Laboratory assessment
Clinical assessment
Decision to treat

Laboratory assessment

A blood test is done to check the level of calcium. Other blood tests may be done to check kidney function.

Patients with high calcium levels should be examined for the following:

• Symptoms:
  • Nerves and muscles (muscle strength, muscle tone, reflexes, tiredness, indifference, depression, confusion, restlessness).
  • Heart (high blood pressure, heart changes, irregular heartbeat, digitalis poisoning).
  • Kidneys (production of too much urine, night-time urinating, sugar in the urine, excess thirst).
  • Gastrointestinal (loss of appetite, nausea, abdominal pain, constipation, abdominal bloating).
  • Other (muscle and bone pain, itching).
• History:
  • How fast did the symptoms appear?
  • Is there x-ray evidence of primary or metastatic bone disease?
  • Has the patient been taking tamoxifen, estrogen, or androgens?
  • Is the patient taking digoxin?
  • Is the patient receiving calcium in intravenous fluids?
  • Is the patient receiving thiazide diuretics, vitamins A or D, or lithium?
  • Is there another disease present that could cause dehydration or lack of movement?
  • Are there effective treatments for the patient's cancer?

The decision to treat hypercalcemia depends on the treatment goals determined by the patient, caregivers, and the physician. The natural course of untreated hypercalcemia progresses to loss of consciousness and coma. This may be preferred by some patients at the end of life who have unrelieved suffering and/or untreatable symptoms.

Glossary Terms

Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

A type of hormone that promotes the development and maintenance of male sex characteristics.

A desire to satisfy a physical or mental need, such as for food, sex, or adventure.

A swelling or feeling of fullness in the abdomen. Bloating is usually the result of gas in the intestines and can be caused by many things, including overeating, lactose intolerance, and constipation. Bloating can also be a side effect of cancer or cancer treatment.

A procedure in which a sample of blood is examined to measure the amounts of certain substances made in the body. An abnormal amount of a substance can be a sign of disease in the organ or tissue that produces it.

A mineral needed for healthy teeth, bones, and other body tissues. It is the most common mineral in the body. A deposit of calcium in body tissues, such as breast tissue, may be a sign of disease.

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

A condition in which a patient is in a state of deep sleep and cannot be awakened. A coma may be caused by many things, including trauma, drugs, toxins, or certain diseases.

A mental state in which one is not thinking clearly.

A condition in which stool becomes hard, dry, and difficult to pass, and bowel movements don’t happen very often. Other symptoms may include painful bowel movements, and feeling bloated, uncomfortable, and sluggish.

A condition caused by the loss of too much water from the body. Severe diarrhea or vomiting can cause dehydration.

A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.

A substance used to make drugs that are used to treat several heart conditions, including congestive heart failure. Digitalis is made from the dried leaves of Digitalis purpurea (common foxglove) plants. It is a type of cardiac glycoside.

A drug used to treat irregular heartbeat and some types of heart failure. It is also being studied in the treatment of some types of cancer. Digoxin helps the heart work normally by controlling the amount of calcium that goes into the heart muscle. It also may kill cancer cells and make them more sensitive to anticancer drugs. It is a type of cardiac glycoside. Also called Lanoxin.

A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.

A substance that flows smoothly and takes the shape of its container. Liquids and gases are fluids.

Refers to the stomach and intestines. Also called GI.

A blood pressure of 140/90 or higher. High blood pressure usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. Also called hypertension.

Higher than normal levels of calcium in the blood. Some types of cancer increase the risk of hypercalcemia.

Into or within a vein. Intravenous usually refers to a way of giving a drug or other substance through a needle or tube inserted into a vein. Also called IV.

One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.

A soft metal. Lithium salts are used to treat certain mental disorders, especially bipolar (manic depressive) disorder. Lithium salts include lithium carbonate and lithium citrate.

Having to do with metastasis, which is the spread of cancer from the primary site (place where it started) to other places in the body.

A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.

A bundle of fibers that receives and sends messages between the body and the brain. The messages are sent by chemical and electrical changes in the cells that make up the nerves.

Medical doctor.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A drug used to treat certain types of breast cancer in women and men. It is also used to prevent breast cancer in women who have had ductal carcinoma in situ (abnormal cells in the ducts of the breast) and in women who are at a high risk of developing breast cancer. Tamoxifen is also being studied in the treatment of other types of cancer. It blocks the effects of the hormone estrogen in the breast. Tamoxifen is a type of antiestrogen. Also called tamoxifen citrate.

Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.

A nutrient that the body needs in small amounts to function and stay healthy. Vitamin A helps in vision, bone growth, reproduction, growth of epithelium (cells that line the internal and external surfaces of the body), and fighting infections. It is fat-soluble (can dissolve in fats and oils). Vitamin A is found in liver, egg yolks, and whole milk dairy products from animals and in fish oils. It can also be made in the body from a substance found in some fruits and vegetables, such as cantaloupes, carrots, spinach, and sweet potatoes. Vitamin A is being studied in the prevention and treatment of some types of cancer. Also called retinol.

A nutrient that the body needs in small amounts to function and stay healthy. Vitamin D helps the body use calcium and phosphorus to make strong bones and teeth. It is fat-soluble (can dissolve in fats and oils) and is found in fatty fish, egg yolks, and dairy products. Skin exposed to sunshine can also make vitamin D. Not enough vitamin D can cause a bone disease called rickets. It is being studied in the prevention and treatment of some types of cancer. Also called cholecalciferol.

A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.