Tumor Lysis Syndrome

Tumor lysis syndrome is a group of metabolic complications that can happen during cancer treatment. It occurs when cancer therapies like chemotherapy kill large numbers of tumor cells very quickly. These dying cells release their contents into your bloodstream all at once.

When tumor cells break down rapidly, they dump potassium, uric acid, phosphate, and other substances into your blood. Your kidneys may not be able to filter out these substances fast enough. This can lead to dangerous imbalances in your blood chemistry. High levels of potassium can affect your heart rhythm. Excess uric acid can damage your kidneys.

This condition most often occurs within 12 to 72 hours after starting cancer treatment. It is more common in people with fast-growing cancers like certain types of leukemia and lymphoma. Doctors can prevent or manage tumor lysis syndrome by monitoring blood tests closely before and during treatment.

• Decreased urine output or dark-colored urine
• Nausea and vomiting
• Muscle weakness or cramps
• Irregular heartbeat or heart palpitations
• Confusion or difficulty concentrating
• Fatigue and extreme tiredness
• Tingling or numbness in hands and feet
• Seizures in severe cases
• Joint pain or swelling

Some people may not notice symptoms right away. Blood test abnormalities often appear before physical symptoms do. This is why close monitoring during cancer treatment is so important.

Tumor lysis syndrome happens when cancer treatment kills tumor cells faster than your body can clear the cellular debris. Chemotherapy is the most common trigger, but radiation therapy and some targeted cancer drugs can also cause it. When massive numbers of cells die at once, they release potassium, uric acid, and phosphate into your bloodstream. Your kidneys become overwhelmed trying to filter these substances out.

Certain factors increase your risk. Fast-growing cancers like acute leukemia, high-grade lymphoma, and Burkitt lymphoma carry higher risk. Having a large tumor burden, meaning a lot of cancer in your body, also raises risk. Dehydration, existing kidney problems, and high uric acid levels before treatment make tumor lysis syndrome more likely. People receiving very effective cancer treatments that kill cells rapidly may also face higher risk.

Doctors diagnose tumor lysis syndrome through blood tests that measure potassium, uric acid, phosphate, and calcium levels. These tests are done before cancer treatment starts and repeated frequently during the first few days of therapy. Elevated potassium and uric acid levels are key diagnostic criteria. Kidney function tests also help doctors see how well your kidneys are handling the cellular breakdown products.

Rite Aid offers testing for potassium and uric acid levels through our preventive health panel. Regular monitoring helps catch dangerous changes early. If you are undergoing cancer treatment, your oncology team will order frequent blood draws through your treatment facility. For ongoing health monitoring after cancer treatment, Rite Aid testing at Quest Diagnostics locations can track your kidney function and uric acid levels.

• Aggressive intravenous fluid hydration before and during cancer treatment to help kidneys flush out excess substances
• Medications like allopurinol or rasburicase to lower uric acid levels and prevent kidney damage
• Potassium-binding medications to reduce dangerous potassium levels
• Phosphate binders to control phosphate levels
• Dialysis in severe cases when kidneys cannot filter waste effectively
• Close monitoring of electrolyte levels with frequent blood tests
• Adjusting cancer treatment timing or dosing if needed
• Treating underlying electrolyte imbalances promptly