What Happens To Untreated Paraneoplastic Syndrome & When To Go To Doctor?

What Happens To Untreated Paraneoplastic Syndrome?

Paraneoplastic syndromes (PNS) are rare disorders that occur due to an effect from a cancerous tumor in the body. It occurs in 1-8% of patients with cancers, although the actual incidence can differ as some people go undiagnosed with Paraneoplastic syndromes. The probable mechanisms of how Paraneoplastic syndromes occur can be either due to cancer secretion of functional hormone and peptides which causes the symptoms (in the case of endocrine PNS) or it’s an immunological reaction between cancer cells and normal healthy cells (in the case of neurological PNS). These hormone and immunological reactions alter the normal function of various tissues in the body and symptoms occur because of these alterations. The symptoms occur in distant areas from primary cancer according to the tissue that is affected. Some of the commonly affected systems are the nervous system, endocrine system, hematologic system, rheumatologic, and dermatologic systems.

What Happens To Untreated Paraneoplastic Syndrome?

Let us see what are the clinical presentations of common Paraneoplastic syndromes

Paraneoplastic Endocrine Syndromes

  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
  • Gait disturbances
  • Headaches
  • Falls
  • Nausea
  • Muscle cramps
  • Fatigue
  • Seizures
  • Lethargy
  • Hypercalcemia
  • Ataxia
  • Lethargy
  • Weakness
  • Altered mental status
  • Nausea/ vomiting
  • Hypertension
  • Bradycardia
  • Cushing syndrome
  • Weight gain
  • Hypertension
  • Peripheral edema
  • Muscle weakness
  • Centripetal fat distribution
  • Hypoglycemia
  • Sweating
  • Anxiety
  • Tremors
  • Weakness
  • Seizures
  • Confusion
  • Comas

Paraneoplastic Neurologic Syndromes

  • Limbic encephalitis
  • Mood changes
  • Hallucinations
  • Memory loss
  • Seizures

Paraneoplastic cerebellar degeneration

  • Ataxia
  • Dysarthria
  • Dysphagia
  • Diplopia

Lambert-Eaton myasthenic syndrome

  • Fatigue
  • Lower limb proximal muscle weakness
  • Diaphragmatic weakness
  • Ptosis
  • Impotence
  • Dry mouth
  • Myasthenia gravis
  • Eye muscle weakness
  • Limb weakness
  • Diaphragmatic weakness

Paraneoplastic Dermatologic And Rheumatologic Syndromes

  • Acanthosis nigricans
  • Hyperpigmented, velvety skin in the neck and armpits
  • Changes in the mucous membranes
  • Rugose changes in the palms and soles

Dermatomyositis

  • Heliotrope rash (edematous rash on the eyelids)
  • Scaly papules on bony surfaces
  • Edematous photosensitive rash on face, neck, shoulders, chest, and back
  • Proximal muscle weakness
  • Dysphagia
  • Dyspnoea

Hypertrophic osteoarthropathy

  • Clubbing
  • Large joints pain and swelling
  • Paraneoplastic pemphigus
  • Severe skin blisters and erosions in the trunk, palms, soles, and mucous membranes
  • Polymyalgia rheumatica
  • Limb-girdle pain and stiffness
  • Paraneoplastic haematologic syndromes

Paraneoplastic Hematologic Syndromes

  • Eosinophilia
  • Dyspnoea
  • Wheezing

Pure red cell aplasia

  • Syncope
  • Fatigue
  • Pallor
  • Dyspnoea
  • Thrombocytosis
  • Asymptomatic
  • Can have prolonged bleeding (1) (2) (3)

When To Go To Doctor For Paraneoplastic Syndromes?

These are some of the common Paraneoplastic syndromes and some symptoms associated with each syndrome. Most of these symptoms can be symptoms of the actual syndrome (non-paraneoplastic syndrome) or due to cancer. So, if you start getting any of the above-mentioned symptoms and generally you feel unwell, loss of appetite, loss of weight and lethargic consult a doctor. From the clinical presentation alone, the doctor cannot tell exactly whether this is due to Paraneoplastic syndromes or not.

Your doctor will perform several investigations and if an exact cause cannot be identified and if the doctor suspects there can be a tumor in the body and the symptoms are probably due to Paraneoplastic syndromes, then relevant investigations will be done to identify a tumor in the body.

Most of the time Paraneoplastic syndromes symptoms lead to the diagnosis of a malignant tumor in the body. If you present to the doctor with the symptoms at initial stages there is a chance that the malignancy is in the initial stages and in a curable state. But if you wait with the symptoms thinking it’s nothing to worry, the symptoms get worst gradually and the malignancy also spread to other organs in the body and when you present to the doctor it might be too late to cure cancer completely. (3)

Conclusion

Paraneoplastic syndromes are a rare condition that occurs due to the effect of cancer that is present in the body. Paraneoplastic syndromes commonly affect the nervous, endocrine, hematologic, rheumatologic and dermatologic systems. If you have symptoms involved with these systems it’s best you consult a doctor as early as possible.

Then if there is cancer it can be diagnosed at an early stage and sometimes even can cure it completely. If the symptoms of the Paraneoplastic syndrome are not treated the symptoms get worst and cancer will also spread to other organs.

References:

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