Endocrine Dysregulation

Clinical symptoms of malignancy typically occur late in disease and are frequently characterized by pain resulting from tissue destruction. The generic symptoms of cachexia or fatigue are also common. In specific cases, however, cancer may present with more specific disease manifestations. The proliferation of cells with particular differentiation may lead to an overabundance of factors secreted by them. If such factors have hormone-like properties they may cause symptoms. Conversely, tissue destruction by cancer growth may damage hormone-producing cells causing endocrine deficiency or imbalance. Clinically, tumor-induced endocrine dysregulations present as paraneoplastic syndromes (Table 13.A). Approximately 15% of hospitalized cancer patients have a paraneoplastic syndrome. The risk that a patient with cancer will develop a paraneoplastic syndrome is 50-75%.