- Hypercalcemia is associated with several cancers, most commonly breast, lung, lymphoma, and multiple myeloma. Hypercalcemia in the setting of advanced cancer may be caused by release of calcium due to bone metastases, solid tumor release of PTHrP (parathyroid hormone-related protein), or tumor production of calcitriol leading to increased intestinal calcium resorption. Hypercalcemia in cancer patients is indicative of widespread disease and is associated with a poor prognosis for long-term survival.
The prevalence of pain varies by dx, stage of disease, and setting of care. Approximately 1/3 of patients with cancer experience pain at the time of diagnosis, while 2/3 with metastatic disease report pain. Less is known about the prevalence of pain in those with diagnoses other than cancer.
Pain is described by the World Health Organization as a “multidimensional phenomenon with sensory, physiological, cognitive, affective, behavioral and spiritual components.” Pain is a complex biopsychosocial phenomenon, an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in these terms. (Pain is whatever the patient says it is.)Continue reading “Pain Management at the End of Life (Reading and Sharing)”