Vol 15, No 2 (2021)
Review paper
Published online: 2021-05-20

open access

Page views 560
Article views/downloads 530
Get Citation

Connect on Social Media

Connect on Social Media

Endocrine and metabolic disorders in cancer patients

Małgorzata Niemiec1, Aleksandra Niemiec2
Palliat Med Pract 2021;15(2):203-211.


Endocrine and metabolic disorders can occur in the form of paraneoplastic syndrome and as a consequence
of oncological treatment. The most common disorders include hypercalcaemia, ectopic production of vasopressin
in the course of cancer, ectopic Cushing’s syndrome and secondary osteoporosis. What should be
taken into account during the diagnosis of endocrine disorders, is paraneoplastic syndrome that frequently
precedes the occurrence of symptoms typical of a particular diagnosis, which could influence the proper
orientation of the diagnostic process. During and after anticancer treatment, it is recommended that
patients should be monitored for the possible development of acute or chronic metabolic and endocrine
disorders which may pose a threat to their life or health.

Article available in PDF format

View PDF Download PDF file


  1. Dec M, Ryczak E, Borowicz B, et al. Zaburzenia hormonalne w chorobach nowotworowych. Oncology and Radiotherapy. 2016; 4(38): 46–49.
  2. Goldner W. Cancer-Related Hypercalcemia. J Oncol Pract. 2016; 12(5): 426–432.
  3. Mirrakhimov AE. Hypercalcemia of Malignancy: An Update on Pathogenesis and Management. N Am J Med Sci. 2015; 7(11): 483–493.
  4. Sternlicht H, Glezerman IG. Hypercalcemia of malignancy and new treatment options. Ther Clin Risk Manag. 2015; 11: 1779–1788.
  5. Zagzag J, Hu MI, Fisher SB, et al. Hypercalcemia and cancer: Differential diagnosis and treatment. CA Cancer J Clin. 2018; 68(5): 377–386.
  6. Rucińska M. Stany nagłe w medycynie paliatywnej. In: Ciałkowska-Rysz A, de Walden-Gałuszko K. ed. Medycyna paliatywna. PZWL, Warszawa 2015: 250.
  7. Seccareccia D. Cancer-related hypercalcemia. Can Fam Physician. 2010; 56(3): 244–6, e90.
  8. Misiowski W. Hiperkalcemia. In: Zgliczyński W. ed. Wielka Interna. Endokrynologia. Tom 1. Medical Tribune, Warszawa 2020: 384–391.
  9. Narayanan P. Denosumab: A comprehensive review. South Asian J Cancer. 2013; 2(4): 272–277.
  10. Mirza F, Canalis E. Management of endocrine disease: Secondary osteoporosis: pathophysiology and management. Eur J Endocrinol. 2015; 173(3): R131–R151.
  11. Roodman GD. Pathogenesis of myeloma bone disease. Leukemia. 2009; 23(3): 435–441.
  12. Drake MT. Osteoporosis and cancer. Curr Osteoporos Rep. 2013; 11(3): 163–170.
  13. Nishio K, Tanabe A, Maruoka R, et al. Bone mineral loss induced by anticancer treatment for gynecological malignancies in premenopausal women. Endocr Connect. 2013; 2(1): 11–17.
  14. Bolanowski M. Osteoporoza wtórna. In: Zgliczyński W. ed. Wielka Interna. Endokrynologia. Tom 1. Medical Tribune, Warszawa 2020: 467–469.
  15. Shapiro CL, Van Poznak C, Lacchetti C, et al. Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease: ASCO Clinical Practice Guideline. J Clin Oncol. 2019; 37(31): 2916–2946.
  16. Magnowski P, Wolski H, Magnowska M, et al. Bone loss in women with malignant genital neoplasms. Polish Gynaecology. 2014; 85(12): 955–960.
  17. Lewiecki EM. New and emerging concepts in the use of denosumab for the treatment of osteoporosis. Ther Adv Musculoskelet Dis. 2018; 10(11): 209–223.
  18. McDonald P, Lane C, Rojas GE, et al. Syndrome of inappropriate anti-diuretic hormone in non-small cell lung carcinoma: a case report. Ecancermedicalscience. 2012; 6: 279.
  19. Castillo JJ, Glezerman IG, Boklage SH, et al. The occurrence of hyponatremia and its importance as a prognostic factor in a cross-section of cancer patients. BMC Cancer. 2016; 16: 564.
  20. Marquina G, Gomez-Hoyos E, Runkle I. The management of hyponatremia in cancer patients: a practical view in Spain. Journal of Cancer Metastasis and Treatment. 2020; 2020.
  21. Castillo JJ, Vincent M, Justice E. Diagnosis and management of hyponatremia in cancer patients. Oncologist. 2012; 17(6): 756–765.
  22. Onitilo AA, Kio E, Doi SAR. Tumor-related hyponatremia. Clin Med Res. 2007; 5(4): 228–237.
  23. Witek P. Postępy w rozpoznawaniu i leczeniu hiponatremii. Postępy Nauk Medycznych. 2008; 21: 75–82.
  24. Witek P, Misiorowski W, Zgliczyński W. Zespoły ektopowego wydzielania hormonów. In: Zgliczyński W. ed. Wielka Interna. Endokrynologia. Tom 2. Medical Tribune, Warszawa 2020: 259–275.
  25. Cieszyński Ł, Berendt-Obołończyk M, Szulc M, et al. Cushing's syndrome due to ectopic ACTH secretion. Endokrynol Pol. 2016; 67(4): 458–471.
  26. Young J, Haissaguerre M, Viera-Pinto O, et al. MANAGEMENT OF ENDOCRINE DISEASE: Cushing's syndrome due to ectopic ACTH secretion: an expert operational opinion. Eur J Endocrinol. 2020; 182(4): R29–R58.
  27. Sharma ST, Nieman LK. Cushing's syndrome: all variants, detection, and treatment. Endocrinol Metab Clin North Am. 2011; 40(2): 379–91, viii.
  28. Carroll TyB, Peppard WJ, Herrmann DJ, et al. Continuous Etomidate Infusion for the Management of Severe Cushing Syndrome: Validation of a Standard Protocol. J Endocr Soc. 2019; 3(1): 1–12.
  29. Juszczak A, Grossman A. Postępowanie w chorobie Cushinga – od testu diagnostycznego do leczenia. Endokrynol Pol. 2013; 64(2): 166–174.
  30. Carvalho F, Louro F, Zakout R. Adrenal Insufficiency in Metastatic Lung Cancer. World J Oncol. 2015; 6(3): 375–377.
  31. Papierska L. Niedoczynność kory nadnerczy. In: Zgliczyński W. ed. Wielka Interna. Endokrynologia. Tom 2. Medical Tribune, Warszawa 2020: 22–32.
  32. Ciałkowska-Rysz A. Zaburzenia metaboliczne i hormonalne. In: Ciałkowska-Rysz A, Dzierżanowski T. ed. Medycyna Paliatywna. Termedia, Poznań 2019: 262–265.
  33. Bednarczuk T, Kasperlik–Załuska A. Choroby układu wewnątrzwydzielniczego. In: Interna Szczeklika 2020. Medycyna Praktyczna, Kraków 2020: 1432–1438.
  34. Okabayashi T, Shima Y, Sumiyoshi T, et al. Diagnosis and management of insulinoma. World J Gastroenterol. 2013; 19(6): 829–837.
  35. Shin JJ, Gorden P, Libutti SK. Insulinoma: pathophysiology, localization and management. Future Oncol. 2010; 6(2): 229–237.
  36. Handkiewicz-Junak D. Nowotwory neuroendokrynne wysoko zróżnicowane. In: Płaczkiewicz-Jankowska E. ed. Interna Szczeklika Mały Podręcznik 2020/2021. Medycyna Praktyczna, Kraków 2020: 887–891.
  37. Garla V, Sonani H, Palabindala V, et al. Non-islet Cell Hypoglycemia: Case Series and Review of the Literature. Front Endocrinol (Lausanne). 2019; 10: 316.
  38. Potempa M, Jonczyk P, Zalewska-Ziob M. Endokrynologiczne oblicze raka płuca. Onkol Prakt Klin. 2015; 11(3): 121–128.
  39. Rubin de Celis Ferrari AC, Glasberg J, Riechelmann RP. Carcinoid syndrome: update on the pathophysiology and treatment. Clinics (Sao Paulo). 2018; 73(suppl 1): e490s.
  40. Ito T, Lee L, Jensen RT. Carcinoid-syndrome: recent advances, current status and controversies. Curr Opin Endocrinol Diabetes Obes. 2018; 25(1): 22–35.
  41. Lewis MA, Hendrickson AW, Moynihan TJ. Oncologic emergencies: Pathophysiology, presentation, diagnosis, and treatment. CA Cancer J Clin. 2011; 61(5): 287–314.
  42. Howard SC, Jones DP, Pui CH. The tumor lysis syndrome. N Engl J Med. 2011; 364(19): 1844–1854.
  43. Muslimani A, Chisti MM, Wills S, et al. How we treat tumor lysis syndrome. Oncology (Williston Park). 2011; 25(4): 369–375.
  44. Cairo MS, Bishop M. Tumour lysis syndrome: new therapeutic strategies and classification. Br J Haematol. 2004; 127(1): 3–11.
  45. Howard SC, Jones DP, Pui CH. The tumor lysis syndrome. N Engl J Med. 2011; 364(19): 1844–1854.
  46. Dec M, Ryczak E, Borowicz B. Małecka–Massalska T. Rzadkie zaburzenia hormonalne w chorobach nowotworowych. Oncology and Radiotherapy. 2016; 4(38): 43–45.
  47. Dimitriadis GK, Angelousi A, Weickert MO, et al. Paraneoplastic endocrine syndromes. Endocr Relat Cancer. 2017; 24(6): R173–R190.