Hypercalcemia?

GoldenGirls · June 2016

Does anyone have any experience with hypercalcemia from bone mets? If so, how is it treated and how long does it take to get relief from the bone pain caused by it? Any insight would be much appreciated.

Longtermsurvivor · June 2016

Hi Golden Girls,

In the distant past, hypercalcemia from bone mets was a very bad sign that the cancer got out of control and the bone was breaking down into its components and poisoning the person.

High blood calcium levels

When cancer spreads to the bones, calcium from the bones can be released into the bloodstream. This can lead to high levels of calcium in the blood called hypercalcemia (HI-per-kal-SEE-me-uh). This can cause problems such as constipation, nausea, loss of appetite, and extreme thirst. The high calcium also causes you to make more urine, leading to dehydration. It can make you feel very tired and weak, too. You may be sleepy or even confused. If hypercalcemia is not treated, you can even go into a coma. - http://www.cancer.org/acs/groups/cid/documents/web...

Since the bone strengthening drugs Zometa and Xgeva have been used, I almost never hear of it.

Is your mother taking either of these drugs? What do her doctors say about her condition and it's solvability?

btw, I've had a small number of bone mets for over 4 years. I don't take those drugs, because they made me ill - that's why I keep track of hypercalemia though - maybe I'll encounter it on my own unique cancer journey.

healing regards, Stephanie

PS, here's an excerpt from a longer piece for doctors

12 Key points for clinical practice:

 Bisphosphonates and denosumab improve pain in women with bone metastases from breast cancer;
 Bisphosphonates may improve quality of life, as was demonstrated with IV ibandronate;
 8 Gy single fraction external beam radiotherapy is an effective means of palliation for bone pain;
 Combined surgery and radiotherapy for spinal cord compression is superior to radiotherapy alone in terms of functional outcomes;
 Optimal treatment of bone metastases involves integration of bone-targeted agents with local and systemic therapy and supportive care through a multidisciplinary team.

www.mdpi.com/2077-0383/3/1/1/pdf

GoldenGirls · June 2016

She does take Zometa and went from monthly to every 3 months and then to every 6 months. They gave her Zometa yesterday immediately after the high levels of calcium were found. She has been on Faslodex for the past 2 months after being stable on chemo. She was having bad back pain for a couple of weeks so her scans were moved up. CT showed mets still stable but I guess the blood says otherwise. She is now going back to chemo next week. That's all we know so far. I wasn't with her at the appointment to ask questions.

Edited to add: The oncologist told her she would get two infusions of the same chemo she was recently on in order to stabilize the cancer and then they would discuss the next treatment. As far as I know he didn't say that she was nearing the end or anything along those lines. I don't know how mild or severe it is because I didn't see the numbers.

After reading more about it I am very worried! She is in good spirits with no symptoms other than the back pain which was originally thought to be from the Faslodex since it's a fairly common side effect.

JFL · June 2016

I had hypercalcemia when diagnosed. I had some treatment limitations because I was pregnant. I was given a few different bisphosphonates, 24-hour a day saline drip for nearly two weeks to dilute my calcium levels, steroids and Taxotere. I eventually switched from bisphosphonates to XGeva once approved by insurance and switched from Taxotere to hormone therapy after I had the baby. I had a lot of pain from both the hypercalcemia and bone mets that took months to go away. However, if your mom's pain was more suddenly brought on by the hypercalcemia, it should improve once your mom's hypercalcemia is under control. The best way to control hypercalcemia is by finding a cancer treatment that works. The other stuff prevented my hypercalcemia from getting worse but did not resolve it. Good luck finding some relief. Hypercalcemia is tough to manage!

DaughterOfStageIV · June 2016

My mom gets that once in a while. The doctors don't seem concerned about it. It usually goes away after her xgeva. She was on Aredia a few years ago, and the Aredia would also bring the calcium levels back to normal.She has extensive bone mets.

GoldenGirls · June 2016

Thank you ladies! I will be speaking to her onc for more details when I take her for chemo. She had Zometa on Friday so we hope that her back pain resolves soon. We do feel a little more assured hearing your stories.

GoldenGirls · June 2016

As of yesterday her calcium levels were back to normal, though her potassium is now low. She had chemo and will go back in 10 days to check her blood again. If her calcium levels increase she will get Zometa again. Her pain also seems to be improving, though that could be from the steroids given with chemo. Either way, she is feeling better which is all that matters

Longtermsurvivor · June 2016

Thanks for reporting back, GoldenGirls!

Wonderful news!

That's the way it's supposed to work in these days of Zometa and Xgeva - use the blood tests as indicators and the drugs to treat the underlying problem.

So very happy she's feeling better and you are relieved!

healing regards, Stephanie

GoldenGirls · June 2016

Thanks Stephanie! She'd had Zometa in March so I'm surprised at how quickly the calcium levels changed. Her scans show no progression but her pain and calcium levels show that Faslodex was not doing its job. So glad the onc was on top of it. We'd have been happy to just go by the scans, though more and more in her case we are realizing that her symptoms are more telling than scans when it comes to her bone mets.

Rosieo · August 2016

Golden girls and Steph

Steph, I know you are so well read, perhaps you can comment. I just had a cat scan of my face. there is a crack in my jaw bone at the end where your two jaws come to gether. I have false teeth and I cannot even put them in anymore because it is too painful. I went to a radiologist and he said he can do some radiation and gave me some hope. My biggest problem right now is pain. I have been taking at lease 6 to 8 500 miligrams of Tylenol with 1 ibuprofen. This works pretty good if I take it every four to five hours. I had some tramadol my ONC gave me some time ago when I had pain else where but that doesn't work as good, Now the oralsurgion gave me hydrocone and that doesn't work as well either. I guess my question is do you have any suggestions as to this pain management. Just worried that so much of this Tylenol will notdo well on my stomach. :-)

Golden I hope your Mom is pain free as I cansee now that is the that is the thine thatcan really wear you down.

Steph I just want to let you know that your postings give me so much. You are a true warrior. I only wish I could be as striong

Any comments on the pain or what you think of radiation to that area would be so greatly appreciative.

Rosieo

Longtermsurvivor · August 2016

Hi Rosieo,

You don't have a health or treatment history as a signature or at your personal page, so I may be going off on a tangent to ask where your mets are, whether you have bone mets and if you've been on the bone drugs - usually Zometa (a bisphosphonate) or Xgeva? I wonder if you are at risk for osteonecrosis of the jaw (ONJ) that is far too common, but far too infrequently discussed in our cancer world.

Whether or not you have taken those drugs or have ONJ, I hope that you'll be thoroughly worked up by a dental oncologist (usually found through major cancer centers) or a specialist in head and neck cancers.

You should not stop with the radiation oncologist, but seek to preserve your jaw and to get proper pain relief.

Also, have you consulted with a palliative care team? I'm worried that you are not eating, because of the tremendous pain in your face/jaw. https://getpalliativecare.org

You can continue with active treatment while receiving palliative care. They will address your pain through various approaches, including as many drugs as you feel comfortable taking.

Please remember, I am not a medical professional, but am advising you to get the best medical care possible.

I've a beloved friend with MBC who suffered severe face pain for nearly a year and was misdiagnosed with a variety of problems. She was finally diagnosed with ONJ last month and is seeking proper pain control. It's ruined her quality of life, more than the progressing cancer has. It's been truly terrible to witness her decline.

Rosieo, please advocate for yourself by getting the best proper medical care - a dental oncologist would be your next consult, if you can find one.

Sending hug of rainbow loving light to shelter and relax you during this challenge.

warm healing wishes, Stephanie

Rosieo · August 2016

Steph

Thank you so much for your reply. I have breast cancer metastized to my lung. Diagnosed with the metastis about 10 months ago. I am taking the chemo Abraxane. I had a cat scan about 2 weeks ago and it showed my tumor grew hardly at all. Then I got this pain in my face. I got the run around from 3 Dr's and now about three weeks later I finally got to a oral surgeon He sent me for a full face cat scan. His report to me was that my jaw bone is broke. Now I went to the radiologist and he said with radiation he can give me some relief of the pain and may even heal it???? I have an appt for Monday and then for Wed formy first treatment. So sacred. You give so many people on this board strength and hope because of you strength. God Bless you. Any other reply is greatly appreciated.

Thank you so much again. Rosieo

Longtermsurvivor · August 2016

Hi Rosieo,

It doesn't sound like you've been taking bone strengthening drugs, so it's unlikely that you have ONJ.

Why is your jaw broken?

Why does the radiation oncologist think radiation will help with pain relief and maybe repair the broken bone?

A few more details would help us to see the puzzle better.

What about seeing an oncological dentist? Is that a possibility where you are, Rosieo?

And this is a scary time - pain and the unknown tip us into the fear zone.

Rosieo, another thought is to post a separate new topic on this forum asking about jaw problems in those with MBC. You might get more responses, since hypercalcemia (the title of this topic) is seldom a problem in MBC now that so many are taking the bone strengthening drugs.

warm hug, Stephanie

Hypercalcemia?

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