How Long Will It Take To Recover From Paraneoplastic Syndrome & How Long Does The Symptoms Last?

How Long Will It Take To Recover From Paraneoplastic Syndrome?

The recovery period of the paraneoplastic syndrome (PNS) depends on the treatment of underlying malignancy and additional treatment. Sometimes, symptoms of paraneoplastic syndrome occur before the manifestation of the malignancy symptoms, especially in paraneoplastic neurological syndromes. Most of the time it’s by the paraneoplastic syndrome symptoms doctors diagnose the underlying malignancy. Some paraneoplastic syndrome is asymptomatic e.g. paraneoplastic hematologic syndromes.

Usually, treatment of the underlying malignancy cures PNS as paraneoplastic symptoms occur as a result of the effects of the tumor. Therefore, the recovery of paraneoplastic syndrome and the symptoms depend on the treatment of the malignancy. Treatment of the malignancy can be either curative which involves surgery, chemotherapy, radiotherapy, and other curative cancer treatments or it can be palliative. Depending on how soon the malignancy treatment is started and its effectiveness the paraneoplastic syndrome will also resolve with time. However, some of the paraneoplastic syndromes will need additional treatment especially paraneoplastic syndrome that is associated with immunological reactions. So, additional treatment is required in that case. Treatment for the malignancy and specific treatment for paraneoplastic syndrome will resolve the symptoms and you can recover from paraneoplastic syndrome depending on the effectiveness of the treatment. We cannot tell an exact recovery period of paraneoplastic syndrome and how long the symptoms might last it all depends on the treatment. (1) (2)

Here, are some of the additional treatment options available for the treatment of some of the paraneoplastic syndrome

Paraneoplastic Endocrine Syndromes

Most of the symptoms associated with the syndrome resolve with the treatment of the malignancy. Specific treatment for endocrine syndromes is not needed always, only till the treatment of malignancy and if the symptoms persist afterward.

  • SIADH
  • Restriction of fluids and adequate salt and protein intake.
  • Hypertonic (3%) saline
  • Demeclocycline

Vasopressin receptor antagonists – conivaptan, tolvaptan

  • Hypercalcemia
  • Normal saline
  • Furosemide

Intravenous bisphosphonates – pamidronate, zoledronate

Inhibition of steroid production – ketoconazole, aminoglutethimide, metyrapone, mitotane

  • Etomidate
  • Octreotide
  • Adrenalectomy
  • Hypoglycemia
  • In the acute setting to control glucose levels – Glucose/ dextrose
  • Recurrent or chronic hypoglycemia episodes – prednisolone, dexamethasone
  • diazoxide, glucagon infusion, octreotide, human growth hormone

Paraneoplastic Neurologic Syndromes

Paraneoplastic neurological syndromes are a result of immune cross-reactions between tumor cells and nervous system components. The body produces tumor-directed antibodies in response to the tumor cells. There are some antigenic similarities, therefore, the antibodies attack the nervous system. These antibodies can cause permanent damage and treatment of malignancy does not always resolve the neurological symptoms successfully. Therefore, immunosuppressive therapy is needed. The main immunosuppressive treatments are:

  • Corticosteroids
  • Steroid-sparing treatment – azathioprine, cyclophosphamide, antiCD20 monoclonal antibody rituximab, IV immunoglobulin, and plasmapheresis.

Paraneoplastic Dermatologic And Rheumatologic Syndromes

Paraneoplastic dermatologic and rheumatologic syndromes are rare. The treatment includes cancer treatment and specific treatment for the paraneoplastic syndrome symptoms similar to the standard treatment methods.

  • Acanthosis nigricans
  • Topical steroids
  • Dermatomyositis
  • Prednisone
  • Methylprednisolone
  • Azathioprine
  • Methotrexate
  • Cyclosporine A
  • Mycophenolate mofetil
  • Cyclophosphamide
  • Hypertrophic osteoarthropathy
  • NSAIDs
  • Opiate analgesics
  • Pamidronate
  • Zoledronate
  • Localized radiation therapy bone.
  • Paraneoplastic pemphigus
  • Prednisone
  • Azathioprine
  • Cyclophosphamide
  • Cyclosporine A
  • IV IG
  • Mycophenolate mofetil
  • Plasma exchange
  • Rituximab
  • Polymyalgia rheumatica
  • Prednisolone
  • Methotrexate.

Paraneoplastic Hematologic Syndromes

  • Eosinophilia
  • Inhaled corticosteroids
  • Prednisolone
  • Pure red cell aplasia
  • Blood transfusions
  • Prednisone
  • Antithymocyte
  • Cyclosporine A
  • Cyclophosphamide
  • Alemtuzumab
  • Plasma exchange
  • Splenectomy (1) (2)

How Long Does Paraneoplastic Syndrome Symptoms Last?

The recovery period of paraneoplastic syndrome and the symptoms depend on the treatment of the malignancy and additional treatment. Treatment of the malignancy can be either curative or palliative. Depending on how soon the malignancy treatment is started and its effectiveness the paraneoplastic syndrome will also resolve with time.

However, some of the paraneoplastic syndromes will need additional treatment especially PNS that is associated with immunological reactions. Treatment for the malignancy and specific treatment for paraneoplastic syndrome will resolve the symptoms and you can recover from the paraneoplastic syndrome depending on the effectiveness of the treatment. An exact recovery time period and how long the symptoms will last cannot be told as it depends on the response to the treatment and on the individual person.

References:

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