Information
Patients with cancer most at risk of hypercalcaemia are those with known bone metastases or myeloma. However 20% do not have bone metastases.
Most common symptoms of mild hypercalcaemia are nausea, poor appetite, vomiting and constipation. Moderate levels may produce fatigue, excessive tiredness, polyuria, polydipsia, heart rhythm abnormalities. High levels may produce muscle twitching, anxiety, depression, personality changes and confusion
M.A, K.E & J.W. 12-02-26
Who to refer:
Any patient with a cancer diagnosis who is on treatment, within 6 weeks of treatment, has had immunotherapy within last 12 months or who is under oncology follow up who has an adjusted calcium of above 2.8.
Who not to refer:
If in doubt please do not hesitate to call the on call oncology team. You may be advised to refer via medical team if patient is no longer under oncology follow up.
How to refer:
Contact the Acute Oncology team at the Edinburgh Cancer Centre on 07798774842 or 0131 537 1000 and ask to speak to Acute Oncology team for oncology.
If patient has mild symptoms and a adjusted calcium of below 2.8. Please ensure patients stop any calcium supplements and ensure the patient is adequately hydrated and recheck in a few days. If you have any questions do not hesitate to call the On Call Team.
All patients on or within six weeks of treatment should be encouraged to monitor symptoms and call The Cancer Treatment Helpline (CTH; 08009177711) with any treatment-related concerns. Please note, the CTH is a call operator service provided by NHS 24, who then refer on to an acute care specialist. They cannot give specialist advice.
If the patient has been assessed by a healthcare practitioner in Primary Care, and Oncology advice/input is felt to be required, the Primary Care clinician should call the Acute Oncology team at the Edinburgh Cancer Centre (based in the WGH) and discuss directly. The Acute Oncology team can be contacted during working hours (Mon-Fri 9-5) on 07798774842; If out of hours, please discuss with the Oncology Registrar On-Call via NHS Lothian Switchboard (0131 537 1000).
If the primary care clinician requires any further guidance on the suitability of referral to Acute Oncology, they can consult Pg 10 of the The UKONS Oncology/Haematology 24 Hour Triage Toolkit.
Note if a patient has presented to primary care for assessment, the patient should NOT be advised to call the CTH themselves to pass on this information or seek further advice.
Link to Acute Oncology Initial Management Guidelines:
UKONS | Acute Oncology Initial Management Guidelines (sundownsolutions.co.uk)
