Paraneoplastic Syndromes in Lung Cancer: SIADH

Share this content:
SIADH can be difficult to treat as a paraneoplastic syndrome, especially if the patient has concurrent gastrointestinal and renal losses.
SIADH can be difficult to treat as a paraneoplastic syndrome, especially if the patient has concurrent gastrointestinal and renal losses.

Paraneoplastic syndromes represent a constellation of clinical findings and effects from a primary malignancy, though they are not related to the malignancy's direct invasion or metastases. These syndromes are mediated by hormones secreted by the malignant cells and/or the immune response the hormones trigger.1

The clinical manifestations of paraneoplastic syndromes may represent the very early or late stages of disease and have no direct correlation on the extent or prognosis of disease.2 Up to 10% of patients with lung cancer will develop paraneoplastic syndromes, many of which are dependent on the subtype of lung cancer.3

One of the most common paraneoplastic syndromes associated with lung cancer is the syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Up to 16% of patients with small cell lung cancer (SCLC) will develop SIADH.4

An overwhelming majority (70%) of paraneoplastic SIADH cases are diagnosed in patients with SCLC. SIADH is a euvolemic hypoosmolar hyponatremic state in which the patient can present with nonspecific symptoms such as nausea, vomiting, decreased oral intake, and fatigue. Patients can develop hyponatremia at varying degrees below a “normal” value of 135 mEq/L: mild (130 to 134), moderate (125 to 129) and severe (less than 125). Not only is it important to assess the “absolute” sodium level, but also the time period over which the sodium decreased.

RELATED: Rovalpituzumab Tesirine Active in Recurrent Small Cell Lung Cancer

There is a vast differential diagnosis for patients with hyponatremia, especially those with malignancy. A careful history and physical examination must therefore be performed to rule out other potential causes, as the treatment algorithms will vary based on type of hyponatremia.

Page 1 of 2

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters