Hypercalcaemia of malignancy (HCM)

Hypercalcaemia is a complex metabolic abnormality that affects up to 30% of people with cancer. It is characterised by high calcium levels in the blood stream and can result in death and is considered an oncological emergency. 

In this rapid learning you will learn how to:

• recognise the signs and symptoms of HCM
• assess the severity
• initiate the right interventions and escalate care appropriately

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Module

Mini quiz

Download the eviQ Education app to access exclusive content, including the HCM mini quiz and seven other oncological emergency interactive lessons. Use the QR code to access to HCM mini quiz, or visit our mini quizzes homepage for more information.

Additional resources

You can use the following resources in the workplace to assist you in caring for patients.

Save a copy of these resources so you can refer back to them in the workplace.

• HCM summary sheet
• HCM signs and symptoms
• HCM assessment and interventions table
• ESMO Handbook of Oncological Emergencies
• eviQ clinical resource - Hypercalcaemia of malignancy (HCM)- ID 486 
• eviQ clinical resource – Hypercalaemia of malignancy (HCM) pamidronate – ID 1505
• eviQ clinical resource – Hypercalaemia of malignancy (HCM) zoledronic acid – ID 1504
• Oncological emergencies - Oncology for Medical Students
• Society for endocrinology endocrine emergency guidance: Emergency management of acute hypercalcaemia in adult patients
• EdCaN resource: Lung cancer and HCM case study

Patient information

• American College of Physicians (ACP) Patient Education Resources: Hypercalcaemia

References: 

1. Stewart, A. F. 2005. "Clinical practice. Hypercalcemia associated with cancer." N.Engl.J.Med. 352(4):373-379.
2. Horwitz, MJ. 2018 , Hypercalcaemia of malignancy: mechanisms, Uptodate, viewed 3rd January 2020, < https://www.uptodate.com/contents/hypercalcemia-of-malignancy-mechanisms>
3. Sternlicht, H. and Glezerman, I.G., 2015. Hypercalcemia of malignancy and new treatment options. Therapeutics and clinical risk management, 11, p.1779.
4. Mirrakhimov, A.E., 2015. Hypercalcemia of malignancy: an update on pathogenesis and management. North American journal of medical sciences, 7(11), p.483.
5. Clinical resource: Hypercalcaemia of malignancy 2019 V.3, eviQ Cancer Treatments Online, Cancer Institute NSW, viewed 1st April 2020, eviq.org.au/p/486
6. Walsh, J., Gittoes, N., Selby, P. and Society for Endocrinology Clinical Committee, 2016. Society for endocrinology endocrine emergency guidance: Emergency management of acute hypercalcaemia in adult patients. Endocrine connections, 5(5), p.G9.
7. Throvardur R. et al. 2017. Emergencies in hematology and oncology. Mayo clin proc. 92(4)):609-641
8. Payne RB, Little AJ, Williams RB. 1973, Interpretation of serum calcium in patients with abnormal serum proteins. Br Med J; 4:643.
9. Goldner, W. 2016. "Cancer-Related Hypercalcemia." J Oncol Pract 12(5):426-432.
10. Shane, E. and Berenson, JR. 2020 , Treatment of hypercalcaemia, Uptodate, viewed 7th January 2020, < https://www.uptodate.com/contents/treatment-of-hypercalcemia>