Tumor lysis syndrome is a potentially serious complication of chemotherapy treatment for certain types of cancer. As chemo drugs begin to destroy cancerous cells, they break apart and release their contents into other tissues and the bloodstream. The situation can result in major metabolic imbalances in the body, with potassium, uric acid, and phosphate levels skyrocketing while blood calcium is diminished. Tumor lysis syndrome can lead to a number of different symptoms including shortness of breath, muscle weakness, mental confusion, and kidney complications. Treatment depends on the particular metabolic imbalances involved but often includes intravenous medications and kidney dialysis.
It is possible for tumor lysis syndrome to occur when treating any type of tumor with chemo drugs, but certain cancers are more likely than others to result in symptomatic episodes. Leukemia, lymphoma, myeloma, and other inoperable cancers most frequently result in tumor lysis syndrome. The condition can also arise when treating quickly growing and spreading soft tissue malignancies, including breast and testicular cancer.
Tumor cells usually contain very high levels of phosphates, potassium, and uric acid, which are released as byproducts when the cells die. The mineral byproducts eventually reach and overwhelm the kidneys. The patient's kidneys are incapable of filtering out enough of the waste through urine, resulting in high mineral levels in the bloodstream.
Symptoms can arise very quickly once a tumor starts breaking down, and may include nausea, vomiting, and fatigue. Over the course of several days, a patient can experience painful muscle cramps, itchy skin, blood in the urine, and sharp abdominal pains. Elevated heart rate, high blood pressure, breathing difficulties, and seizures are possible. Without treatment, a person can become very lethargic and experience mental confusion and delusions. Permanent brain, kidney, and heart damage can occur if metabolic problems are not addressed early.
Tumor lysis syndrome is diagnosed by testing samples of blood and urine for unusual mineral contents. A doctor might also take imaging scans of the kidneys to see how badly they are damaged. Treatment is typically initiated right away in the form of diuretics and other medications that flush minerals from the bloodstream. If kidney failure occurs or is impending, dialysis may be needed for the medications to work properly. An emergency kidney transplant might be considered if the organs are severely compromised.
Cancer doctors are highly aware of the dangers of tumor lysis syndrome, and many steps are taken to help prevent it from becoming a major problem. Patients who are at risk of developing the condition are usually given prophylactic drugs that help to regulate uric acid, potassium, and other minerals throughout chemo treatment. In addition, regular screenings and frequent doctor's visits are important to make sure symptoms do not arise.
