A 68-year-old man with advanced lung cancer has malignant hypercalcaemia (corrected calcium 3.8 mmol/L) with confusion, dehydration, nausea, and

Question

A 68-year-old man with advanced lung cancer has malignant hypercalcaemia (corrected calcium 3.8 mmol/L) with confusion, dehydration, nausea, and constipation. This is his third episode in 3 months. Each episode has been treated with rehydration and bisphosphonate. He asks whether treatment is still worthwhile. What factors should guide this discussion?

Accepted Answer

Treatment may remain worthwhile if it restores function and quality of life, the recovery period is acceptable (typically 3–5 days), and benefits outweigh the burden of repeated hospital admissions — but each recurrence should trigger honest discussion about diminishing returns

Answer

The decision should be made entirely by the oncologist without patient input

Answer

After three episodes, treatment should automatically be stopped

Answer

Hypercalcaemia should always be treated regardless of context

Answer

Only the first episode of hypercalcaemia warrants treatment

Recurrent Hypercalcaemia Treatment Decisions — SCE Palliative Medicine MCQ