A client has been undergoing radiotherapy for the treatment of mandibular cancer. After a few sessions, the client is diagnosed with Tumor Lysis Syndrome (TLS). Which of the following findings correlates with TLS?
A. Phosphorus level of 6 mg/dL.
B. Phosphorus level of 3 mg/dL.
C. Phosphorus level of 4 mg/dL.
D. Phosphorus level of 2 mg/dL.
Correct Answer: A. Phosphorus level of 6 mg/dL.
Tumor lysis syndrome (TLS) is a potentially life-threatening metabolic disorder characterized by elevated phosphorus levels. The normal phosphorus is 2.5 to 4.5 mg/dL. When cancer cells break down quickly in the body, levels of uric acid, potassium, and phosphorus rise faster than the kidneys can remove them. This causes TLS. Excess phosphorus can “sop up” calcium, leading to low levels of calcium in the blood.
Option B: 3 mg/dL is a normal phosphorus level. Changes in blood levels of uric acid, potassium, phosphorus, and calcium can affect the functioning of several organs, especially the kidneys, and also the heart, brain, muscles, and gastrointestinal tract.
Option C: 4 mg/dL is a normal phosphorus level. Not all cancer patients are at equal risk of developing TLS. Patients with a large “tumor burden” of cancer cells and/or tumors that typically have rapidly dividing cells, such as acute leukemia or high-grade lymphoma, as well as tumors that are highly responsive to therapy, are at greatest risk of developing TLS.
Option D: 2 mg/dL is a normal phosphorus level. TLS is not limited to patients receiving traditional chemotherapy; it can also occur in patients receiving steroids, hormonal therapy, targeted therapy, or radiation therapy. Patients who are dehydrated and those with existing kidney dysfunction are at higher risk of developing TLS.