Hypercalcemia (Elevated Blood Calcium Level)
Hypercalcemia is a high level of calcium in the blood. 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. In cancer patients, there are many potential causes of hypercalcemia including:
- Bone break down, which results in increased levels of calcium being released into the blood stream; especially in cancers that are located in the bone (myeloma) or that have spread to the bone.
- Certain cancers impact protein levels and organ functions that increase the levels of calcium in the blood.
- Some medications, including alkaline antacids, diuretics, estrogens and progesterone, can influence calcium levels.
- Decreased physical activity.
Hypercalcemia can be difficult to detect, as there may not be any obvious symptoms. The first indication of hypercalcemia may appear in routine lab tests. If symptoms are present, they include:
- Loss of appetite.
- Nausea and vomiting.
- Abdominal pain.
- Increased thirst.
- Frequent urination.
- Fatigue, weakness, and muscle pain.
- Feeling disoriented, confused or having a hard time processing thoughts.
- Depressed mood.
There are three degrees of hypercalcemia: mild, moderate and severe. This level is based on results of laboratory tests that measure the level of calcium in the blood. The degree of hypercalcemia influences the treatment plan. Because hypercalcemia is often caused by the underlying cancer, the degree of success in treating hypercalcemia can be directly tied to the success of treating the cancer.
Treatments include: IV fluids, medications to reduce the level of calcium in the blood and prevent further bone breakdown (including bisphosphonates and steroids) and, in the most severe cases, dialysis may be indicated if the hypercalcemia has caused kidney failure. Untreated hypercalcemia can lead to loss of consciousness, heart arrhythmia, heart attack and death.
When to contact your care team
Contact your care team if you are experiencing any symptoms of hypercalcemia for further examination, lab work and treatment.