There are several cancer medications, such as cisplatin, diuretics, antibiotics and steroids, which have been linked with electrolyte imbalance. Among other causes of electrolyte imbalance are persistent vomiting, diarrhoea, loss of appetite, inappropriate nutrition and hydration.
What is Electrolyte Imbalance?
- Electrolytes imbalance is the inability of body to regulate important physiological functions. Among serious forms of electrolyte imbalance in cancer include high blood calcium levels (hypercalcemia) or a disorder called tumour lysis syndrome (a condition that develops from the killing of cancer cells).
- Calcium, chloride, potassium, magnesium and sodium are the electrolytes present in our bodies. Calcium is responsible for muscle contraction, nerve function, blood clotting, cell division and healthy bones/teeth, while chloride helps to maintain fluid balance in the body. Potassium regulates heart contraction, while magnesium manages nerve function, heart rhythm and build up of protein. Sodium is necessary to maintain fluid balance and maintaining nerve functions.
Electrolyte Imbalances in Cancer
Hypercalcemia
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- Hypercalcemia becomes critical condition in combination with electrolyte imbalance, wherein patient may experience destruction of bones due to bone metastases.
- The prominent signs and symptoms of hypercalcemia include nausea, lethargy, irritability, anorexia, extreme muscle weakness, irregular heartbeat, frequent urination and coma. Difficult to diagnose, hypercacemia is a medical emergency requiring immediate medical attention.
- Hyperkalemia could be induced by chemotherapy for large malignant tumours, owing to tumour lysis syndrome.
- Hypercalcemia and hyponatremia mostlyaffect breast cancer, renal cancer and prostate cancer patients.
- Hypercalcemia may result from osteolysis, but most are induced by hormonal factors, such as parathyroid protein.
Tumour Lysis Syndrome (TLS)
- Owing to spilling of intracellular contents in the process of therapy, cells are not treated entirely. The spilling causes them to get accumulated faster.
- These intracellular contents cause metabolic as well as electrolyte disturbances. The condition becomes critical if untreated, and its advancement along with cancer may cause acute kidney failure, cardiac arrhythmias, seizures and loss of muscle control death.
- Cancer patients do not feel symptoms of tumour lysis syndrome in its early stages, but have abnormal laboratory results.
- Patients vulnerable to TLS have leukaemia or lymphoma, and the condition is very responsive to chemotherapy.
- It is a motile condition, caused by encephalopathy or arrhythmia in some cases.
- The risk of developing TLS could be treated with preventive measures, which includes intravenous hydration, alkalinisation of the urine with sodium bicarbonate and medications including allopurinol or Elitek® (rasburicase).
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