What metabolic abnormalities are associated with tumor lysis syndrome?

Tumor lysis syndrome (TLS) is a potentially life-threatening condition that can occur after the treatment of certain cancers, especially those with a high cell turnover, such as leukemia and lymphoma. This syndrome results from the rapid release of intracellular contents into the bloodstream following the destruction of cancer cells, which can lead to a series of metabolic abnormalities.

Hyperphosphatemia and hypocalcemia are hallmark features of tumor lysis syndrome. When cancer cells lyse, they release large amounts of phosphate into the circulation, causing elevated phosphate levels (hyperphosphatemia). The elevated phosphate can bind with calcium, leading to decreased calcium levels in the serum (hypocalcemia). This imbalance can result in a number of complications, including cardiac arrhythmias and neuromuscular irritability.

Understanding these metabolic changes is critical for oncology nurses, as they must monitor patients for TLS and its consequences closely. By being aware of the specific abnormalities such as hyperphosphatemia and hypocalcemia, nurses can implement timely interventions to manage these issues, such as hydration, electrolyte monitoring, and, in some cases, medications like phosphate binders or calcium supplementation.