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Endocrine and Metabolic Symptoms of Cancer and Its Treatment

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The MASCC Textbook of Cancer Supportive Care and Survivorship

Abstract

Tumor Lysis Syndrome (TLS), a potentially life-threatening complication for patients with cancer, has been subclassified into either laboratory TLS or clinical TLS. Laboratory TLS is characterized by the rapid development of two or more of the following abnormalities – hyperuricemia, hyperkalemia, hyperphospatemia, hypocalcemia, and azotemia – which occur in cancer patients most often 28–72 h after the initiation of chemotherapy or radiation; however, spontaneous cases have been reported [1]. Clinical manifestations of TLS include renal failure (glomerular filtration rate ≤60 ml/min) and organ damage leading to cardiac arrhythmias or seizures. Predisposing factors for TLS include neoplasms with high growth rates, patients with a large tumor size or burden, high white blood cell count (>50,000/mm3), cancers highly sensitive to chemotherapy or radiation, and patients with extensive bone marrow involvement [2]. Comorbidities that increase the risk for developing TLS include elevated uric acid level prior to treatment, preexisting renal insufficiency, obstructive uropathy, and advanced age [2]. Patients with hematological malignancies including high-grade lymphomas (i.e., Burkitt’s lymphoma) and acute or chronic leukemias are more likely to have complications of TLS. In adults with solid tumors, TLS is a rare complication in chemosensitive tumors including bulky small cell lung cancer and metastatic germ cell carcinoma. In children, TLS is more frequently associated with malignancies that have an increased proliferative fraction, large tumor burden, widely metastatic disease, or increased sensitivity to chemotherapy.

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References

  1. Tosi P, Barosi G, Lazzaro C, et al. Consensus conference on the management of tumor lysis syndrome. Haematologica 2008;93(12):1877–1885.

    Article  PubMed  Google Scholar 

  2. Cairo MS, Bishop M. Tumor lysis syndrome: new therapeutic strategies and classification. Br J Haematol 2004;127:3–11.

    Article  PubMed  Google Scholar 

  3. Rampello E, Ficia T, Malaguarnera M. The management of tumor lysis syndrome. Nat Clin Pract Oncol 2006;3:438–447.

    Article  PubMed  Google Scholar 

  4. Merten GJ, Burgess WP, Gray LV, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA 2004;291:2328–2334.

    Article  PubMed  CAS  Google Scholar 

  5. DeConti RC, Calabresi P. Use of allopurinol for prevention and control of hyperuricemia in patients with neoplastic disease. N Engl J Med 1966;274:481–486.

    Article  PubMed  CAS  Google Scholar 

  6. Pui CH. Rasburicase: a potent uricolytic agent. Expert Opin Pharmacother 2002;3:433–442.

    Article  PubMed  CAS  Google Scholar 

  7. Coiffer B, Altman A, Pui C, Younes A, Cairo M. Guidelines for the management of pediatirc and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol 2008;26(16):2767–2778.

    Article  Google Scholar 

  8. Bosly A, Sonet A, Pinkerton CR, et al. Rasburicase (recombinant urate oxydase for the management of hyperuricemia in patients with cancer. Cancer 2003;98:1048–1054.

    Article  PubMed  CAS  Google Scholar 

  9. Cleary JF. Fever and sweats: including the immunocompromised hosts. In: Berger A, Portenoy RK, Weissman DE, eds.: Principles and practice of supportive oncology. Philadelphia: Lippincott-Raven, 1998, pp 119–131.

    Google Scholar 

  10. Dinarello CA, Bunn PA. Fever. Semin Oncol 1997;24(3):288–298.

    PubMed  CAS  Google Scholar 

  11. Klastersky J, Paesmans M, Rubenstein EB, et al. The multinational association for supportive care in cancer risk index: a multinational scoring system for identifying low-risk febrile neurtopenic cancer patients. J Clin Oncol 2000;18(16):3038–3051.

    PubMed  CAS  Google Scholar 

  12. Steele RW, Tanaka PT, Lara RP, et al. Evaluation of sponging and of oral antipyretic therapy to reduce fever. J Pediatr 1970;77(5):824–829.

    Article  PubMed  CAS  Google Scholar 

  13. Quigley CS, Baines M. Descriptive epidemiology of sweating in a hospice population. J Palliat Care 1997;13(1):22–26.

    PubMed  CAS  Google Scholar 

  14. Dalal S, Zhukovsky DS. Pathophysiology and management of hot flashes. J Support Oncol 1006;4(7):315–320.

    Google Scholar 

  15. Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principle results from the Women’s Health Initiative randomized controlled trial. JAMA 2002;288(3):321–333.

    Article  Google Scholar 

  16. Li CI, Malone KE, Poster PL, et al. Relationship between long duration and different regimens of hormone therapy and risk of breast cancer. JAMA 2003;289(24):3254–3263.

    Article  PubMed  CAS  Google Scholar 

  17. Ralston SH, Gallager SJ, Patel U, et al. Cancer associated hypercalcemia: morbidity and mortality: clinical experience in 126 treated patients. Ann Intern Med 1990;112:499–504.

    PubMed  CAS  Google Scholar 

  18. Stewart A. Hypercalcemia associated with cancer. NEJM 2005;352(4):373–379.

    Article  PubMed  CAS  Google Scholar 

  19. Ladenson JH, Lewis JW, McDonald JM, et al. Relationship of free and total calcium in hypercalcemic conditions. J Clin Endocrinol Metab 1978;48:393–397.

    Article  Google Scholar 

  20. Layman R, Olson K, Van Poznak C. Bisphosphonates for breast cancer. Hematol Oncol Clin North Am 2007;21(2):341–367.

    Article  PubMed  Google Scholar 

  21. Woo SB, Hellstein JW, Kalmar JR. Systematic review: bisphosphonates and osteonecrosis of the jaws. Ann Intern Med 2006;144(10):753–761.

    PubMed  CAS  Google Scholar 

  22. Klastersky J. Side effects of ifosfamide. Oncology 2003;65(Suppl 2):7–10.

    Google Scholar 

  23. Cao L, Prashant J, Sumoza D. Renal salt wasting in a patient with cisplatin-induced hyponatremia. Am J Clin Oncol 2002;25:344–346.

    Article  PubMed  Google Scholar 

  24. Hammond IW, Ferguson JA, Kwong K, Muniz E, Delisle F. Hyponatremia and syndrome of inappropriate anti-diuretic hormone reported with the use of Vincristine: an over representation of Asians? Pharmacoepidemiol Drug Saf 2002;11(3):229–234.

    Article  PubMed  CAS  Google Scholar 

  25. Ellison DH, Berl T. Clinical practice. The syndrome of inappropriate antidiuresis. N Engl J Med 2007;356(20):2064–2072.

    Article  PubMed  CAS  Google Scholar 

  26. Verbalis JG, Goldsmith SR, Greenberg A, et al. Hyponatremia treatment guidelines 2007: expert panel recommendations. Am J Med 2007;120:S1–S21.

    Article  PubMed  CAS  Google Scholar 

  27. Yeong-Hau LH, Shapiro JI. Hyponatremia: clinical diagnosis and management. Am J Med 2007;120:653–658.

    Article  Google Scholar 

  28. Vassal G, Rubie C, Kalifa C, et al. Hyponatremia and renal sodium wasting in patients receiving cisplatinum. Pediatr Hematol Oncol 1987;4:337–344.

    Article  PubMed  CAS  Google Scholar 

  29. Soupart A, Decaux G. Therapeutic recommendations for management of severe hyponatremia: current concepts on pathogenesis and prevention of neurologic complications. Clin Nephrol 1996;46:149–169.

    PubMed  CAS  Google Scholar 

  30. Rabinstein AA, Wijdicks EF. Hyponatremia in critically ill neurological patients. Neurologist 2003;9(6):290–300.

    Article  PubMed  Google Scholar 

  31. Laureno R. Central pontine myelinolysis following rapid correction of hyponatremia. Ann Neurol 1983;13:232–242.

    Article  PubMed  CAS  Google Scholar 

  32. Palm C, Reimann D, Gross P. The role of V2 vasopressin antagonists in hyponatremia. Cardiovasc Res 2001;51:403–408.

    Article  PubMed  CAS  Google Scholar 

  33. Wolf FL, Maier JA, Nasulewics A, et al. Magnesium and neoplasia : from carcinogenesis to tumor growth and progression or treatment. Arch Biochem Biophys 2007;458:24–32.

    Article  PubMed  CAS  Google Scholar 

  34. Saif MW. Management of hypomagnesemia in cancer patients receiving chemotherapy. J Support Oncol 2008;6:243–248.

    PubMed  Google Scholar 

  35. Mouw DR, Latessa RA, Hickner J. Clinical inquiries. What are the causes of hypomagnesemia? J Fam Pract 2005;54:174–176.

    PubMed  Google Scholar 

  36. Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2008;93:1526–1540.

    Article  PubMed  CAS  Google Scholar 

  37. Blake MA, Kalra MK, Seeney AT, et al. Distinguishing benign from malignant adrenal masses: multi-detector row CT protocol with 10-minute delay. Radiology 2006;238:578–585.

    Article  PubMed  Google Scholar 

  38. Oldfield EH, Chrousos GP, Schulte HM, et al. Preoperative lateralization of ACTH-secreting pituitary microadenomas by bilateral and simultaneous inferior petrosal venous sinus sampling. N Engl J Med 1085;312:100–103.

    Article  Google Scholar 

  39. Luton JP, Cerdas S, Billaud L, et al. Clinical features of adrenocortical carcinoma, prognostic factors, and the effect of mitotane therapy. N Engl J Med 1990;322:1195–1201.

    Article  PubMed  CAS  Google Scholar 

  40. Nayar MK, Lombard MG, Furlong NJ, et al. Diagnosis and management of nonislet cell tumor hypoglycaemia. Endocrinologist 2006;16(4):227–230.

    Article  Google Scholar 

  41. Service FJ, Hypoglycemic disorders. N Engl J Med 1995;91:505–510.

    Google Scholar 

  42. de Groot JW, Rikhof B, van Doorn J, et al. Non-islet cell tumour induced hypoglycaemia: a review of the literature including two new cases. Endocr Relat Cancer 2007;14:979–993.

    Article  PubMed  Google Scholar 

  43. Le Roith D. Tumor-induced hypoglycemia. N Engl J Med 1999;341:757–758.

    Article  PubMed  Google Scholar 

  44. Daughaday WH, Trivedi B. Measurement of derivatives of proinsulin-like growth factor-II in serum by radioimmunoassay directed against the E-domain in normal subjects and patients with nonislet cell tumor hypoglycemia. J Clin Endocrinol Metab 1992;75:110–115.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center, Symptom Control and Palliative Medicine, Houston, TX, 77030, USA

    Rony Dev

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Correspondence to Rony Dev .

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Editors and Affiliations

  1. Clinical Professor, Cancer Coucil Australia, University of Sydney Medical School, Surry Hills, 2010, New South Wales, Australia

    Ian N. Olver

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Dev, R. (2010). Endocrine and Metabolic Symptoms of Cancer and Its Treatment. In: Olver, I. (eds) The MASCC Textbook of Cancer Supportive Care and Survivorship. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1225-1_13

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  • DOI: https://doi.org/10.1007/978-1-4419-1225-1_13

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  • Publisher Name: Springer, Boston, MA

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