Hypercalcemia and cancer: an update

Hypercalcemia is a not infrequent complication of cancer that every physician should be aware of. It is a significant factor in the morbidity and mortality of cancer patients. Almost invariably hypercalcemia is associated with accelerated resorption of bone, which is thought to be mediated by humoral or metabolic factors. Three such factors, parathyroid hormone, E2 prostaglandins and osteoclast activating factor, have been strongly implicated in the pathogenesis of hypercalcemia in cancer patients. Other mechanisms for the hypercalcemia may exist. Accurate diagnosis of the disorder is important in therapy, and current research into the various mechanisms for hypercalcemia in cancer patients may well lead to new modes of therapy that are more specific and perhaps less toxic.