Hypercalcemia of malignancy.
Less than 25 years ago tumor-induced hypercalcemia was often a lethal complication of cancer. Nowadays, it can be treated easily and successfully in at least 90% of cases by volume repletion in addition to the use of bisphosphonates that are potent anti-osteoclastic compounds. The standard therapy consists of the administration of 90 mg pamidronate or, more recently, 4 mg zoledronic acid, a more efficient bisphosphonate. When available, another alternative bisphosphonate is ibandronate. Recurrent hypercalcemia is nevertheless difficult to control and antibodies against parathyroid hormone-related protein could be useful for that matter in selected patients who are not in the terminal stage of their disease. Prevention of tumor-induced hypercalcemia is one of the objectives of long-term therapy with bisphosphonates in patients with tumor bone disease. The use of bisphosphonates in placebo-controlled trials has shown that the incidence of hypercalcemic episodes is reduced by more than one half.
Body
Jean-Jacques
JJ
Supportive Care Clinic and Clinic of Endocrinlogy and Bone Disease, Université Libre de Bruxelles, Belgium. jj.body@bordet.be
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D005544:Forecasting; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D007093:Imidazoles / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications*; D000077268:Pamidronate; D044162:Parathyroid Hormone-Related Protein / Q000378:metabolism; D000077211:Zoledronic Acid
D000970:Antineoplastic Agents; D004164:Diphosphonates; D007093:Imidazoles; D044162:Parathyroid Hormone-Related Protein; D000077211:Zoledronic Acid; D000077268:Pamidronate