Anticancer Medications and Sodium Dysmetabolism

Area of Science:

• Oncology
• Nephrology
• Endocrinology

Background:

• Cancer therapies have improved survival but can cause adverse effects like dyselectrolytaemias.
• Sodium and water balance are critical for physiological function and tightly regulated.
• Cancer and its treatments can disrupt this delicate homeostatic balance.

Purpose of the Study:

• To review essential aspects of sodium homeostasis in cancer patients.
• To focus on alterations in sodium balance caused by anticancer medications.
• To highlight the clinical significance of managing these electrolyte disturbances.

Main Methods:

• Literature review of therapeutic advances in cancer treatment.
• Analysis of mechanisms causing sodium and water imbalance in cancer.
• Exploration of adverse effects of conventional and novel anticancer agents on electrolytes.

Main Results:

• Anticancer drugs, including alkylating agents, platinum-based drugs, vinca alkaloids, small molecule inhibitors, and monoclonal antibodies, can cause hyponatraemia.
• Hyponatraemia mechanisms include inappropriate antidiuretic hormone secretion, hypocortisolism, salt-wasting syndromes, and pituitary dysfunction.
• Hypernatraemia is less common, occasionally resulting from drug-induced nephrogenic diabetes insipidus.

Conclusions:

• Dyselectrolytaemias, particularly hyponatraemia, are significant adverse effects of cancer therapy.
• Identifying the etiology and managing these conditions promptly is vital for patient outcomes.
• Appropriate management of treatment-related electrolyte imbalances can be lifesaving.