From the Research
Yes, bladder cancer can cause hypercalcemia, which is an elevated level of calcium in the blood, as supported by the most recent study on cancer-related hypercalcemia 1. This occurs most commonly in advanced or metastatic bladder cancer through several mechanisms. The primary way bladder cancer causes hypercalcemia is through the production of parathyroid hormone-related protein (PTHrP), which mimics the effects of parathyroid hormone, increasing bone resorption and calcium reabsorption in the kidneys. Additionally, when bladder cancer metastasizes to bone, it can directly stimulate osteoclast activity, leading to increased bone breakdown and calcium release into the bloodstream. Cytokines and other factors produced by tumor cells can also contribute to this process. Symptoms of hypercalcemia include:
- Fatigue
- Weakness
- Confusion
- Constipation
- Increased thirst
- Frequent urination
- Bone pain
- In severe cases, cardiac arrhythmias or coma. Management typically involves treating the underlying bladder cancer while addressing the hypercalcemia with:
- Intravenous fluids
- Bisphosphonates like zoledronic acid (4mg IV)
- Denosumab (120mg subcutaneously)
- Sometimes calcitonin (4-8 IU/kg every 12 hours) for rapid but short-term calcium reduction in severe cases, as discussed in the context of cancer-related hypercalcemia treatment 1. It's also worth noting that zoledronic acid has been shown to be effective in alleviating symptoms of hypercalcemia in patients with bladder cancer, as seen in a case report 2, and is superior to pamidronate in the treatment of hypercalcemia of malignancy, according to a pooled analysis of two randomized, controlled clinical trials 3.