Author: Andrew Parfitt, Shumontha Dev / Editors: Adrian Boyle / Reviewer: Shanthi Siva, Emma Everitt, William Gibbs / Codes: O6, O7 / Published: 20/05/2021
Hypercalcaemia is commonly seen in patients with malignant disease. This module explains the assessment and management of the problem in the emergency department (ED).
By the end of this session you will be able to:
- Describe symptoms and signs of hypercalcaemia in malignancy
- Interpret serum calcium results
- Describe how to respond to hypercalcaemia in an emergency situation
- Explain the ongoing management of hypercalcaemia in oncology patients
References
- Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med. 2005 Jan 27;352(4):373-9.
- BMJ Best Practice, Hypercalcaemia of Malignancy, 2023.
- Fraser Health. Hypercalcaemia in malignant disease (palliative management). Hospice Palliative Care, Clinical Practice Committee 2006
- MDCalc: Calcium Correction for Hypoalbuminaemia and hyperalbuminaemia.
- El-Hajj Fuleihan G, Clines GA, Hu MI, et al. Treatment of hypercalcemia of malignancy in adults: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2023 Feb 15;108(3):507-28.
- Kinirons M T. Newer agents for the treatment of malignant hypercalcaemia. Am J Med Sci 1993; 305(6): 403-6
- Major P Lortholary A Hon J, Zoledronic Acid is superior to pamidronate in the treatment of hypercalcaemia of malignancy: A pooled analysis of 2 randomised controlled clinical trials. Journal Clinical Oncology. 2001; 19: 558-567
- Nussbaum SR, Younger J, et al., Single-dose intravenous therapy with pamidronate for the treatment of hypercalcemia of malignancy: comparison of 30-, 60-, and 90-mg dosages. Am J Med. 1993; 95(3): 297-304.
- Gucalp R, Ritch P, Wiernik PH, et al. Comparative study of pamidronate disodium and etidronate disodium in the treatment of cancer-related hypercalcemia. J Clin Oncol. 1992; 10: 134-42
- Longmore M, Wilkinson I, et al. Oxford handbook of Clinical Medicine 7th Edition. Oxford University Press 2007; page 138
- Medicines and Healthcare products Regulatory Agency. Denosumab (Xgeva) for advanced malignancies involving bone: study data show new primary malignancies reported more frequently compared to zoledronate. Jun 2018.