Having high calcium levels is called hypercalcaemia. It is a serious condition that your specialist will need to assess so you get the right diagnosis and treatment.
Diagnosing high calcium
Your doctor will want to examine you if you have any of the symptoms of high calcium. They will measure your calcium levels with a blood test. You might also have other tests and investigations to see how well your kidneys are working. You will need treatment if the test results show that you have high levels of calcium in your blood.
Before your doctor can manage your high calcium, they will need to ask you a lot of questions about the history of your illness and your symptoms. It might seem like a lot to deal with if you are not feeling very well at the time. But it is very important that your doctor takes the time to assess all aspects of your condition so that you get the right diagnosis and treatment.
Your family and friends might be able to help with answering questions if you are in too much pain or feeling too tired or sick. It is unlikely that you will be able to answer the questions if you have very high blood calcium. Your doctor will rely on information from the people close to you and your test results to decide on your treatment.
Your doctor will ask about your symptoms, how long you have had them and whether you:
- are feeling or being sick
- have lost your appetite
- feel thirsty
- feel more tired than usual
- feel confused
- have pain
Your doctor will use your answers and test results to decide if high calcium levels are causing your symptoms or whether they could be due to something else.
Preventing high calcium
Recognising the symptoms of high blood calcium is very important so that you can ask your doctor for help as soon as possible. Drinking plenty of fluids and staying physically active can help to prevent it.
Treating high calcium
The main aims of treatment for high blood calcium are to lower the levels and relieve the symptoms. Your specialist will treat you and you might have to spend a day or 2 in hospital to get your calcium levels down. You might have some of the following treatments.
Fluids through a drip help flush the extra calcium out of your system. Drinking plenty of fluid will help too, if you can manage it.
Bisphosphonates (bis-fos-fon-ates) are very effective drugs for helping to get your calcium levels down. You can have some of these drugs through a drip into a vein, but others come as tablets. Which type you need depends on how high your calcium levels are. Your doctor will decide on the best treatment for you.
As well as getting calcium levels down, bisphosphonates can help to reduce pain from bone secondaries and help to stop damaged bones breaking. You might have bisphosphonate tablets to take home to stop the calcium building up in your blood again.
Bisphosphonates can sometimes make your calcium level go too low (hypocalcaemia). This should be picked up by blood tests, but also causes symptoms such as changes in sensation – for example, tingling or burning in the lips or tongue.
You might have another drug called calcitonin to help stop the breakdown of bone. You have this drug as an injection. You might also have drugs to help relieve high calcium symptoms, such as sickness, constipation, pain or confusion.
Denosumab is a monoclonal antibody. Denosumab is also known by its brand names Xgeva and Prolia.
Denosumab (Xgeva) is licensed for use in preventing fractures and other cancer related bone problems in adults with cancer that has spread to the bones.
Deciding on treatment
The type of treatment you have depends on how high your calcium levels are and how severe your symptoms are. Your doctor will need to treat it urgently with fluids and bisphosphonate drugs if you have moderate to severe high calcium, or severe symptoms. You will still need treatment but less urgently if it is mild high calcium. You might just need bisphosphonate treatment if you are able to drink plenty of fluids.
Treatment relieves some symptoms more quickly than others. For example, sickness, constipation and thirst are much easier to relieve than tiredness and loss of appetite. It will probably not be possible to control high calcium permanently if your cancer is very advanced and you are in the final days or weeks of life. But your doctors will do all they can to help make you as comfortable as possible.
Once your blood calcium levels go back to normal, your doctor will want to keep a close eye on you. You will need to have regular blood and urine tests to make sure the treatment is still working.
It is very important that you see your doctor as soon as possible if at any time you feel the symptoms of hypercalcaemia are coming back. Even if something else is causing your symptoms it is better to see your doctor to find out for sure.
You might worry about eating foods that contain calcium if you have high calcium or think you may be at risk of it. But cutting down on these foods will not help high calcium that is caused by cancer. It will not make any difference to your calcium levels. Do talk to your doctor or nurse if you are concerned about your diet. And make sure you check with your doctor before taking any vitamin or mineral supplements.