Paraneoplastic syndrome refers to a range of symptoms that can occur in the context of cancer. However, the symptoms are not caused locally by the tumor or its metastases: they are often caused by hormone production away from the tumor. Paraneoplasia can occur in both benign and malignant cancers.
Here you will find further information as well as selected specialists and centers for paraneoplastic syndrome.
In the context of cancer, various accompanying symptoms can occur that are not caused by the tumor itself. This means, for example, that the symptoms are not based on the destruction of the tissue by the tumor. Instead, they are triggered by signaling substances, such as hormone-like substances, which are produced by the tumor cells.
A basic distinction can be made between general and specific paraneoplasia.
General paraneoplasia includes, for example, pronounced tiredness (fatigue) and significant weight loss. This is also known in medicine as tumor cachexia. General paraneoplasia occurs in the majority of cancer patients.
Specific paraneoplasia, on the other hand, includes tumor-specific accompanying symptoms. The symptoms often indicate a specific type of tumor. Paraneoplastic dysfunctions are often the first sign of a malignant tumor.
This group of paraneoplasia includes endocrinological paraneoplasia, such as bronchial carcinoma. It can produce the hormones erythropoietin or calcitonin.
The nature of the symptoms of specific paraneoplasia depends primarily on the messenger substances produced by the tumor.
The most common endocrinological paraneoplasia is bronchial carcinoma, which produces increased amounts of parathyroid hormone. Parathyroid hormone is actually produced in the parathyroid glands and is responsible for the calcium balance in the blood. Increased production leads to a breakdown of bone substance and calcification of the blood vessels.
If, on the other hand, the cancer cells produce the hormone TSH (thyrotropin), this leads to hyperthyroidism with symptoms such as
Low blood sugar (hypoglycemia) with symptoms such as
can be an indication of increased insulin production. Such hyperinsulinemia occurs, for example, in the case of a tumor disease of the liver or pancreas.
Another variant of paraneoplasia is antibody-mediated reactions. Here, the immune system forms antibodies against the cancer. However, these antibodies also attack healthy tissue. Doctors refer to this as cross-reactivity. This cross-reactivity can lead to inflammation of the brain (encephalitis) as part of a tumor disease, for example, with the following symptoms:
Antibody-mediated paraneoplasia also includes
Depending on the type of primary tumor, paraneoplastic symptoms can vary greatly. The symptoms often occur as early signs before the cancer is discovered. Antibody-mediated neurological paraneoplasia, for example, precedes the actual tumor disease by years.
Diagnosis is therefore often difficult. Therefore, whenever a symptom cannot be clearly explained by a specific disease, paraneoplasia should also be considered.
If antibody-mediated paraneoplasia is suspected, the attending physician will determine antibodies in the blood. Even if no tumor has yet been diagnosed. Various antibodies are associated with certain tumors. Hu antibodies, for example, are found in prostate cancer, whereas ANNA-3 antibodies indicate cancer of the lung.
Evidence of hormone-mediated paraneoplastic syndrome can also be found in the blood. In this type of endocrine paraneoplasia, the corresponding hormone is elevated in the blood. However, such a hormonal disorder can also have other causes. This is why endocrine paraneoplasia is often a diagnosis of exclusion.
If the doctor suspects paraneoplasia as the cause of the symptoms, a tumor search is also always carried out. In addition, various diagnostic tools are used such as
are used. Other methods used in cancer diagnostics are
Treatment depends primarily on the type of tumor and its degree of malignancy. This degree describes the growth and differentiation of tumors and neoplasms. The term neoplasia is often used synonymously for a malignant tumor disease.
The paraneoplastic syndrome can only be successfully treated via the primary tumor. The doctor often achieves initial success by reducing the size of the tumor. Chemotherapy and radiation are the main methods used for this.
In most cases, surgical removal of the triggering tumor can completely eliminate the accompanying paraneoplastic symptoms. Antibody-mediated paraneoplasia is an exception here. Even after removal of the tumor, antibodies can remain in the blood and cause symptoms.
In addition to the tumor-specific treatment strategies, the doctor also uses non-specific measures. Depending on the type and severity of the symptoms, patients are given medication such as non-steroidal anti-inflammatory drugs or opiates to relieve pain.
The diagnosis and treatment of paraneoplastic syndrome falls under the specialist field of oncology. Oncology is the medical specialty that deals with cancer. Oncology includes
of cancer and its accompanying symptoms.
Oncology is a complex specialist field. It is therefore generally characterized by interdisciplinary cooperation. In oncology, for example
In order to be allowed to practice in the specialist field of oncology, a doctor must complete further training to become a specialist in haematology and oncology after completing their medical studies. This training lasts a total of six years and includes diagnostic and therapeutic procedures in hematology and oncology.
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