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Parathyroid Cancer

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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. If parathyroid cancer is found, the parathyroid gland may be making too much PTH. 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. Hyperparathyroidism is a condition which can cause the body to make extra PTH. If hyperparathyroidism runs in the family, there is a greater chance of getting this type of 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fs general health.

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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.

Localized

The cancer is only on the parathyroid gland and has not spread to tissues next to the parathyroid.

Metastatic

The cancer has spread to lymph nodes in the area or to other parts of the body, such as the lungs (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells).

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

How parathyroid cancer is treated

There are treatments for all patients with parathyroid cancer. Two kinds of treatment are used:

  1. Surgery (taking out the cancer).
  2. Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells).

Surgery is the most common treatment of 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).

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 (using drugs to kill cancer cells) is being studied in clinical trials. 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.

Treatment by stage

Treatment for parathyroid cancer depends on the type and stage of the disease and the patientfs age and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information.

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Localized Parathyroid Cancer

Treatment may be one of the following:

  1. Surgery to remove the parathyroid gland (parathyroidectomy) and the half of the thyroid on the same side as the cancer (ipsilateral thyroidectomy).
  2. A clinical trial of surgery followed by radiation therapy.
  3. A clinical trial of radiation therapy.

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Metastatic Parathyroid Cancer

Treatment may be one of the following:

  1. Surgery to remove the parathyroid gland (parathyroidectomy) and other tissues around the thyroid if they contain cancer.
  2. Surgery to remove as much of the parathyroid gland as possible in order to reduce production of PTH.
  3. Medical treatment to reduce the amount of calcium in the blood.
  4. A clinical trial of surgery followed by radiation therapy.
  5. A clinical trial of radiation therapy.
  6. A clinical trial of chemotherapy.

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Recurrent Parathyroid Cancer

Recurrent disease can occur as late as 34 years after the first tumor.

Treatment may be one of the following:

  1. Surgery to remove the parathyroid gland (parathyroidectomy) and other tissues around the thyroid if they contain cancer.
  2. Surgery to remove as much of the parathyroid gland as possible in order to reduce production of PTH.
  3. Medical treatment to reduce the amount of calcium in the blood.
  4. A clinical trial of surgery followed by radiation therapy.
  5. A clinical trial of radiation therapy.
  6. A clinical trial of chemotherapy.

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Parathyroid Cancer