Tumor Lysis Syndrome

[PARKER3237]

Anyone have this happen after a treatment? I am well aware of all the symptoms and events but was wondering if anyone experienced this while getting treatments.

My potassium level had gone from 5.4 to 7.0 after treatment a week beforehand and was told by the Oncologist to get to the ER ASAP. ER tested again for potassium levels and it came back 5.6, so was advised to return home and get an intravenous hydration done the next day which I did yesterday. Was told this can happen when the treatments are killing off and breaking up cancer cells rapidly and the kidneys are working overtime to process everything. Was told that a intravenous hydration will fix the issue and if it occurs again in the future, it may simply become a protocol with treatment a few days/week later.

Anyone have this happen to them while under treatment?

[LowT]

Could have been a lab error or hemolysis of blood cells in tube or from collection process.

[PARKER3237 in reply to LowT]

Not sure but did an IV hydration to be safe. Have been having very low BP the last two weeks since treatments. And the potassium level MUST always be monitored if above 5.5 as can be potential for heart attack, stroke, or death. That was why the oncologist wanted a rush to the ER. While getting the IV, another guy who was having it done too had similar issues.

[HikerWife]

What treatment, please?

[PARKER3237 in reply to HikerWife]

Treatment plan as per the oncologist.

Degarelix, Zometa, and Apalutamide.

Tumor Lysis Syndrome may occur as the treatment is killing off cancer cells and they are being dumped into the bloodstream for processing by the kidneys to be filtered out in the urine. If the kidneys get overwhelmed, the potassium level may go up rapidly and can be life threatening.

[HikerWife]

Thank you for the clarification. Had never heard of this - boy, you'd think all cancer patients starting treatment would be warned!

[PARKER3237 in reply to HikerWife]

I had read about it in all my research since May but did not give it a second thought. But getting that phone call from the MO just as you are getting home to get to the ER ASAP was not expected. The ER ran all the lab work again and said that it may have been happening as the potassium level will often jump after starting treatment as the cancer cells are sluffing off and dying. They elevate the potassium, and it has to be watched, especially with my heart condition. Suddenly you have all your team and the specialist contacting you on how to adjust heart meds, etc. while lowering the potassium number.

[j-o-h-n]

Tumor Lysis Syndrome - AI definition:

ChatGPT

Tumor Lysis Syndrome (TLS) is a serious condition that can occur when a large number of cancer cells break down rapidly, usually in response to treatment such as chemotherapy. This rapid cell destruction releases their contents into the bloodstream, leading to metabolic abnormalities.

Key points about TLS include:

Symptoms: Common symptoms include nausea, vomiting, diarrhea, fatigue, and muscle cramps. More severe symptoms can involve irregular heart rhythms, seizures, and kidney failure.

Metabolic Changes:

Hyperuricemia: Increased levels of uric acid due to the breakdown of purines from the cells.

Hyperkalemia: Elevated potassium levels from cell destruction.

Hyperphosphatemia: Elevated phosphate levels.

Hypocalcemia: Low calcium levels, which can occur due to the binding of calcium with phosphate.

Risk Factors: TLS is more likely to occur in patients with aggressive cancers, such as lymphomas or leukemias, especially when they have a high tumor burden or are receiving intensive chemotherapy.

Diagnosis: It is diagnosed based on clinical symptoms and laboratory findings indicating the metabolic changes mentioned above. The presence of these abnormalities, especially shortly after starting treatment, can suggest TLS.

Prevention and Treatment:

Hydration: Ensuring adequate fluid intake helps flush out toxins and reduce the risk of kidney damage.

Medications: Drugs such as allopurinol or rasburicase are used to manage uric acid levels and prevent gout.

Electrolyte Management: Monitoring and correcting imbalances in potassium, phosphate, and calcium.

Monitoring: Regular blood tests are crucial to detect changes early and manage them promptly.

TLS is a medical emergency that requires prompt recognition and treatment to prevent serious complications. If you suspect TLS, it's important to seek immediate medical attention.

Good Luck, Good Health and Good Humor.

j-o-h-n

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

Scary stuff. Thanks for research.