We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Lactic Acidosis and Death Owing to Cancer

Paul Y. Holoye, MD
Arch Intern Med. 1978;138(11):1613. doi:10.1001/archinte.1978.03630360011008.
Text Size: A A A
Published online


The relationship between the presence of a malignancy and the death of a patient is often obscure. Sometimes the clinician, more frequently the pathologist, can point to a single mechanism of death. One can mention hypercalcemia, acute cerebral edema surrounding a brain metastasis, or bilateral ureteral obstruction with uremia. However, it appears that death is most frequently due to a remote mechanism, such as infection, hemorrhage, or infarction.1

Even more subtle mechanisms are now being discovered. For example, the presence of hepatic metastases was of interest to the clinician only as a poor prognostic factor or a contraindication to surgery. Massive replacement of liver parenchyma by metastasis is not usually considered crucial to patient survival but only as a source of discomfort.

Recently, hepatic involvement has been recognized as an infrequent cause of death. Eras et al described hepatic coma in 7.2% of all patients with metastatic liver disease,


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.