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Bisphosphonates caused normalization of calcium levels in 60-90% of patients who were treated for hypercalcemia of malignancy. [22] Denosumab is a bone anti-resorptive agent that can be used to treat hypercalcemia in patients with a contraindication to bisphosphonates such as severe kidney failure or allergy.
Zoledronic acid is used to prevent bone fractures in patients with cancers such as multiple myeloma and prostate cancer, as well as for treating osteoporosis. [10] It can also be used to treat hypercalcaemia of malignancy and can be helpful for treating pain from bone metastases. [11] It can be given at home rather than in hospital.
Primary treatment of hypercalcemia consists of administering IV fluids. [3] If the hypercalcemia is severe and/or associated with cancer, it may be treated with bisphosphonates. [3] [14] For very severe cases, hemodialysis may be considered for rapid removal of calcium from the blood. [3] [14]
Milk-alkali syndrome (MAS), also referred to as calcium-alkali syndrome, is the third most common cause of elevated blood calcium levels (hypercalcemia). [2] [3] Milk-alkali syndrome is characterized by hypercalcemia, metabolic alkalosis, and acute kidney injury.
Risk factors for tumor lysis syndrome depend on several different characteristics of the patient, the type of cancer, and the type of chemotherapy used. [ 14 ] Tumor characteristics: Tumors with a high cell turnover rate, rapid growth rate, and high tumor bulk tend to be more associated with the development of tumor lysis syndrome.
Metastatic calcification is deposition of calcium salts in otherwise normal tissue, because of elevated serum levels of calcium, [1] which can occur because of deranged metabolism as well as increased absorption or decreased excretion of calcium and related minerals, as seen in hyperparathyroidism.
Multiple national cancer treatment guidelines recommend early palliative care for people with advanced multiple myeloma at the time of diagnosis and for anyone who has significant symptoms. [ 142 ] [ 143 ]
Mutations that inactivate a CaSR gene cause familial hypocalciuric hypercalcemia (FHH) (also known as familial benign hypercalcemia because it is generally asymptomatic and does not require treatment), [22] when present in heterozygotes. Patients who are homozygous for CaSR inactivating mutations have more severe hypercalcemia. [23]