A paraneoplastic syndrome is a group of symptoms arising due to the presence of tumor in the body which may be known or unknown. It is a collection of various diverse types of symptoms occurring away from the site of tumor or cancer and may or may not be related to the tumor directly or indirectly.
What Is The Prognosis For Paraneoplastic Syndrome?
Since there are a huge number and a wide variety of symptoms which can present as paraneoplastic syndromes, the prognosis cannot be explained directly and may vary widely. It can vary from having very good prognosis to almost fatal prognosis. Few of the paraneoplastic syndromes can have very poor prognosis like lupus erythematosus where the chances of the syndrome to be fatal are very high. On the other hand, there may be other paraneoplastic syndromes which may have very good prognosis like hypertrophic osteoarthropathy.
As the paraneoplastic syndromes are divided into various categories; the cutaneous, rheumatologic, gastrointestinal and miscellaneous paraneoplastic syndromes usually have high survival rate and good prognosis whereas paraneoplastic syndromes belonging to neuromuscular, renal, metabolic, and hematologic types have a very bad prognosis.
The prognosis in the paraneoplastic syndrome usually depends on the involvement of the system, it’s functioning, and importance in the body. For example, the cutaneous category usually has good prognosis whereas neuromuscular and cardiovascular have the poorest prognosis because of the involvement of less important organ of the body in cutaneous ones whereas cardiac failure or brain dysfunction can lead to life-threatening conditions or even death.
Classification Of Paraneoplastic Syndromes And Their Prognosis:
Rheumatologic paraneoplastic syndromes include joint pain, inflammation, erosion of joints, etc. which have a fairly good prognosis and can be treated with the help of steroids, disease-modifying agents like methotrexate.
Metabolic or endocrine paraneoplastic syndromes include hypercalcemia, hyperglycemia, hypernatremia, hypokalemia, etc. which can be treated easily by maintaining the adequate electrolytes in the body and regular monitoring but may get complicated sometimes.
Renal paraneoplastic syndromes include glomerulonephritis, renal failure, erythropoietin deficiency, etc. out of which renal failure can lead to serious complications and even death. Others can be managed by exogenous erythropoietin or specific therapies for the other causes.
Neurological paraneoplastic syndromes include myasthenia gravis, respiratory failure, autonomic instability, etc. few of which can cause sudden death like respiratory failure. Myasthenia gravis can be managed by the acetylcholinesterase inhibitors.
Cardiovascular paraneoplastic syndromes include amyloidosis, cardiomyopathies, congestive heart failure, etc. which can lead to long term complications and sometimes death can also occur in severe cases. Otherwise, these can be managed by beta-blockers, Ace inhibitors, etc.
Cutaneous paraneoplastic syndromes include itching, pigmentation, and nodules, etc. which usually do not require any treatment and subsides when the underlying tumor is treated. Itching can be relieved by the use of calamine lotion etc.
Hematologic paraneoplastic syndromes include lupus erythematosus, scleroderma, vasculitis, etc. which usually have a poor prognosis and high death rate because of widespread involvement of vascular system throughout the body and development of complications. These can be managed sometimes with the usage of steroids.
Since the involvement of organs differs with the different tumors, the paraneoplastic syndromes which are related to the tumors also vary accordingly. The prognosis can vary according to the extent of involvement of the organ by the tumor. At times it can be difficult to attribute whether death or a life-threatening condition is due to the tumor or the paraneoplastic syndrome caused by the tumor. Sometimes even tumor could not be found and the only paraneoplastic syndrome is seen which makes it more difficult to detect the cause of death. The prognosis cannot be described in clear words about the paraneoplastic syndromes because of their great variety.