Introduction
When cells in the body grow uncontrolled, it is called cancer. Cells divide as a usual part of their functioning. But, at times, the cell division becomes uncontrolled due to some mutation or other factors. This is when the organ is said to have cancer cells. It is called lung cancer when it starts dividing uncontrolled in the lungs. Lung cancer is the third most common cancer in the U.S.
What Is Hyponatremia?
When the serum concentration of sodium is less than 135 mEq/L, the condition is called hyponatremia. An excess of the total body water, compared to the sodium content, results in hyponatremia, a common condition. Nausea, headache, confusion, and fatigue are the common symptoms seen. The condition can be treated by limited fluid intake, medication, and hospitalization.
Electrolyte disorders are common among cancer patients. It can reduce the prognosis of the condition. Hyponatremia is the most common electrolyte imbalance seen. The classification of the types of hyponatremia may differ. There can be different factors that cause hyponatremia in cancer patients. The medicines given, comorbidities, side effects of the anti-neoplastic treatments, or even the cancer cells can cause sodium levels to go below normal. The condition may not be life-threatening. However, it may delay the planned chemotherapy sessions and reduce the patient’s prognosis and quality of life. Out of the many cancers seen, lung cancer has been found to have hyponatremia commonly.
What Are the Symptoms of Hyponatremia in Lung Cancer?
The symptoms of hyponatremia in lung cancer depend on the level of sodium levels, how low the sodium levels are, and how fast the levels drop. In acute hyponatremia, the sodium levels drop low in less than forty-eight hours. The symptoms of acute hyponatremia can include:
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Headache.
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Nausea.
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Vomiting.
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Muscle cramps.
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Slow heartbeat.
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High blood pressure.
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Inability to regulate blood pressure.
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Brain swelling.
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Convulsions.
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Coma.
Chronic hyponatremia is when sodium levels fall over more than forty-eight hours. The symptoms seen in chronic hyponatremia can include:
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Weakness.
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Loss of appetite.
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Nausea.
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Vomiting.
Long-term consequences of hyponatremia, even though mild to moderate, can include:
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Difficulty in concentrating.
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Difficulty walking.
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Increased rate of bone loss.
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Greater risk of falls.
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Increased risk of fractures.
How Is Hyponatremia in Lung Cancer Diagnosed?
In some cases of lung cancer, people might not have any symptoms, which may cause a delay in finding the condition. The condition is usually identified by the routine blood tests done. They will correlate the blood results with signs of hyponatremia, which can include:
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Electrolyte and water balance.
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Particle concentration in urine.
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Body fluid volume.
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Functions of kidney, thyroid, and adrenal glands.
Other symptoms like seizures or confusion can be achieved by eliciting the patient’s history.
How Is Hyponatremia in Lung Cancer Managed?
The treatment of the condition may depend upon the patient's condition, like the duration and the level of sodium levels. The most common approach to managing this condition can include limiting fluid intake to reduce swelling. A vasopressor receptor antagonist may be used. It is a hormone that tightens the blood vessels and increases the water reabsorption in the kidneys. With no reduction in salt intake, these medicines help to remove large amounts of water in the urine as urine, thereby reducing the difference in sodium water ratio.
Corrupting sodium levels requires careful management, as too much management or over-caring can result in neurological side effects. Chronic hyponatremia causes the brain to secrete osmotically active solutes to adapt to the hyposmolality of extracellular space. Osmotic demyelination results from complement activation, influx, and damage to the blood-brain barrier, caused by the cell’s inability to adjust rapidly when the extracellular sodium concentration rises. The risk of osmotic demyelination is high in patients with severe and chronic hyponatremia.
Managing the condition early is very important. Even though patients with mildly low levels of chronic serum sodium levels remain asymptomatic, they are at high risk of complications like gait instability and fractures due to falls. The clinical effects of hyponatremia are greater in hospitalized patients suffering from cancer. However, hypertonic saline can recover the serum sodium levels if the patient is symptomatic. Euvolemic hyponatremia is a condition where the sodium levels in the body remain constant, but the fluid levels rise. Limiting the fluid intake can be beneficial in these conditions. However, if the symptoms are more severe, management using hypertonic saline might be required.
Hyponatremia can affect the prognosis and quality of life in lung cancer patients. It can also have a negative impact on the hospitalization and performance status of the patient. The number of days stayed in the hospital can differ between mild and severe cases of hyponatremia. The performance in both conditions also might be different. Normalizing the serum sodium levels in patients with lung cancer also helps to improve their survival rates, according to studies.
How Is Hyponatremia in Lung Cancer Prevented?
Preventing an electrolyte imbalance or hyponatremia can help to prevent the prognosis from decreasing in lung cancer patients. New methods of cancer treatment and prolonged duration of therapies can cause hyponatremia in lung patients. Monitoring the electrolyte levels in these patients can be helpful to prevent such scenarios. This helps them to manage the condition at an earlier stage, thereby preventing further complications. A study shows that reducing the fluid intake just before chemotherapy can considerably help to prevent hyponatremia.
Conclusion
Patients with cancer, especially with lung cancer, may find hyponatremia as an emerging issue. It may be asymptomatic in some cases. However, they may show signs as time progresses. Signs and symptoms can include body swelling, headaches, vomiting, and nausea. Managing them early and appropriately can help prevent further complications that can worsen the prognosis of the condition. This helps to improve the quality of life, prognosis, and compliance with the cancer treatment. Severe hyponatremia can be serious and can cause death if not managed appropriately.
