Parathyroid Cancer Overview

There are different types of glands found in the human body. The glands found in the parathyroid release hormones, which are substances inside the body that tell it how to work and grow. These glands are a part of the endocrine system.  The parathyroid glands are small glands that are located on the posterior surface of the thyroid gland. There are usually four parathyroid glands, two glands on each lobe of the thyroid. 

Parathyroid cancer is a rare endocrine gland cancer.  The disease often occurs in midlife and occurs in both males and females equally. Patients with parathyroid cancer may have a moderate to severe increase in blood calcium level (hypercalcemia). High calcium levels may cause painful bones, kidney stones, constipation, depression, and fatigue.  Patients may also have high parathyroid hormone levels.  Sometimes a patient may have a benign (noncancerous) tumor in the parathyroid gland. Benign and cancerous tumors of the parathyroid glands may have some similar signs and symptoms such as an increase in blood calcium level and an increase in parathyroid hormone. Surgery is usually done to determine if the tumor is benign or cancerous. Parathyroid cancer is considered likely if the patient has a high blood calcium level (greater than 14mg/dl), hard mass in the neck, and hoarseness due to vocal cord paralysis.

Parathyroid cancer can spread to tissue surrounding the parathyroid and to nearby lymph nodes. The cancer can also travel through the blood stream and spread to one or both lungs, the liver, and to the bones. 

Currently, it is not known if there is something in the environment that increases a person’s chances of developing cancer of the parathyroid. Benign tumors of the parathyroid are more likely to develop if the patient has been exposed to radiation of the head and neck. It can also occur more often in patients who have a family history of hyperparathyroidism-jaw tumor syndrome. 

Parathyroid cancer has some common signs and symptoms. Symptoms can be due to the increased blood calcium level, the increase in parathyroid hormone or due to the mass found in the neck. Symptoms may include the following:

  • Fatigue
  • Nausea and vomiting
  • Muscle weakness
  • Musculoskeletal aches and pains
  • Depression
  • Kidney stones
  • Kidney disease
  • Osteoporosis
  • Peptic ulcer
  • Gout
  • Inflammation of the pancreas
  • Hoarseness due to vocal cord paralysis (loss of nerve function to the voice box)

Treatment of parathyroid cancer is usually aimed at controlling the increase in blood calcium levels caused by the slow growing tumor. The increase in calcium levels can cause hypercalcemia which can be difficult to control and may lead to death.  Different kinds of treatment are available for parathyroid cancer depending on the stage of disease. Some treatments are standard of care which is the currently used treatment for this type of cancer. Patients may also have the option to be treated on a clinical trial which is meant to help improve current treatments (standard of care) or obtain information on new treatments for patients with cancer. Most patients will need a combination of surgery, radiation treatment, and chemotherapy. It is important is discuss all treatment options with your medical oncologist.

Recurrent parathyroid cancer is cancer that has returned after it has been treated. If the physician thinks it is appropriate, surgery is often the treatment used for recurrent parathyroid cancer. Other treatment options include surgery along with radiation therapy, radiation therapy alone, and chemotherapy. One of the goals of treatment is to decrease blood calcium in the patient’s body and reduce symptoms that increased blood calcium levels may cause. It is important is discuss all treatment options with your medical oncologist.