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Mesothelioma and Hypercalcemia?
Hypercalcemia is a condition marked by elevated levels of calcium in the blood, which can cause a number of related complications while also likely representing bone density loss. While rare, hypercalcemia can develop in patients with malignant mesothelioma. The detection of hypercalcemia in relation to malignancy often reveals a very poor prognosis.
The medical description of hypercalcemia is relatively simple, but it often indicates more complex underlying conditions. Most commonly, elevated blood calcium levels indicate improperly functioning parathyroid glands[1]. These glands are located behind the thyroid and near the throat, and they can have abnormal behaviors that lead to excess leaching of bone calcium, leading to an excess of calcium in the bloodstream.
Hypercalcemia can also result from side effects of certain medications, including lithium, hydrochlorothiazide, and even calcium-containing antacid tablets, such as Tums or Rolaids[2]. Individuals who take too much vitamin D, vitamin A, or calcium supplements may also develop the condition. Some individuals may acquire hypercalcemia as a result of prolonged inactivity or because they have too much calcium in their diet[3].
In cancer patients, hypercalcemia may develop during late stages of malignancy. Approximately 10% to 30% of all cancer patients will acquire hypercalcemia, and cancer is the most frequent culprit behind hypercalcemia in hospitalized patients[4]. Secondary conditions related to cancer are called paraneoplastic syndromes[5].
Cancer can cause hypercalcemia in an number of ways. One of the most typical is that the cancer cells produce a peptide that is similar to the parathyroid hormone produced to regulate blood calcium levels[6]. Bone cancers can cause hypercalcemia by breaking down the tissues directly, whereas other cancers may reduce kidney functioning to the point that blood calcium is not filtered out as intended.
Lung cancers have a strong association with hypercalcemia[7], but its development in those with mesothelioma cancers is much less common[8]. Nevertheless, medical researchers do recognize a connection between pleural mesothelioma and hypercalcemia[9].
Symptoms of hypercalcemia include extreme thirst, excessive urination, irritability, depression, weakness, confusion, loss of appetite, and a number of other wide-ranging effects[10]. Those who develop hypercalcemia in conjunction with cancer often have a poor prognosis[11], and palliative care measures are often suggested.
In conclusion, patients with malignant mesothelioma may develop hypercalcemia, but the condition is more often associated with other cancers, supplement excesses, or parathyroid related syndromes. In those with advanced pleural mesothelioma, hypercalcemia may develop, and it often indicates a dismal prognosis.
[1] https://www.mayoclinic.org/diseases-conditions/hypercalcemia/symptoms-causes/syc-20355523
[2] https://my.clevelandclinic.org/health/diseases/14597-hypercalcemia
[3] https://medlineplus.gov/ency/article/000365.htm
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837688/
[5] https://www.mayoclinicproceedings.org/article/S0025-6196(11)60214-0/pdf
[6] https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/high-calcium-levels-or-hypercalcemia
[7] http://ascopubs.org/doi/full/10.1200/JGO.2016.006890
[8] https://www.ncbi.nlm.nih.gov/pubmed/2224795
[9] https://www.birpublications.org/doi/full/10.1259/bjrcr.20150295
[10] https://news.cancerconnect.com/bone-cancer/overview-of-hypercalcemia-_686Bdgvd0Sx3v1rYTBcmA/
[11] http://ascopubs.org/doi/full/10.1200/jop.2016.011155
