Paraneoplastic syndrome (patient information)

Paraneoplastic syndrome
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for (Condition)?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2]

Overview

A paraneoplastic syndrome is a disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells. These phenomena are mediated by humoral factors (by hormones or cytokines) excreted by tumor cells or by an immune response against the tumor. Sometimes the symptoms of paraneoplastic syndromes show even before the diagnosis of a malignancy. A paraneoplastic syndrome is a set of symptoms that are caused by a cancer. The symptoms happen in a different area of the body from the cancer.

What are the Symptoms of Paraneoplastic syndrome?

• Paraneoplastic syndromes cause different symptoms depending on the tissues and organs they are involved.
• About 20% of people with cancer get a paraneoplastic syndrome and the most common cancers are lung, hepatocellular, ovarian, breast, gastric , pancreatic and other cancers.

General symptoms

• General symptoms of paraneoplastic syndrome include:
  • Fever
  • Night sweats
  • Loss of appetite
  • Weight loss

Skin symptoms

• Itching
• Skin flushing or blushing, causing the face, neck, or upper chest to become warm and red

Neurologic (brain, spinal cord, and nerve) symptoms

• Weakness or loss of strength
• Loss of feeling
• Slower reflexes
• Trouble using different parts of the body, such as the arms or legs
• Trouble speaking
• Dizziness
• Double vision or being unable to control eye movements
• The cancer can cause these symptoms without pushing on the nerves or spinal cord.

Endocrine (hormone system) symptoms

• Weakness
• Weight gain
• High blood pressure
• Confusion
• Kidney problems
• Red, warm skin
• Wheezing
• Diarrhea

Other symptoms

• Muscle swelling that causes weakness and soreness
• Painful swelling of the joints that may change the shape of the fingers and toes
• Changes to the blood cells (red blood cells, white blood cells, and platelets)

What Causes Paraneoplastic syndrome?

• Paraneoplastic syndromes may be caused by two different mechanisms:
  • The cancer making hormones
  • The immune system making antibodies (substances that protect the body against certain infection) that flow through the blood

Who is at Highest Risk?

• Patients with the following type of cancers will be at risk of developing paraneoplastic syndrome:
  • Lung tumors
  • Breast cancer
  • Kidney cancer
  • Liver cancer
  • Cancers of blood
  • Gynaecological tumors
  • Gastrointestinal tumors
  • Skin cancers
  • Thymic tumors

Diagnosis

• Diagnosis can be made before, or concurrently, or after the diagnosis of the original cancer depending on the clinical manifestations.

When to Seek Urgent Medical Care?

• Patients with the signs and symptoms suggesting paraneoplastic syndrome should seek medical care.

Treatment Options

• The tumor and/or cancer are treated first, followed by efforts to decrease the autoimmune response, either through steroids or high-dose intravenous immunoglobulin, or irradiation.
• Plasmapheresis, a process that exchanges antibodies of the blood, may ease symptoms in people with paraneoplastic disorders that affected the peripheral nervous system.
• Speech and physical therapy may help individuals regain some functions.

Where to find Medical Care for Paraneoplastic syndrome?

• Medical care for (disease name) can be found here.

Prevention

• Preventive measures for cancer may also reduce the risk of paraneoplastic syndrome.

What to Expect (Outlook/Prognosis)?

• There are no cures for paraneoplastic syndromes.
• The type and stage of the original cancer determines the prognosis.

Possible Complications

• They may result in different complications according to the involved organs.

Sources

• https://www.merckmanuals.com/home/quick-facts-cancer/overview-of-cancer/paraneoplastic-syndromes
• https://www.ninds.nih.gov/Disorders/All-Disorders/Paraneoplastic-Syndromes-Information-Page