Low Sodium Levels

My dad is on his third treatment of chemo therapy...and his tumor has shrank and his lung is working at full capacity...things were looking really good...

Now, his sodium is being attacked and they can't figure out why. His PET scan came back ok, he has had MRI of the brain about a month ago and it was clear...now they are thinking there is cancer not showing up on the scan attacking his system...
Has anyone out there gone through this?
Thank you all for the support!

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hey, Tina,
What you are describing is very common for SCLC - it is called hyponatremia (that just means low sodium in Latin). There is dispute about what exactly causes it - the two camps are the adrenal glands and the kidneys. (funny thing there - the adrenal glands sit on top of the kidneys). SCLC tends to send mets to one of the adrenals but not the other. Before you freak, the chemo he's already taking goes there also.

Now - here's the scoop on the hyponatremia - if the blood sodium dips down and stays down, his fluid balance in his body can get messed up and crappy things like convulsions can occur. It is IMPERATIVE that this get treated. It is dangerous.

BTW - your onc should be looking at the kidneys not at the brain - it should be with a CAT scan with contrast. PET scans don't always pick up SCLC mets real well.

Now - what do you do about it? The onc needs to decide on what to do. Our onc (at the beginning) prescribed a bowl of potato chips every day. Once the potato chips stopped working, they tried salt pills (they are about the size of a small dog), and finally they prescribed Declomycin (it's a wimpy antibiotic that doesn't actually do much, but it has a side effect of raising blood sodium).

You know, with SCLC, the side effects can be a real pain. Check out www.chemocare.com. It gives some real good guidance in down-home language.

Welcome to the family of warrior princesses, Tina. I truly hope you and your daddy get through this rough patch real well. Sending big hugs to all.
Pat

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ok....forgot something....

If you need to take your daddy to the ER for any little old reason - tell EVERYONE you see that he has hyponatremia. The standard procedure is to hang a bag of salt water onto the IV line. This sounds good- but there is less salt in it than people with SCLC require, and it results in LOWER blood sodium levels. It then takes about a week to get it back to semi-normal.

This sounds stupid, but you need to get it out there with the hope someone hears the message. Honestly, the MDs are generally so shocked that a civilian knows the word, you can get their attention fairly easily!!! Let's hear it for shock and awe!

Hugs
Pat

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Hi Tina - Pat is right - the low sodium is important to take care of - could affect the brain with seizures. My Dad had two bouts with low sodium (hospitalized both times), he did take sodium pills for a while, but did not tolerate them well and decided to eat lots of chicken soup. Follow up blood work indicated Dad's low sodium seems to have resolved itself. Hope your Dad gets through this easily.
Maria

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Mom had her first round of chemo last M, T, W and this past Tuesday had a KILLER headache and was very fatigued. Turns out it was low sodium, magnesium and potasium. She was put on a 2.5 hour drip and a high, high sodium diet. She felt somewhat better by the evening.

I will say prayers that your dad's sodium gets back to normal and that he stays cancer free.

Blessings,

Cork

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Pat,
Is this something I should be concerned with for my dad? He has enough issues without worrying about low sodium.

Kristi

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hey, Kristi,
with SCLC patients, they typically test for sodium periodically. Check your papers - if they haven't tested, go hit someone up side their head and get your daddy tested; if they have tested and nothing was flagged (in normal range), then do the happy dance. If your daddy has a problem, it can be controlled very well with salt or a little red pill - the only problem comes up if he has a problem and is not being treated. This is just one of those things we have to keep an eyeball on.

Hope this helps, girl!!! Hugs
Pat

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Hey Kristi - my Dad gets a full blood workup every third week (always before chemo) or sooner if he shows any symptoms!

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I will have to ask about the sodium level. I get a copy of Dad's labs if I with him at the time he gets them. I will ask the next time I am at the onc's office. Thanks you two!

Kristi

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I had a lobectomy of the right lower lung in June of 2006. In July of 2007 I was informed during pre-ops for cervical disk replacement, that my sodium levels were low. My primary doctor took me off of the hydrochlorothiazide that I took for high blood pressure. My doc told me to eat more salty food and drink less. I continued as instructed and gradually I couldn't eat and landed in the emergency room. Low sodium levels once again. I have been taking sodium pills and liberally salting foods since then. In April of 2008 the cancer came back in my right lung and had spread to the adrenal gland. It was then I was told of the connection between low sodium levels and cancer in the adrenal gland. For almost a full year I have been telling various doctors about my problems with low sodium and not ONE of them ever made a cancer connection. I advise everyone now to keep close watch of electrolyte levels and speak up to the doctors!

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I found it!
The syndrome associated with hyponatremia and SLCL is called SIADH (syndrome of inappropriate diuretic hormone). The adrenal glands are supposed to secrete some kind of hormone to keep fluid and sodium balance in check - when they get hit with mets, they get whacked out (how's that for a good technical term?!).

The medical article says that about 1/3 of SCLC patients have some form of SIADH. When SIADH gets out of control it can be pretty dangerous. Again - if raising salt in food doesn't quite do it, talk to your onc about the declomycin. It works well and quickly!

have a great day!
Pat

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one other thought - they sometimes give Latin symbols on the test reports. If the word sodium doesn't appear, look for "Na". Natrium is the Latin word for sodium, and has the abbreviation Na.

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Thanks! I couldn't remember the abbreviation for sodium. Science class was too long ago. :)

Kristi

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I looked at my dad's last set of labs from Monday... I didn't see any checks for sodium levels. I will ask the onc about checking that.

Kristi

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good point there - the patients get different standardized tests depending on which chemo they are getting. carbo+etoposide automatically gets the bigger set of tests. cisplatin + irinotecan got a smaller group. somehow, my poor little pea-brain can't get itself around the fact that 33% of SCLC patients have problems with sodium and this wouldn't be a standardized test....

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My dad is on the Carboplatin/VP-16 chemo regiment.

Kristi

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Hey Kristi
VP 16 = etoposide.
They should be checking his sodium level regularly!!!
Tell them an old engineer said so!!!
Pat

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thank you so much

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Knowledge is everything when you are in the ER..that is so true. My brother and I have been researching everything we can and talking to as many people as we can.
I will make sure they check the kidneys. Thank you all! God bless

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low sodium levels can be quite dangerous I cant remember exact level - i believe it is around 114 that a person can slip into coma my moms was at 104. she was semi comatose until her level was raised uo She had SIADH and it was a battle treating this because her oncologist informed me that you needed to have active cancer to have SIADH and he insisted that she did not. Well she must have had because a mere 8 days after he eventually confirmed SIADH she passed away I still dont know if it is true or not- was told by many different docs, different things I do believe that mom had active cancer and they just didnt know

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