Parathyroid cancer, or parathyroid carcinoma, is a rare form of cancer that affects the four parathyroid glands found in the neck. These glands are responsible for producing parathyroid hormone, which regulates the body’s calcium levels.
What is parathyroid cancer (parathyroid carcinoma)?
Parathyroid cancer is a serious condition that can lead to a variety of complications. Most cases are not inherited, and it is more common in people over the age of 40. Unlike many other types of cancer, parathyroid cancer typically does not spread beyond the initial location. In addition to this, it is one of the few forms of cancer that can be treated if detected at an early enough stage. However, it has the potential to create life-threatening complications if it is not recognized and treated at an early enough stage.
Surgical removal of one or more of the patient’s damaged parathyroid glands is the standard course of treatment for this extremely rare form of cancer. The goal of surgery is to eliminate any malignant cells, as well as to restore normal parathyroid hormone levels.
Depending on how aggressive the tumor is, radiation therapy and chemotherapy may also be employed in extremely unusual circumstances.
When cancer cells develop in the parathyroid glands, they can form tumors and cause disruption to hormone production. In more serious cases, these tumors can spread to other parts of the body and cause significant damage.
Professionals in the medical field almost never refer to parathyroid carcinoma by its four-stage nomenclature. Instead, there are three distinct types of parathyroid cancer:
Localized Parathyroid Carcinoma
In the situation known as localized parathyroid cancer, the cancerous cells have not yet moved to other areas of the body, and the tumor is still confined to the parathyroid gland. This is the most frequent type of cancer that affects the parathyroid glands, and it almost often affects just one of the four glands that are located in the neck. Even though localized parathyroid carcinoma is not as dangerous as some other types of cancer, it can still cause major disturbance to the body’s calcium levels. For this reason, it is essential that the condition be diagnosed and treated as soon as possible.
Surgery is typically the recommended treatment for localized parathyroid cancer, although radiation and chemotherapy may be used in more aggressive cases.
Metastatic Parathyroid Carcinoma
Metastatic parathyroid cancer is a more serious form of the disease, in which cancer cells have spread beyond the original location in the neck. This type of parathyroid cancer is more difficult to treat and can be life-threatening. In most cases, surgery is recommended to remove the tumors, and radiation and chemotherapy may also be used if cancer has spread to other parts of the body. Metastatic parathyroid cancer is more difficult to treat than localized parathyroid cancer, and it is important for individuals to seek immediate medical attention if they are diagnosed with this condition.
Recurrent Parathyroid Carcinoma
Recurrent parathyroid cancer is a rare condition in which cancer returns after treatment. It is more common in people who have already been diagnosed with primary parathyroid cancer, and it can be difficult to treat. The most common symptom of recurrent parathyroid cancer is an elevated calcium level in the blood, as the cancerous cells produce an excess amount of parathyroid hormone. Treatment for recurrent parathyroid cancer typically involves further surgery and/or radiation therapy.
How are parathyroid cancer and adenoma different?
Parathyroid carcinoma is a malignant condition, which indicates that the cancerous cells have the potential to spread to other areas of the body. On the other hand, parathyroid adenoma is a benign condition, which indicates that the cells are isolated to one place and do not spread.
Surgery, radiation therapy, and/or chemotherapy are the standard modes of treatment for parathyroid cancer; however, parathyroid adenoma is frequently curable via surgical removal alone.
The prognosis for parathyroid cancer is usually worse than for parathyroid adenoma, as the cancerous cells can spread to other organs and cause damage. Therefore, it is important to seek medical attention as soon as possible if you have symptoms of either condition.
How does parathyroid cancer relate to hypercalcemia?
Hypercalcemia is an increase in the calcium levels in the blood, and it is often a symptom of parathyroid cancer. When the parathyroid glands produce excess parathyroid hormone, it can lead to an oversupply of calcium in the body, which in turn can cause a variety of symptoms such as fatigue, confusion, and muscle pain. High levels of calcium can also put a strain on the kidneys, as they are responsible for filtering out excess calcium from the body.
Hypercalcemia can be controlled with medicine and lifestyle adjustments, but if it goes untreated, it can have severe consequences.
Could there be various forms of parathyroid cancer?
There are several different types of parathyroid cancer, including squamous cell carcinoma, follicular carcinoma, and medullary carcinoma.
- Squamous cell carcinoma is the most common type of parathyroid cancer, and it is usually found in the upper neck area.
- Follicular carcinoma is rarer, and it typically appears in the lower neck area.
- Medullary carcinoma is the least common type of parathyroid cancer, and it is often found in the middle part of the neck. It is usually more aggressive than the other types of parathyroid cancer and can spread to other parts of the body. Treatment for medullary carcinoma usually involves surgery, radiation, and/or chemotherapy.
It is important to seek medical help as soon as possible if you have any symptoms of parathyroid cancer to get the best possible treatment.
Who usually gets parathyroid cancer?
It is most common in adults, with many cases occurring in individuals over the age of 60. It is also more common in women than men, as well as in individuals who have had radiation to the neck for other medical conditions.
Family history of parathyroid cancer can also be a factor, as can certain genetic conditions such as multiple endocrine neoplasia type 1 (MEN1). It is important to note that parathyroid cancer is a rare condition and many people who do have it may never experience any symptoms.
People with certain genetic conditions, such as multiple endocrine neoplasia, are also at an increased risk for this type of cancer.
This type of cancer is also more likely to occur in those who have had radiation therapy in the neck area, and those with conditions like Down syndrome and Carney complex.
To what extent does the incidence of cancer of the parathyroid occur?
Incidence rates of parathyroid cancer are low, with only around 4,000 new cases diagnosed annually in the United States. While exact numbers are unknown, it is thought that 1 in 100,000 persons will acquire parathyroid cancer each year.
While it is more common in the elderly, it can occur at any age. Early diagnosis and treatment of parathyroid cancer can improve the chances of a successful outcome, so it is important to be aware of the signs and symptoms and book an appointment with your doctor as soon as possible if you have any concerns. Fortunately, with proper treatment, most people can live normal, healthy lives.
Causes of Parathyroid Cancer
The exact cause of parathyroid cancer is unknown, but there are several factors that may increase the risk, such as:
- Age
- genetics
- radiation exposure
- certain medical conditions.
Some studies have found a correlation between anomalies in the gene that regulates parathyroid hormone production and the development of parathyroid cancer.
Other factors that may increase the risk of parathyroid cancer include:
- a family history of the disease
- exposure to radiation
- certain genetic conditions
It is important to talk to a doctor if you have any risk factors for parathyroid cancer so they can monitor you and provide appropriate treatment if necessary.
Symptoms of Parathyroid Cancer
Parathyroid cancer may not cause any symptoms, but the symptoms can vary from person to person and may not be obvious at first.
Some common symptoms of parathyroid carcinoma include:
- neck pain
- swollen lymph nodes
- feeling depressed
- nausea and vomiting
- difficulty swallowing or speaking
- unexplained weight loss
- constipation
- fatigue
- weakness
- frequent urination
If you experience any of these symptoms, you should consult your doctor as soon as possible as they may indicate a more serious issue such as parathyroid carcinoma. Early diagnosis is key to successful treatment, so it is important to have any concerns checked out by a qualified medical professional.
How to Diagnose?
It can be difficult to diagnose, as it often does not cause any symptoms. The diagnosis of parathyroid cancer typically begins with a physical examination and a review of the patient’s medical history.
If the doctor suspects that the patient has parathyroid carcinoma, further testing such as:
- Parathyroid scan (MRI or CT scans)
- blood tests to measure parathyroid hormone levels (PTH).
If the diagnosis is still uncertain, a parathyroid biopsy may be performed. It is important to note that other conditions, such as benign tumors or overactive parathyroid glands, can also cause similar symptoms and should be ruled out before a diagnosis of parathyroid cancer is made. Early diagnosis and treatment are key to successful outcomes, so it is important to be aware of the signs and symptoms and speak to your doctor if you have any concerns.
Treatment of Parathyroid Cancer
The treatment usually depends on the stage of cancer and can include surgery to remove the affected parathyroid gland. In most cases, this operation, known as a parathyroidectomy, can permanently eliminate the problem. Depending on the size and stage of the tumor, additional treatments such as radiation therapy, chemotherapy, and hormone therapy may also be recommended.
When treating parathyroid cancer, the following surgical methods may be used:
Tumor debulking
Tumor debulking is the removal of as much of the cancerous tissue as possible. It is often used in conjunction with other treatments, such as radiation or chemotherapy, to reduce the size of a tumor before more invasive treatments are used.
This procedure is particularly useful for tumors that have spread to other parts of the body as it can help contain the spread of cancer. To reduce the size of a tumor, surgery is one option, but drugs and non-invasive techniques like cryosurgery or laser ablation are also viable options.
En bloc resection
En bloc resection is a type of surgery that involves removing both the tumor and the surrounding normal tissue. It is typically used in cases where the cancer is advanced and has spread to nearby tissue. This type of surgery is often used to provide a more thorough treatment with fewer chances of recurrence.
It can also protect surrounding tissue, making it a recommended treatment for some parathyroid cancers.
Metastasectomy
If cancer has spread to other parts of the body or metastasized, it can be surgically removed in a procedure called a metastasectomy. When the disease has already spread to other organs, such as the liver or lungs, this form of surgery is typically the only option. The goal of this procedure is to remove as much of the cancerous tissue as possible to limit the spread and improve the chances of successful treatment. It can be used as a standalone treatment or in conjunction with other treatments such as chemotherapy or radiation therapy.
The prognosis for parathyroid carcinoma is often good, particularly if it is caught in its early stages. However, it is important to discuss treatment options with your doctor and determine the best course of action for your individual situation.
Parathyroid cancer treatment with chemotherapy or radiation
Radiation therapy or chemotherapy may be suggested for patients with advanced parathyroid carcinoma. If the tumor is too large for surgical removal or if cancer has spread to other parts of the body, this option may be suggested.
Talking to your doctor about your symptoms and concerns is essential to establishing a treatment plan that is right for you. When used in conjunction with surgery, radiation and chemotherapy can reduce the size of a tumor or remove any remaining cancer cells.
Can I expect to use medicine to treat my parathyroid cancer?
To alleviate discomfort or prevent complications, medication may be recommended. In addition, certain medications such as calcimimetics can help regulate parathyroid hormone levels and reduce the risk of hypercalcemia, a common side effect of parathyroid cancer.
Rarely, targeted medications like kinase inhibitors or monoclonal antibodies may be provided to aid in tumor reduction or cancer progression. You and your doctor should talk about all of your treatment options to find the one that works best for you.
Recurrence of Parathyroid Cancer
Predicting whether it will repeat is impossible, however, there are risk factors that can be taken into account. Such conditions include advanced cancer, a tumor that is too large for surgical removal, or metastasis (the spread of cancer cells to other parts of the body).
Additionally, certain lifestyle factors such as smoking, and a poor diet may also increase the risk. The best way to decrease the risk of recurrence is to follow your doctor’s recommendation for treatment and to maintain a healthy lifestyle.
Can parathyroid cancer metastasize?
It can spread, or metastasize, to other parts of the body. This is more common in advanced-stage cancers, as well as in those that have been diagnosed at a later stage. Early detection and prompt treatment can help reduce the risk of metastasis.
Metastasis is most likely to occur when cancer has reached an advanced stage and has spread beyond the original tumor site. The most common sites for metastasis are the lungs, bones, and liver. Additionally, metastasized cancer cells can travel through the bloodstream or lymph system to other organs. Cancer cells that have spread to other parts of the body are known as secondary tumors.
Surgery is often the first line of treatment to remove as much of the cancerous tissue as possible, followed by radiation or chemotherapy to target any remaining cancer cells.
What are the Prevention methods?
Unfortunately, there is no surefire way to prevent parathyroid carcinoma. However, altering one’s way of living can help mitigate the risk. Reduce your risk of developing cancer by eating healthily, never smoking, and maintaining a regular exercise routine.
Also, it’s crucial to catch problems early on, so if you notice any lumps or growths in your neck or upper chest, make an appointment with a doctor right once.
What are the Complications?
Parathyroid cancer can lead to several complications, including hypercalcemia, hypocalcemia, and bone problems.
- Hypercalcemia occurs when the body produces too much parathyroid hormone, leading to high calcium levels in the blood.
- Hypocalcemia, on the other hand, is the result of too little parathyroid hormone and low calcium levels in the blood.
- Bone problems can occur because of metastasized cancer cells that spread to the bones and damage them.
Prognosis
Parathyroid carcinoma has a mixed prognosis that depends on the patient and the stage of the disease at diagnosis. Detection and treatment at the earliest possible stages are connected with the best outcomes. Localized cancers are more likely to respond to curative surgery, but metastatic cancers may not respond to any treatment at all.
Further, if cancer has progressed to a later stage or if the tumor was too large to be removed surgically, the risk of recurrence increases.
Appointment
For more information on the topic “Parathyroid Cancer – Symptoms and Treatment” or consultation about Thyroid Treatment with Dr. Valeria Simone MD, at Southlake General Surgery, Texas. You can contact our healthcare expert today for a quick appointment at +1 (817) 748-0200.