Hypercalcemia is most commonly seen with which cancers?

Hypercalcemia is most commonly seen with which cancers?

• A. Breast and lung cancers, lymphoma, and multiple myeloma
• B. Prostate cancer
• C. Colon cancer
• D. Leukemia

Answer: (A)

Hypercalcemia from cancer usually comes from two main mechanisms: substances the tumor releases that dial up bone breakdown, and direct bone involvement by the tumor. The cancers most commonly linked to this are breast and lung cancers, lymphoma, and multiple myeloma. Some tumors secrete a hormone-like protein called PTH-related protein (PTHrP). PTHrP acts like parathyroid hormone, stimulating bone resorption and kidney calcium reabsorption, which raises calcium levels in the blood. This “humoral hypercalcemia of malignancy” is especially common with certain lung cancers and with some breast cancers. When cancer involves bone directly, such as breast cancer with bone metastases and multiple myeloma, the cancer cells or the altered bone environment cause osteolysis, releasing calcium into the bloodstream. Lymphomas can cause hypercalcemia through increased production of active vitamin D (calcitriol) by macrophages or tumor cells, which increases calcium absorption and release from bone. Other cancers listed—such as prostate cancer, colon cancer, or leukemia—are less typically associated with hypercalcemia. Prostate cancer, for example, often affects bone in an osteoblastic (bone-building) way and may not raise calcium as commonly as the four mentioned. So the cancers most commonly seen with hypercalcemia are breast and lung cancers, lymphoma, and multiple myeloma.

Hypercalcemia from cancer usually comes from two main mechanisms: substances the tumor releases that dial up bone breakdown, and direct bone involvement by the tumor. The cancers most commonly linked to this are breast and lung cancers, lymphoma, and multiple myeloma.

Some tumors secrete a hormone-like protein called PTH-related protein (PTHrP). PTHrP acts like parathyroid hormone, stimulating bone resorption and kidney calcium reabsorption, which raises calcium levels in the blood. This “humoral hypercalcemia of malignancy” is especially common with certain lung cancers and with some breast cancers.

When cancer involves bone directly, such as breast cancer with bone metastases and multiple myeloma, the cancer cells or the altered bone environment cause osteolysis, releasing calcium into the bloodstream.

Lymphomas can cause hypercalcemia through increased production of active vitamin D (calcitriol) by macrophages or tumor cells, which increases calcium absorption and release from bone.

Other cancers listed—such as prostate cancer, colon cancer, or leukemia—are less typically associated with hypercalcemia. Prostate cancer, for example, often affects bone in an osteoblastic (bone-building) way and may not raise calcium as commonly as the four mentioned.

So the cancers most commonly seen with hypercalcemia are breast and lung cancers, lymphoma, and multiple myeloma.