Doctor's column: "Doctor, what if it's a tumor?" - how to check

Anesthesiologist Yuri Suponitsky explains paraneoplastic syndromes—conditions where a tumor affects the body without manifesting as a tumor. Mechanisms include hormone secretion and immune reactions. Examples: hypercalcemia, hyponatremia, Eaton-Lambert myasthenic syndrome, limbic encephalitis. The author emphasizes most such symptoms are not cancer-related, and mass screening is unjustified.

Anesthesiologist and intensive care specialist Dr. Yuri (Uri) Suponitsky, in an author column on the Vesty website, explains the phenomenon of paraneoplastic syndromes—conditions where a tumor affects the body without manifesting as a tumor. Two main mechanisms are described: the tumor secreting hormones or hormone-like substances (e.g., parathyroid hormone causing hypercalcemia, or vasopressin leading to hyponatremia) and triggering autoimmune reactions where the immune system attacks its own tissues (e.g., Eaton-Lambert myasthenic syndrome in small-cell lung cancer, limbic encephalitis). The author emphasizes that tumor size is irrelevant—the effect of secreted molecules matters. However, the vast majority of hypercalcemia or muscle weakness cases are not cancer-related, so mass referral of patients for CT and MRI is unjustifiably expensive and unsafe. Treatment primarily targets the cause—the tumor itself.