Hypercalcemia (Elevated Blood Calcium Level)

Author: Karen Arnold-Korzeniowski, BSN RN
Last Reviewed:

What is hypercalcemia?

Hypercalcemia is a high level of calcium in the blood. Calcium is a mineral stored in the bones. It helps keep our bones healthy, helps your muscles and heart work, and helps your body make blood clots. Hypercalcemia occurs in 10-20% of cancer patients, usually those with advanced or late-stage cancers. Hypercalcemia is most common in breast and lung cancer, myeloma, lymphoma, and other blood cancers. 

Hypercalcemia is an oncologic emergency, which is a serious health problem caused by the cancer itself or its treatment. Oncologic emergencies need to be treated right away. 

What causes hypercalcemia?

In cancer patients, cause of hypercalcemia include:

  • Bone breakdown. This results in increased levels of calcium being released into the bloodstream, especially in cancers that are located in the bone (myeloma) or that have spread to the bone.
  • Some cancers affect protein levels and organ functions that increase the levels of calcium in the blood.
  • Some medications, including alkaline antacids, diuretics, estrogens and progesterone, can affect calcium levels.
  • Dehydration.
  • Decreased physical activity.

What are the symptoms of hypercalcemia? 

Hypercalcemia does not always cause obvious symptoms. In some cases, it is found through lab test results. If symptoms are present, they can include:

  • Loss of appetite.
  • Nausea and vomiting.
  • Constipation.
  • Abdominal (belly) pain.
  • Increased thirst.
  • Frequent urination.
  • Fatigue, weakness, and muscle pain.
  • Feeling disoriented, confused, or having a hard time processing thoughts.
  • Headaches.
  • Depressed mood.

How is it treated?

There are three degrees of hypercalcemia: mild, moderate, and severe. This level is based on the results of laboratory tests that measure the level of calcium in the blood. The degree of hypercalcemia determines the treatment plan. Because hypercalcemia is often caused by cancer, how well it can be treated depends upon the success of treating the cancer.

Treatments can include: 

  • IV (intravenous, into a vein) fluids. 
  • Medications to reduce the level of calcium in the blood and prevent further bone breakdown (including bisphosphonates and steroids). 
  • In the most severe cases, dialysis may be needed if the hypercalcemia has caused kidney failure. 

Untreated hypercalcemia can lead to serious health problems such as loss of consciousness, heart arrhythmia, and heart attack.

When should I contact my care team?

Contact your care team right away if you are having any symptoms of hypercalcemia listed above.

References

Goldner, W. (2016). Cancer-related hypercalcemia. https://ascopubs.org/doi/pdf/10.1200/JOP.2016.011155

Nursing Times. (2018). Malignant hypercalcemia: definition, symptoms and treatment. https://www.nursingtimes.net/clinical-archive/cancer-clinical-archive/malignant-hypercalcaemia-definition-symptoms-and-treatment-08-10-2018/

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