia is an excessive amount of calcium in the blood. Hypercalcemia can be life threatening and is the most common metabolic disorder associated with cancer, occurring in 10% to 20% of people with cancer. The cancers most often associated with hypercalcemia are cancer of the breast and lung , as well as certain cancers of the blood , particularly multiple myeloma . Early diagnosis and treatment with fluids and drugs that lower calcium levels in the blood can improve symptoms in a few days, but diagnosis may be difficult.

Symptoms of hypercalcemia can appear gradually and may resemble symptoms of many cancers and other diseases. Early diagnosis and treatment are not only lifesaving in the short term, but may also increase the patient's ability to complete cancer therapy and improve the patient's quality of life . When a patient has a refractory, widely disseminated malignancy for which specific therapy is no longer being pursued, the patient may want to consider withholding therapy for hypercalcemia.

For patients or family who have expressed their wishes regarding end-of-life issues, this may represent a preferred timing and/or mode of death (as compared to a more prolonged death from advancing metastatic disease). This option is best considered long before the onset of severe hypercalcemia or other metabolic abnormalities that impair cognition, so that the patient may be involved in the decision-making.

Hypercalcemia is an abnormally high level of calcium in the blood, usually more than 10.5 milligrams per deciliter of blood. This can cause a number of nonspecific symptoms, including loss of appetite, nausea, thirst, fatigue, muscle weakness, restlessness, and confusion. Excessive intake of calcium may cause muscle weakness and constipation , affect the conduction of electrical impulses in the heart lead to calcium stones (nephrocalcinosis), in the urinary tract, impair kidney function, and interfere with the absorption of iron predisposing to iron deficiency.

The main cause of hypercalcemia is overactivity in one or more of the four glands that regulate calcium in your body (parathyroid glands). Women older than 50 are most likely to develop hypercalcemia caused by overactive parathyroid glands. Other causes of hypercalcemia include cancer, certain other medical disorders, some medications and excessive use of calcium and vitamin D supplements. Treatment depends on the underlying cause.

Causes of Hypercalcemia

The most common causes of hypercalcemia are: poor kidney function, hyperparathyroidism, cancer , excessive intake of vitamin D , and therapy for peptic ulcers . The state where one or more parathyroid glands secrete parathyroid hormone in disproportionate quantity is called Hyperparathyroidism. Another cause is considered to be Cancer leads to mounting calcium levels in the blood. This destroys the bony tissue .

Signs and Symptoms of Hypercalcemia

Sign and symptoms may include the following :

• Headaches
• Tiredness.
• Weakness, and muscle pain.
• Muscle and joint aches .
• Nausea, and vomiting.
• Confusion .
• Loss of appetite.
• Constipation and abdominal pain .
• Lethargy and fatigue .

Treatment for Hypercalcemia

Successful management of hypercalcemia requires management of the underlying disease. Variations in the cause of hypercalcemia and the extent to which hypercalcemia is a clinical problem factor into the decision-making process. Intravenous saline with intravenous furosemide (Lasix) is often adequate. In hypercalcemia of malignancy (cancer), more specific therapy is required including a bisphosphonate, which lowers blood calcium levels. If the hypercalcemic state is likely to be sensitive to steroids, the concurrent administration of calcitonin and glucocorticoids may be considered.

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