Overall, observed metabolic alterations on whole body metabolism were significantly related to reduced Health Related Quality of life when split by PTHrP positivity versus PTHrP-negativity in patients, evaluated by SF-36 (SF: p<0.08, MH: p<0.02) as well as increased anxiety and depression evaluated by HAD-scales (HAD 1-7: p<0,004; HAD 8-14: p<0.008), analyzed on all available serum samples at inclusion and follow ups. Here, PTHLH is linked to depressive symptom measurement.