Finding out you have a rare health condition can feel overwhelming and scary. You might worry about what the future holds or what treatments you will need. Take a deep breath because you are not alone on this journey. Understanding your diagnosis is the very first step toward feeling more in control of your health.
Today, we are going to talk about a very rare condition called parathyroid cancer. While it sounds frightening, learning the facts can help clear up confusion. Let us break down what this condition means, how doctors find it, and what treatment options are available to you.
Key Takeaways
- Parathyroid cancer is an extremely rare type of cancer affecting the tiny parathyroid glands in your neck.
- It often causes high calcium levels in your blood, a condition known as hypercalcemia.
- Surgery to remove the affected gland is the primary and most effective treatment option.
- Doctors use blood tests and imaging scans to diagnose and monitor the condition closely.
- Knowing the signs and symptoms helps you seek medical advice and support right away.
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What Is Parathyroid Cancer?
Simply put, parathyroid cancer is a rare type of cancer that starts in the tissues of your parathyroid glands. Your parathyroid glands are normally located in the front part of your neck, sitting right behind your butterfly-shaped thyroid gland.
Unlike many other types of cancer, doctors do not use a standard four-stage naming system for parathyroid cancer. Instead, doctors divide this condition into three main categories based on how it behaves:
- Localized Cancer: The cancer stays entirely inside your parathyroid gland. Sometimes it may spread slightly into nearby tissues. This means the cancer is still contained in one local area.
- Metastatic Cancer: The cancer spreads to other parts of your body. This can include your lymph nodes, liver, lungs, bones, or pancreas. About 10% to 30% of people have metastatic parathyroid cancer when they first receive their diagnosis. The lungs, bones, and liver are the most common sites for spreading.
- Recurrent Cancer: The cancer comes back after your initial treatment, which is usually surgery to remove the cancerous gland. More than half of people with parathyroid cancer experience a recurrence. It usually happens between two and five years after the first surgery. However, it can sometimes return even 20 years later.
What Are the Parathyroid Glands?
Most of us have four tiny parathyroid glands, each about the size of a grain of rice. As mentioned before, they sit right behind your thyroid gland. Just like your thyroid gland, your parathyroid glands are a part of your body system called the endocrine system. Sometimes, these glands can also be found along your food pipe or inside your chest. Doctors call these misplaced glands ectopic parathyroid glands because they are not in their usual spot.
The main job of your parathyroid glands is to make a chemical messenger called parathyroid hormone, or PTH for short. This hormone controls the amount of calcium in your blood. Sometimes, one or more of these glands start making way too much parathyroid hormone. Doctors call this condition primary hyperparathyroidism. When your body makes extra parathyroid hormone, your blood calcium level goes up. This high calcium level is known as hypercalcemia.
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What Is the Difference Between Parathyroid Cancer and a Parathyroid Adenoma?
A parathyroid adenoma is a non-cancerous, or benign, growth on a parathyroid gland. On the other hand, parathyroid cancer involves cancerous, or malignant, cells growing in your parathyroid tissues. Among gland issues, benign adenomas happen much more often than parathyroid cancer.
Here is the most important thing to know: in both parathyroid cancer and a parathyroid adenoma, your parathyroid gland becomes overactive. It produces too much parathyroid hormone. This leads to hypercalcemia, which can harm your health and body. Because of this, the main treatment for both conditions is removing the overactive gland with surgery.
Even doctors sometimes find it hard to tell the difference between an adenoma and parathyroid cancer before surgery. Their cells can look very similar under a microscope. Therefore, after a surgeon removes the overactive gland, they run extra laboratory tests to confirm whether it is an adenoma or cancer.
What Is Hypercalcemia and How Does It Relate to Parathyroid Cancer?
Hypercalcemia means your blood calcium level is higher than normal. Many people with parathyroid cancer develop hypercalcemia. This happens because the cancer makes your parathyroid gland overactive and produces a large amount of parathyroid hormone. Since parathyroid hormone regulates your blood calcium, having extra hormone causes your blood calcium to rise.
Hypercalcemia can be harmful to your health and body. Because of this, treating the hypercalcemia is just as important as treating the parathyroid cancer itself.
Are There Different Types of Parathyroid Cancer?
Yes, there are two main types of parathyroid cancer.
1. The More Common Type: In this type, the cancer cells cause your parathyroid gland to make too much parathyroid hormone. It releases this hormone into your blood, which raises your blood calcium level.
2. Non-functioning Parathyroid Carcinoma: This type is also known as non-secreting parathyroid carcinoma. It is very different from the first type. People with this type of cancer do not have high parathyroid hormone levels or high calcium levels in their blood. This type is extremely rare and occurs in less than 10% of parathyroid cancer patients.
Once doctors diagnose parathyroid cancer, they run further tests to see if it is localized, metastatic, or recurrent. As mentioned earlier, doctors do not use the standard four-stage system for this condition.
Who Is Most Likely to Get Parathyroid Cancer?
This cancer affects women and men equally. Doctors usually find it in adults who are over the age of 30.
How Common Is This Condition?
Parathyroid cancer is an extremely rare disease. Think about it this way: it accounts for only about 0.005% of all cancer cases. Also, it makes up only 0.5% to 1% of all parathyroid gland conditions. So, finding this condition is truly a rare occurrence.
What Causes Parathyroid Cancer?
Doctors still do not know the exact cause of parathyroid cancer.
However, doctors consider certain rare inherited genetic conditions as risk factors for this cancer:
- Multiple endocrine neoplasia type I (MEN1).
- Familial isolated hyperparathyroidism (FIHP).
- Hyperparathyroidism-jaw tumor syndrome.
Also, if you received radiation therapy to your head or neck in the past, it might raise your risk of developing parathyroid cancer.
What Are the Symptoms of Parathyroid Cancer?
Often, the symptoms of parathyroid cancer are actually symptoms of hypercalcemia caused by the disease. The signs and symptoms of hypercalcemia can include:
- Needing to pee more often than usual .
- Feeling much thirstier than normal .
- Feeling sick to your stomach and vomiting .
- Not feeling hungry like you normally do .
- Having trouble with constipation .
- Feeling very tired all the time .
- Feeling down or having depression .
- Forgetfulness or having trouble remembering things .
- Muscle aches, weakness, or feeling stiff .
Other possible signs of parathyroid cancer include:
- Feeling a lump in your neck .
- Changes in your voice or sounding hoarse .
- Trouble swallowing your food .
If you have one or more of these signs, do not panic and assume it is parathyroid cancer. Many other health conditions can cause these exact same symptoms. However, if these issues continue for a long time, the best thing to do is see a doctor and get advice.
How Do Doctors Diagnose Parathyroid Cancer?
Diagnosing parathyroid cancer can sometimes be quite challenging. One reason is that the cells of a non-cancerous parathyroid adenoma look very similar to the cells of parathyroid cancer.
Often, doctors diagnose parathyroid cancer only after they remove your abnormal, overactive parathyroid gland with surgery, known as a parathyroidectomy. Sometimes, the surgeon might even realize it is parathyroid cancer right during the operation.
What Tests Are Used for Diagnosis?
As mentioned, doctors usually diagnose parathyroid cancer after they remove an overactive parathyroid gland during treatment for primary hyperparathyroidism. Before your surgery to remove the gland, your doctor may order tests such as:
- Blood calcium test.
- Blood PTH test.
- Parathyroid scan: This is usually a radioactive sestamibi scan and/or a CT scan.
If doctors diagnose you with parathyroid cancer, your doctor may order imaging tests to see if the cancer has spread to other parts of your body:
- CT scan: A CT scan uses X-rays and a computer to create many 3D pictures of your body.
- MRI scan: An MRI scan uses a large magnet, radio waves, and a computer to create detailed pictures of your inside body parts. It does not use X-rays or radiation.
What Treatments Are Available for Parathyroid Cancer?
The main treatment option for parathyroid cancer is surgical removal of the cancerous gland, often called an en bloc resection. If the cancer has spread, your surgeon may also need to remove tissues around your parathyroid gland or cancer cells in other parts of your body.
Surgeons may use these surgical methods for parathyroid cancer:
- En Bloc Resection: The surgeon removes your entire parathyroid gland along with its outer covering. Sometimes, they also need to remove half of the thyroid gland on the same side, along with nearby tissues, muscles, and nerves.
- Tumor Debulking: The surgeon removes as much of the tumor as possible. Sometimes, doctors cannot remove certain tumors completely.
- Metastasectomy: The surgeon removes any cancer that has spread to other tissues or organs, such as your lungs.
Will I Need Chemotherapy or Radiation Therapy?
Doctors usually do not use chemotherapy and radiation therapy to treat parathyroid cancer. Your doctor will decide if any chemotherapy or radiation options might work for your specific situation.
Are There Medicines for Parathyroid Cancer?
Currently, doctors have not found medicines specifically made to cure parathyroid cancer. Many people with parathyroid cancer develop symptoms of hypercalcemia. Because hypercalcemia is harmful, your doctor may ask you to take one or more of these medicines:
- Cinacalcet (Sensipar).
- Bisphosphonates.
- Denosumab (XGEVA).
If you have severe symptoms of hypercalcemia, your doctor may recommend that you go to the hospital right away to receive intravenous fluids and other urgent treatments.
| Treatment Type | Primary Goal / Common Use |
|---|---|
| Surgery (En Bloc Resection) | Primary Goal: Remove the cancerous gland and nearby tissues completely. Common Use: Main and most effective treatment option. |
| Medicines (Cinacalcet, etc.) | Primary Goal: Lower high blood calcium levels (hypercalcemia). Common Use: Used to manage calcium symptoms safely. |
| Chemo / Radiation | Primary Goal: Target remaining cancer cells. Common Use: Rarely used, as standard options have limited effect. |
Can My Parathyroid Cancer Come Back?
Yes, more than half of people diagnosed with parathyroid cancer experience a cancer recurrence. Usually, the cancer comes back within a few years, typically between two and five years after the first surgery. However, in some cases, this can happen many decades—even 20 years or more—after your first diagnosis.
Can This Cancer Spread to Other Parts of My Body?
Yes, parathyroid cancer can spread to other parts of your body. Between 10% and 30% of people have metastatic disease when doctors first diagnose them. When it spreads, it most often goes to your lungs, bones, or liver. However, it can also spread to your lymph nodes or pancreas.
What Is the Outlook or Prognosis for Parathyroid Cancer?
Your outlook depends greatly on how completely surgeons can remove the parathyroid gland during your very first operation, since secondary options like radiation and chemotherapy are quite limited.
For patients who undergo a complete en bloc resection where tests confirm no cancer cells remain around the removed gland margins, the five-year survival rate after the first surgery is up to 90%. Also, the ten-year survival rate is about 67%.
As noted, more than half of patients experience a recurrence, usually within two to five years, though it can sometimes happen decades later.
Can Parathyroid Cancer Be Prevented?
Unfortunately, doctors do not know any way to prevent parathyroid cancer. There is also no known way to lower your risk of getting this disease. If anyone in your family has a history of parathyroid gland conditions, talking about it with your doctor is a good idea.
What Questions Should I Ask My Doctor?
If you have parathyroid cancer, you may want to ask your doctor questions such as:
- Has the cancer spread outside my parathyroid gland?
- What is the best treatment option for my parathyroid cancer?
- What are the risks and side effects of these treatments?
- Do my family members face a risk of getting parathyroid cancer?
- Can my parathyroid cancer come back in the future?
- Am I at risk for developing other types of cancer?
- What follow-up care will I need after finishing treatment?
- Should I watch out for specific signs of complications?
When to Seek Emergency Help
If you or someone you care for experiences severe symptoms of very high calcium levels—such as extreme confusion, severe drowsiness, chest pain, irregular heartbeat, or fainting—call 911 (US/Canada) or 999 (UK) right away, or go straight to the nearest Emergency Department (ER or A&E).
Final Thoughts to Keep in Mind
Finding out you have cancer is truly scary. But remember that your medical team is there to support you and guide you toward the best treatment path. Although surgery is currently the primary treatment for parathyroid cancer, researchers continually improve cancer therapies and explore new clinical trials. Do not ever be afraid to ask your doctor questions so you can understand everything clearly.
Sources & References:
- Cleveland Clinic: Parathyroid Cancer Overview and Treatment Options.
- Mayo Clinic: Parathyroid Cancer Diagnosis and Management.
- NHS UK: Overview of Parathyroid Gland Disorders and Cancers.
- National Institutes of Health (NIH) / PubMed: Clinical Characteristics and Outcomes of Parathyroid Carcinoma.
- Centers for Disease Control and Prevention (CDC): Health Information Resources.
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