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      Cancer-Related Hypercalcemia

      Author(s): 1
      Publication date Created:
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      Journal: Journal of Oncology Practice
      Publisher: American Society of Clinical Oncology (ASCO)

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          Abstract

          Hypercalcemia has been reported to occur in up to 30% of patients who have a malignancy. Hypercalcemia is most common in those who have later-stage malignancies and predicts a poor prognosis for those with it. The most common causes include humoral hypercalcemia of malignancy mediated by parathyroid hormone-related peptide, osteolytic cytokine production, and excess 1,25-dihydroxy vitamin D production. However, the etiology is not always mediated by malignancy. Hypercalcemia can occur in those with malignancy and an additional etiology for hypercalcemia such as primary hyperparathyroidism or granulomatous diseases. This paper reviews the cancers associated with hypercalcemia and their proposed mechanisms, nontumor-mediated hypercalcemia, as well as diagnosis and treatment strategies for each condition.

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          Clinical practice. Hypercalcemia associated with cancer.

          Andrew F Stewart (2005)
          Article 0 comments Cited 198 times – based on 0 reviews     Review now
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            The RANKL/RANK/OPG pathway.

            Brendan Boyce, Lianping Xing (2007)
            Understanding of osteoclast formation and activation has advanced considerably since the discovery of the RANKL/RANK/OPG system in the mid 1990s. Osteoblasts and stromal stem cells express receptor activator of NF-jB ligand (RANKL), which binds to its receptor, RANK, on the surface of osteoclasts and their precursors. This regulates the differentiation of precursors into multinucleated osteoclasts and osteoclast activation and survival both normally and in most pathologic conditions associated with increased bone resorption. Osteoprotegerin (OPG) is secreted by osteoblasts and osteogenic stromal stem cells and protects the skeleton from excessive bone resorption by binding to RANKL and preventing it from interacting with RANK. The RANKL/OPG ratio in bone marrow is thus an important determinant of bone mass in normal and disease states. RANKL/RANK signaling also regulates lymph node formation and mammary gland lactational hyperplasia in mice, and OPG protects large arteries of mice from medial calcification. This article reviews the roles of the RANKL/RANK/OPG system in bone and other tissues.
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              Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop.

              Pierre D'Amour, Rajesh Thakker, Karita Costa … (2014)
              Asymptomatic primary hyperparathyroidism (PHPT) is a common clinical problem. The purpose of this report is to provide an update on the use of diagnostic tests for this condition in clinical practice. This subgroup was constituted by the Steering Committee to address key questions related to the diagnosis of PHPT. Consensus was established at a closed meeting of the Expert Panel that followed. Each question was addressed by a relevant literature search (on PubMed), and the data were presented for discussion at the group meeting. Consensus was achieved by a group meeting. Statements were prepared by all authors, with comments relating to accuracy from the diagnosis subgroup and by representatives from the participating professional societies. We conclude that: 1) reference ranges should be established for serum PTH in vitamin D-replete healthy individuals; 2) second- and third-generation PTH assays are both helpful in the diagnosis of PHPT; 3) normocalcemic PHPT is a variant of the more common presentation of PHPT with hypercalcemia; 4) serum 25-hydroxyvitamin D concentrations should be measured and, if vitamin D insufficiency is present, it should be treated as part of any management course; 5) genetic testing has the potential to be useful in the differential diagnosis of familial hyperparathyroidism or hypercalcemia.
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                Author and article information

                Journal
                Title: Journal of Oncology Practice
                Abbreviated Title: JOP
                Publisher: American Society of Clinical Oncology (ASCO)
                ISSN (Print): 1554-7477
                ISSN (Electronic): 1935-469X
                Publication date Created: May 2016
                Publication date (Print): May 2016
                Volume: 12
                Issue: 5
                Pages: 426-432
                Affiliations
                [1 ]University of Nebraska Medical Center, Omaha, NE
                Article
                DOI: 10.1200/JOP.2016.011155
                PubMed ID: 27170690
                SO-VID: 84aa3220-f993-45c6-b3b3-1e6ed90b2982
                Copyright © © 2016
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