You’ve been through surgery, radiation, and chemotherapy. Survived the cancer and the treatment, and now you must live with the consequences. Looking back you’ve had changes in your body since before you were diagnosed with your cancer. The doctors have run every test, every x-ray and still have found no reason for the symptoms. They tell you your cancer could have caused changes or damage to some of the organs in your body before you were even aware you had cancer. You think “These doctors are just making this up!”
Well they aren’t making it up but some of the syndromes are very rare. These syndromes are called paraneoplastic syndromes. Looking at the word paraneoplastic, (para from the Greeks means “at or to one side of, beside, or side by side”, while neoplastic refers to “any abnormal new growth of tissue”) really says it all. These are syndromes that are associated with cancer but not directly related to the physical effects of the tumor or its metastasis. The syndromes may be due to the tumor producing substances that directly or indirectly cause distant symptoms. Some tumors produce hormone like substances while other syndromes are the result of your body making antibodies to the cancer. The antibodies then cross react with other organs or tissues in your body, like nerves, and damage them. The hormone like substances can cause an increase or decrease in sodium, calcium, blood sugar, and changes in bone structure, just to name a few.
Many of these syndromes are the first signs that there is even a cancer present and they are the first signs when the cancer has recurred. The syndromes can be present months or even years prior to diagnosis. Between seven and ten percent of cancer patients present with paraneoplastic syndromes as the first sign of the cancer. Many different types of cancers can be associated with paraneoplastic syndromes. Lung, breast, lymphoma, gastric, melanoma, kidney, prostate, colon, and ovarian cancer are just a few that can cause syndromes.
Paraneoplastic syndromes can resolve with successful treatment of the cancer. Unfortunately, many paraneoplastic syndromes, especially ones of an immune nature, do not resolve with treatment. The nerve damage can be severe and very slow to recover, if it ever does. The hormone related changes generally resolve with successful treatment of the cancer or can be managed treatment.
Dr. Kris Gast is a Board Certified Radiation Oncologist who has been in practice 21 years, the last 13 years at Fort Smith Radiation Oncology.