Managing Endocrine and Metabolic Problems in the Patient With Advanced Cancer

EVEN though the emergency room is jammed with patients with nausea and vomiting, and the telephone is constantly ringing and bringing similar complaints, if a patient has cancer, hypercalcemia may be present. A patient may indeed have the epidemic infection, but symptomatic hypercalcemia can be induced or exacerbated by such an "infection." The most common metabolic consequence of being host to a malignant disease is hypercalcemia, which is potentially lethal. Breast cancer patients manifest hypercalcemia most frequently because breast cancer itself is one of the most common cancers and because it has the highest percentage of patients who experience symptomatic hypercalcemia at some time during the course of their illness. It is characterized by a normal or elevated level of serum phosphorus along with an elevated calcium level. The serum parathyroid hormone (PTH) level, as measured by radioimmunoassay, is generally within normal limits. If a patient with metastatic breast cancer