Parathyroid Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Parathyroid Cancer
Approximately 40% to 60% of patients experience a postsurgical recurrence, typically between 2 to 5 years after the initial resection.[1,2] Because it is difficult to establish a histologic diagnosis of parathyroid cancer at the time of initial surgery, the appearance of recurrent or metastatic tumor can be the first sign of malignancy.
Because these tumors are slow-growing, repeated resection of local recurrences and/or distant metastases can result in significant palliation.[4,5,6,7,8] Pulmonary metastases as well as bone metastases should be resected, if possible, to decrease the magnitude of the hypercalcemia.[7,9] Occasionally, long-term salvage is achieved in this group of patients with aggressive surgical treatment. The major morbidity of recurrent or metastatic parathyroid cancer results from severe hypercalcemia, which can be difficult to control. For patients not fit for surgery, treatment with bisphosphonates, plicamycin, calcitonin, and gallium pamidronate may control hypercalcemia. Control of malignant hypercalcemia with these medical measures is often only temporary. (Refer to the PDQ summary on Hypercalcemia for more information.)
Sweats and hot flashes are common in cancer survivors, from those in the adjuvant setting to those living with advanced disease. Pathophysiologic mechanisms are complex. Treatment options are broad-based, including hormonal agents, nonhormonal pharmacotherapies, and diverse integrative medicine modalities.
Physiologically, sweating mediates core body temperature by producing transdermal evaporative heat loss.[2,3] Sweating occurs in disease states such as fever and in nondisease...
Surgical removal of the local recurrence with surgical removal of metastases when possible. Because parathyroid carcinoma can be slow-growing, resection of local recurrences or distant metastases can bring effective palliation but can rarely cure. Debulking of functional carcinomas may help reduce parathormone production.
Chemotherapy. Anecdotal reports show that short-term remissions with chemotherapy are possible.[10,11]
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent parathyroid cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
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