Parathyroid Cancer
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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 patientfs general health.
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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.
The cancer is only on the parathyroid gland
and has not spread to tissues next to the parathyroid.
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 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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There are treatments for all patients with parathyroid
cancer. Two 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).
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 for parathyroid cancer depends on
the type and stage of the disease and the patientfs 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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Treatment may be one of the following:
- Surgery to remove the parathyroid gland (parathyroidectomy)
and the half of the thyroid on the same side as the cancer (ipsilateral
thyroidectomy).
- A clinical trial of surgery followed by radiation therapy.
- A clinical trial of radiation therapy.
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- Surgery to remove the parathyroid gland (parathyroidectomy)
and other tissues around the thyroid if they contain cancer.
- Surgery to remove as much of the parathyroid gland as possible in order to reduce
production of PTH.
- Medical treatment to reduce the amount of calcium in the blood.
- A clinical trial of surgery followed by radiation therapy.
- A clinical trial of radiation therapy.
- A clinical trial of chemotherapy.
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Recurrent disease can occur as late as 34 years
after the first tumor.
- Surgery to remove the parathyroid gland (parathyroidectomy)
and other tissues around the thyroid if they contain cancer.
- Surgery to remove as much of the parathyroid gland as possible in order to reduce
production of PTH.
- Medical treatment to reduce the amount of calcium in the blood.
- A clinical trial of surgery followed by radiation therapy.
- A clinical trial of radiation therapy.
- A clinical trial of chemotherapy.
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