Hypercalcaemia occurs in about 10% of all cancer patients. About half of all cases is due to underlying malignancy. The commonest cancer to cause this are: multiple myeloma, breast cancer, lung cancer, renal cancer, prostate cancer.

Hypercalcaemia of malignancy is due to metastatic disease in 80% of cases. This means that 20% of cases may be suitable for local treatment such as tumour removal or radical radiotherapy.

When hypercalcaemia from malignancy occurs, it is in general a relatively poor prognostic sign. 50% die within one month. 75% die within three months. 80% die within one year.

The number and severity of symptoms experienced by patients with hypercalcaemia vary considerably. The commonest symptoms of hypercalcaemia are lethargy, malaise, thirst, nausea, constipation, bone pain, confusion, myopathy, seizures, ileus, cardiac arrhythmias, coma, death.

The four main goals of treatment of hypercalcaemia are correct dehydration, enhance renal excretion,, inhibit bone resorption, treat underlying disorder

There are a variety of different treatments to inhibit bone resorption. The main ones are Aredia, Clodronate, Oral Phosphate, Mithramycin, Calcitonin, Gallium, Steroids. In general, the most effective and easiest to administer are IV Aredia every few weeks or oral clodronate. A good second line alternative is oral phosphate tablets