In general, solid cancers (as opposed to cancers of the blood or lymph system such as leukaemias and lymphomas) cause their harmful effects on patients by the effect of the tumour or growth itself, or by spreading in the circulation to other parts of the body. For example a bowel cancer that causes blockage or bleeding from the bowel, or when cancers spread to the bones where they may cause pain or fractures.

However a less familiar manifestation of cancers are paraneoplastic syndromes. These collections of symptoms and examination or test results arise, when cancers (neoplasms) produce signalling molecules that might be hormones or substances called cytokines. that travel in the blood stream. Alternatively, there can be an immune response to the tumour or the substances it produces.

Cancers typically associated with paraneoplastic syndromes include; kidney, ovarian, pancreatic, stomach and lung. Patients who have paraneoplastic syndrome often have symptoms such as night sweats, weight loss, and loss of appetite.

In addition, specific organ systems are targeted. The endocrine system can be challenged causing high calcium levels, hypoglycaemia or high steroid levels. Within the blood system there might be high or low blood counts. Patients might develop disorders of the nervous system with weakness, eye problems and inflammation within the brain. Skin problems can also occur.

As a result the sudden onset of new symptoms like these and in particular the generalised symptoms of night sweats and tiredness, should lead to a degree of suspicion of a possible cancerous cause. These symptoms may present before the more common features of a given cancer.

Written by Mr Sadmeet Singh, Consultant Urological Surgeon

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