Life expectancy-lung cancer with high calcium in blood

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So'n'so - 07 Jan 2004 04:18 GMT

Does anyone have any experience with a lung cancer patient (stage 4) who
presented with high calcium in the blood? Went from 13.5 to 9.6 with
Permidronate (sp?). Thanks in advance.

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J - 07 Jan 2004 11:04 GMT

> Does anyone have any experience with a lung cancer patient (stage 4) who
> presented with high calcium in the blood? Went from 13.5 to 9.6 with
> Permidronate (sp?). Thanks in advance.

Hello So'n'so,
Stage 4 lung cancer is serious indeed.
It's Pamidronate a drug that is used to treat the increased amount of
calcium in the blood (hypercalcemia) that may occur with some kinds of
cancer. It is also used to treat spread of cancer into bones (bone
metastases) in breast cancer and multiple myeloma. (source: BC Cancer
Agency)

High calcium is called hypercalcemia (or to keep Steph happy Hypercalcaemia)

From our FAQ - Part 2
In addition to the functional decline, usually seen in the terminal phase of
progressive illness, there are some circumstances that have a very poor
prognosis in specific illnesses:
- Multiple metastases to the brain, liver, or lung
- Refractory hypercalcemia
- Ongoing bleeding from tumor, or bone marrow failure without transfusions"

so on the face of it, it looks (to me - a non medical person) that the
person's hypercalcemia has responded in part to the treatment. (but I don't
know what the "normal ranges" are for calcium levels).

There's a patient and professional version of hypercalcemia here which might
help you or whoever you are asking about to make treatment decisions. (or
explain some of the symptoms etc)
http://www.nci.nih.gov/cancerinfo/pdq/supportivecare/hypercalcemia/healthprofess
ional/

http://www.nci.nih.gov/cancerinfo/pdq/supportivecare/hypercalcemia/patient

So we know that the person you are inquiring about maybe has bone mets. (or
see above..multiple mets to the brain, liver or lung)..
If you'd like to tell us more and/or why you are asking, perhaps we can be
of more help in some way.

Or if you are in close touch with the person, perhaps you could ask their
doctor if you're trying to assess if it's time for palliative/hospice care
and stop treatment???
J

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So'n'so - 07 Jan 2004 12:18 GMT

The current calcium level is "normal", (which is between 6.5 and 10.5).
There's no question that the cancer has spread to spine, throat, and tongue.
The high calcium is likely due to the cancer attacking the bones.
Palliative care is definitely the way that the treatment is going; the only
"aggressive" treatment is radiation for the back to eliminate pain.

The hypercalcemia has responded to treatment, but I believe it might
eventually come back. The big problem with the high calcium is confusion,
disorientation, etc. The problem is that the doctor seems to half the life
expectancy each time he comes in (first 1-2 years, then 6-12, then 2-3
months when the hypercalcemia was detected). There have been some other
complications (a unit of blood to raise hemoglobin, red cell count, etc.)
and potassium to help the heart.

I am wondering whether the realistic expectation is a couple of weeks or a
couple of months.

Thank you so much for the URL references....

> > Does anyone have any experience with a lung cancer patient (stage 4) who
> > presented with high calcium in the blood? Went from 13.5 to 9.6 with
[quoted text clipped - 25 lines]
> help you or whoever you are asking about to make treatment decisions. (or
> explain some of the symptoms etc)

http://www.nci.nih.gov/cancerinfo/pdq/supportivecare/hypercalcemia/healthprofess
ional/

> http://www.nci.nih.gov/cancerinfo/pdq/supportivecare/hypercalcemia/patient
>
[quoted text clipped - 7 lines]
> and stop treatment???
> J

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J - 07 Jan 2004 19:09 GMT

> The current calcium level is "normal", (which is between 6.5 and 10.5).
> There's no question that the cancer has spread to spine, throat, and tongue.
[quoted text clipped - 12 lines]
> I am wondering whether the realistic expectation is a couple of weeks or a
> couple of months.

Thanks for the additional information. Mom died of lung cancer 14 days after she was
admitted and diagnosed. Her oxygen was low and her WBC's were elevated (which says to me
that she probably had an infection) which prompted an x-ray where they saw the lung mass.
There was no hypercalcemia nor heart issues. She was put on oxygen. 3 days before she
died urinary incontinence occurred and they had a urological consult which found
nothing..(she was not in a cancer hospital nor hospice). She had cancer in the lymph, in
the spine and some in the liver. (perhaps she'd filled out a power of attorney of care and
living will, instructing no treatment nor supportive care). Dad was similar (after
multiple antibiotic tries failed), he had a catheter for his bladder function and some
oxygen. The nurse and then we could tell, once we were there, that there were only days or
a week left.

In the person's case you mention, still receiving supportive care, it would be difficult
for me to even try to guess.
I would try asking the palliative care nurses, since they've probably seen similar and are
actually there to watch the signs and symptoms ..some of which are mentioned here
http://crossingthecreek.com/guts.htm (respiration, circulation, pulse/heart, urinary
output). If you are asking as to know when to go when the person is still semi-cognitive,
or if there's a possibility of arranging a special event for the person, or when to make
work arrangements to go for a funeral, I guess my reply doesn't help at all. I'm sorry.
J

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Mike Radcliffe - 08 Jan 2004 03:13 GMT

> Does anyone have any experience with a lung cancer patient (stage 4) who
> presented with high calcium in the blood? Went from 13.5 to 9.6 with
> Permidronate (sp?). Thanks in advance.

Your cancer is obviously very advanced. Hypercalcaemia indicates bone
involvement but is treatable. I have had patients having regular treatments
for this, usually 4-6week cycles but can vary greatly, over many months or a
year or so. I would suspect that the lung cancer prognosis is in months but
only your oncologist can give you an idea of how long someone at your stage
can expect to survive and even then you have to allow a wide margin for
error.
MIKE

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Steph - 08 Jan 2004 09:45 GMT

> > Does anyone have any experience with a lung cancer patient (stage 4) who
> > presented with high calcium in the blood? Went from 13.5 to 9.6 with
> > Permidronate (sp?). Thanks in advance.
> >
> Your cancer is obviously very advanced. Hypercalcaemia indicates bone
> involvement but is treatable.

Not necessarily.
Squamous cancer can cause hypercalcaemia without bone mets.

> I have had patients having regular treatments
> for this, usually 4-6week cycles but can vary greatly, over many months or a
[quoted text clipped - 3 lines]
> error.
> MIKE

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So'n'so - 08 Jan 2004 12:32 GMT

Yes, the cancer is quite advanced. There was also an associated potassium
drop (causing a few momentary heart stoppages...most likely from bowel
movements that came after correcting an impacted colon) and a unit of blood
to help boost RBC components. You're comment on the high variability of
expectancy is very close to the mark, as we are on tenterhooks about
"actual" life expectancy. Could be months, could be days...I'd be happy
with months, and a minimal amount of pain leading to death while sleeping.
Thanks for your reply.

> > Does anyone have any experience with a lung cancer patient (stage 4) who
> > presented with high calcium in the blood? Went from 13.5 to 9.6 with
[quoted text clipped - 8 lines]
> error.
> MIKE

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