Parathyroid Cancer
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Description
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What is parathyroid cancer?
Parathyroid cancer, a very rare cancer, is a disease in which cancer
(malignant) cells are found in the tissues of the parathyroid gland. The
parathyroid gland is at the base of the neck, near the thyroid gland. The
parathyroid gland makes a hormone called parathyroid hormone (PTH), or
parathormone, which helps the body store and use calcium.
Problems with the parathyroid gland are common and are usually not caused by
cancer. The parathyroid gland may become overactive and make too much PTH, a condition called hyperparathyroidism. This causes too much calcium to be found in the blood. The
extra PTH also takes calcium from the bones, which causes pain in the bones,
kidney problems, and other types of problems. There are other conditions that
can cause the parathyroid gland to make too much PTH. It is important for a
doctor to determine what is causing the extra PTH. Very rarely, hyperparathyroidism is caused by cancer of the parathyroid gland, and too much PTH will be produced by the tumor. A rare inherited disorder of the parathyroid called familial isolated hyperparathyroidism may increase the risk of developing parathyroid cancer. A rare inherited disorder of the endocrine glands called multiple endocrine neoplasia 1 has also been linked with an increased risk of developing parathyroid cancer.
A doctor should be seen if there are the following symptoms: bone pain, a lump
in the neck, pain in the upper part of the back, weak muscles, difficulty
speaking, or vomiting.
If there are symptoms, the doctor will conduct a physical examination and feel
for lumps in the throat. The doctor may also order blood tests and other tests
to check for cancer or other types of tumors that may not be cancer (benign
tumors).
The chance of recovery (prognosis) depends on whether the cancer is just in the
parathyroid gland or has spread to other parts of the body (stage) and the
patient’s general health.
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Stage Explanation
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Stages of parathyroid cancer
Once parathyroid cancer is found, more tests will be done to find out if cancer
cells have spread to other parts of the body. This is called staging. A
doctor needs to know the stage of the disease to plan treatment. The following
stages are used for parathyroid cancer.
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Localized
The cancer is in the parathyroid gland and may or may not have spread into nearby tissues.
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Metastatic
The cancer has spread beyond nearby tissues to lymph nodes in the area or to other parts of the body,
such as the lungs, liver, bone, membrane around the heart, and pancreas.
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Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has
been treated. It may come back in the original place or in another part of the
body.
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Treatment Option Overview
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How parathyroid cancer is treated
There are treatments for all patients with parathyroid cancer. Medical treatment to lower high blood levels of calcium caused by the disease is very important for all patients. In addition, three kinds of
treatment are used:
- Surgery (taking out the cancer).
- Radiation therapy (using high-dose x-rays or other high-energy rays to
kill cancer cells).
- Chemotherapy (using anticancer drugs).
Surgery is the most effective treatment for parathyroid cancer. A doctor may
remove the parathyroid gland (parathyroidectomy) and the half of the thyroid on
the same side as the cancer (ipsilateral thyroidectomy).
Nearby muscles, tissues and nerves may also be removed to prevent the cancer from spreading.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink
tumors. Radiation may come from a machine outside the body (external radiation
therapy) or from putting materials that produce radiation (radioisotopes)
through thin plastic tubes in the area where the cancer cells are found
(internal radiation therapy).
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be
taken by pill, or it may be put into the body by a needle in the vein or
muscle. Chemotherapy is called a systemic treatment because the drug enters
the bloodstream, travels through the body, and can kill cancer cells outside
the parathyroid gland.
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Treatment by stage
Treatment for parathyroid cancer depends on the type and stage of the disease
and the patient’s age and overall health.
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Localized Parathyroid Cancer
Treatment may be one of the following:
- Surgery to remove the parathyroid gland (parathyroidectomy), the half
of the thyroid on the same side as the cancer (ipsilateral thyroidectomy), and possibly other tissues around the thyroid.
Medical treatment before surgery for high blood calcium levels and other complications of hyperparathyroidism is very important.
- Surgery followed by radiation therapy.
- Radiation therapy.
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Metastatic Parathyroid Cancer
Parathyroid cancer which has spread beyond nearby tissues to areas such as the lungs may appear soon after surgery, or as much as 20 years later. Because parathyroid cancer tends to be slow-growing, some patients live for many years even after the cancer has spread.
Treatment may be one of the following:
- Surgery to remove the
cancer from the places where it has spread.
- Medicine to reduce the amount of calcium in the blood.
- Surgery followed by radiation therapy.
- Radiation therapy.
- Chemotherapy.
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Recurrent Parathyroid Cancer
In about half of patients who have surgery for parathyroid cancer, the disease recurs (comes back), usually within 2 to 5 years. Because parathyroid cancer tends to be slow-growing, repeated surgeries to remove cancer which has come back can lower the level of parathyroid hormone and extend survival.
Treatment may be one of the following:
- Surgery to remove the cancer which has come back in the area of the thyroid or in other parts of the body.
- Medicine to reduce the amount of calcium in the blood.
- Surgery followed by radiation therapy.
- Radiation therapy.
- Chemotherapy.
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Changes to This Summary (04/14/2005)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Changes were made to this summary to match those made to the health professional version.
This information is provided from the PDQ® database in collaboration with the NCI.
