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Parathyroid cancer - Treatment

Alternative Names

Parathyroid carcinoma

Treatment:

The following treatments may be used to correct hypercalcemia due to parathyroid cancer:

  • A drug that lowers levels of calcium in the blood (gallium nitrate)
  • A natural hormone produced by the body that helps control calcium levels (calcitonin)
  • Drugs that stop the breakdown and reabsorption of bones into the body, such as pamidronate or etidronate (bisphosphonates)
  • Fluids through a vein (IV fluids)

Surgery is the recommended treatment for parathyroid cancer. Very often, it is impossible to know whether a parathyroid tumor is cancerous or not. Your doctor may recommend surgery even without a confirmed diagnosis. Minimally invasive surgery, using smaller cuts, is becoming more common for parathyroid disease.

If tests before the surgery can find the suspicious gland, surgery may be done on one side of the neck (unilateral). If it is not possible to find the problem gland before surgery, the surgeon will look at both sides of your neck.

Chemotherapy and radiation do not work very well in preventing the cancer from coming back, although radiation can sometimes help reduce the spread of cancer to the bones. Repeated surgeries for cancer that has returned may increase survival rate and reduce the severe effects of hypercalcemia.

Expectations (prognosis):

Parathyroid cancer is a rare cancer. The tumor is slow growing. Surgery may help extend life even when the cancer spreads.

Complications:

The cancer may spread (metastasize) to other places in the body, most commonly the lungs and bones.

The most serious complication of parathyroid cancer is hypercalcemia. Most deaths from parathyroid cancer occur as a result of severe, difficult to control hypercalcemia, and not the cancer itself.

The cancer commonly comes back (recurs). Additional surgeries may be needed. Complications from surgery can include:

  • Hoarseness or voice changes as a result of damage to the nerve that controls the vocal cords
  • Infection at the site of surgery
  • Low levels of calcium in the blood (hypocalcemia), a potentially life-threatening condition
  • Scarring

Calling your health care provider:

Call your health care provider if you feel a lump in your neck or experience symptoms of hypercalcemia.
  • Reviewed last on: 3/2/2010
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Bringhurst R, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 27.

Wysolmerski JJ, Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 266.

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