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Henry Ford Hospital Medical Journal

Abstract

Both actinomycin D and mithramycin are useful agents in the treatment of cancer. They can also produce hypocalcemia, a comparatively rare phenomenon in cancer. Two such cases are presented in detail. Neither patient had the classic symptoms of hypocalcemia. Instead, the clinical picture was more compatible with hypercalcemia. The mechanism of action of each drug is explained; therapeutic implications are made with regards to their synergistic effects when used in combination with the standard calcium-lowering agents. Attention is drawn to the inhibitory action of these two agents on the calcium-mobilizing effect of the parathyroid hormone. The hypocalcemic effects of these two drugs are peripheral and not due to inhibition of parathyroid hormone synthesis. Because of their potentially fatal biochemical side effects, extreme caution is advocated in their use.

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