APC and Hyperparathyroidism

[Dett]

Hello All,

My Stage 4 Gleason 9 husband with mets (diagnosed 8/19) has had borderline elevated serum calcium for at least five years; always dismissed as ‘normal’ or dehydration. His calcium results this past year have been 10.5-11.1 (highest level of normal to above normal). His MO decided to run a PTH Intact test for hyperparathyroidism as a result of the elevated calcium. The results came back at 77.6 (normal range = 9-72). The MO has referred my husband to an endocrinologist for presumed hyperparathyroidism.

I’ve been reading about hyperparathyroidism (which involves the 4 parathyroid glands and has nothing to do with the thyroid, although they’re in close proximity). There are 3 types of hyperparathyroidism - primary (almost always from a benign parathyroid tumor), secondary (generally from kidney failure and associated with LOW calcium), and tertiary (also associated with kidney problems). I’ve also tried to research hyperparathyroidism in the context of prostate cancer. Apparently, elevated PTH significantly increases the possibility of developing ‘fatal’ prostate cancer (as the articles refer to it, presumably meaning metastatic PC). This is where I get hopelessly confused.

Does anyone have any insight into the issue of hyperparathyroidism and advanced prostate cancer? More specifically....

- Is the hyperparathyroidism related to the prostate cancer, or is it a separate entity?

- Are there any implications for prognosis or treatment of the prostate cancer as a result of the hyperparathyroidism?

Thanks for any help that you can provide.

[JNunes]

Your post reminded me that I sometimes heard my father say in his life that the doctor said he had excess calcium (and therefore kidney stones).

I was thinking about what you shared ...

My father has metastatic prostate cancer too.

[pjoshea13]

Do you know what your husband's vitamin D status is? And does he take vitamin k?

Here is a paper that discusses "the causes of hypercalcemia in the patient with cancer":

sci-hub.tw/10.3322/caac.21489

-Patrick

[Dett in reply to pjoshea13]

Thanks for the link! One of the most clear, concise, and comprehensive articles I’ve read on the subject of hypercalcemia and hyperparathyroidism. If I understand correctly, the most frequent cause of elevated calcium combined with elevated PTH in both the cancer and cancer-free populations is primary hyperparathyroidism (generally caused by a benign parathyroid tumor). Secondary hyperparathyroidism caused by hypercalcemia of malignancy (HCM), low Vitamin D (husband is slightly below normal), and kidney disease appears to be associated with unusually low, not high, PTH. Please correct me if I’m wrong. If my husband takes vitamin K, it would only be in the form of a general multivitamin. I guess we’ll find out what the endo thinks on Thursday when we have a virtual appointment. Thanks again.

[pjoshea13 in reply to Dett]

Generally, multivitamins do not perform well in studies. I prefer to take individual vitamins that have science-based evidence of probable benefit. For vitamin K, a product such as this:

lifeextension.com/vitamins-...

is preferred because of the Vitamin K2 (as trans menaquinone-7)

Best, -Patrick

[Tall_Allen]

High serum calcium is associated with prostate cancer. Researchers also found that genetic mutations that limit Vitamin D use by cells may be beneficial. High Vitamin D (like PTH) pulls calcium out of bone to increase serum levels. So be careful about both calcium and Vitamin D intake until he gets this corrected.

cebp.aacrjournals.org/conte...

ncbi.nlm.nih.gov/pmc/articl...

ncbi.nlm.nih.gov/pmc/articl...

[Dett in reply to Tall_Allen]

Hi Allen,

Thanks for your comments. My husband had a one hour video consult with an endocrinologist today and she thinks that he probably has primary hyperparathyroidism, but she recommended changes to his BP medications and retesting. He’s also supposed to stop taking a calcium supplement (prescribed for osteoporosis) and start vitamin D (although there seems to be some controversy regarding that). Followed by a bunch of bloodwork. He is also supposed to get imaging. Fortunately, this issue does not appear to be related to his APC. Unfortunately, it’s still another issue to deal with. Oh well.

[Tall_Allen in reply to Dett]

Maybe email this link to whomever told him to increase Vitamin D intake and ask for comments:

ncbi.nlm.nih.gov/pmc/articl...

It seems like the opposite of what he should be doing.

[j-o-h-n]

Hyperparathyroidism. Try to say that five times fast....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/10/2020 10:15 PM DST

[SPEEDYX in reply to j-o-h-n]

Hyperparathyroidism ..Hyperparathyroidism..Hyperparathyroidism..Hyperparathyroidism ...Hyperparathyroidism

[j-o-h-n in reply to SPEEDYX]

hahahaha.............. ok now backwards...............in pig latin...........

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/10/2020 10:33 PM DST

[SPEEDYX in reply to j-o-h-n]

erparathyroidismhypay 5X

[j-o-h-n in reply to SPEEDYX]

Now you're showing off.............👀

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/10/2020 10:39 PM DST

[SPEEDYX in reply to j-o-h-n]

SOITENLY...nyuk..nyuk..nyuk

[j-o-h-n in reply to SPEEDYX]

Betcha you can't pee in two separate urinals at the same time.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/10/2020 10:50 PM DST

[SPEEDYX in reply to j-o-h-n]

The way mine comes out I probably could

[j-o-h-n in reply to SPEEDYX]

now ya got me...... LOL

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/10/2020 10:57 PM DST

[SPEEDYX in reply to j-o-h-n]

A rare occurrence for sure my brother

[j-o-h-n in reply to SPEEDYX]

Not realy. (uncle Sam got me)... I was drafted into the military..

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/10/2020 11:08 PM DST