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
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 6 weeks of treatment should be encouraged to monitor symptoms and call Cancer Treatment Helpline (CTH) on 08009177711 if any treatment related concerns. Please note the CTH is a call operator service provided by NHS 24 who then refer on to acute care specialist. They are not able to give specialist advice. Note if a patient has presented to primary care for assessment the patient should not be advised to call the CTH to pass on this information or seek further advice. The primary care clinician should call the Acute Oncology team at the Edinburgh Cancer Centre to discuss if appropriate.
Link to Acute Oncology Initial Management Guidelines:
