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Parathyroid cancer

Alternative Names:

Parathyroid carcinoma

Treatment:

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

Fluids by IV
Bisphosphonates (drugs that stop the destruction and reabsorption of bones into the body, such as pamidronate or etidronate)
Calcitonin (a natural hormone produced by the body that helps control calcium levels)
Gallium nitrate (a drug that lowers levels of calcium in the blood)

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.

If tests before the surgery can find the suspicious gland, surgery may be unilateral (done on one side of the neck). 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 (recurrence), although radiation can sometimes help reduce the spread of cancer to the bones. Repeated surgeries for cancer that has returned may increase a person's survival rate and reduce the severe effects of hypercalcemia.

Minimally invasive surgery, using smaller cuts, is becoming more common for parathyroid disease.

Expectations (prognosis):

Parathyroid cancer is a rare cancer. The tumor is slow growing. Surgery may help extend life even when the cancer spreads. The 5-year survival rate is 50 - 80%.

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 (recur). 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
Scarring
Infection at the site of surgery
Hypocalcemia (low levels of calcium in the blood, a potentially life-threatening condition)

Calling your health care provider:

Call your health care provider if you feel a lump in your neck or experience symptoms of hypercalcemia.

References:

Phillip K. Pellitteri PK, Sofferman RA, Randolph GW. Surgical Management of Parathyroid Disorders. In: Cummings CW, Flint PW, Haughey BH, et al. (eds). Otolaryngology Head & Neck Surgery, 4th ed . Philadelphia, Pa: Mosby; 2005

Weigel RJ, Macdonald JS, Haller D, McDougall IR. Cancer of the Endocrine System. In: Abeloff MD, Armitage JO, Niederhuber JE, et al. (eds). Clinical Oncology, 3rd ed . Philadelphia, Pa: Chrchill Livingston; 2004.

National Cancer Institute. Parathyroid Cancer: Treatment. In: Physician Data Query. Available online at http://www.cancer.gov/cancertopics/pdq/treatment/parathyroid. Last accessed on 23 April, 2006.

Review Date: 5/11/2006
Reviewed By: Rita Nanda, M.D., Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.

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