The initial operation should include an en bloc resection of the tumor that takes care to avoid rupture of the tumor capsule and to ensure that the margins are free of tumor. This procedure will involve a parathyroidectomy, typically an ipsilateral thyroidectomy (thyroid lobectomy), and possibly resection of adjacent cervical muscles, paratracheal tissues, and the recurrent laryngeal nerve, if involved. Lymphadenectomy, beyond that necessary to achieve an en bloc excision of the primary malignancy, is not indicated unless enlarged or firm nodes clinically indicate the presence of nodal disease. Local recurrence may be minimized by this en bloc resection approach. Preoperative medical management to lower elevated calcium levels and to correct other metabolic disturbances that are due to hyperparathyroidism is critical.
Check NCI's list of cancer clinical trials for cancer CAM clinical trials on marijuana, nabilone, dronabinol and nabiximols that are actively enrolling patients.
General information about clinical trials is available from the NCI Web site.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with localized 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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Sandelin K, Auer G, Bondeson L, et al.: Prognostic factors in parathyroid cancer: a review of 95 cases. World J Surg 16 (4): 724-31, 1992 Jul-Aug.
Clayman GL, Gonzalez HE, El-Naggar A, et al.: Parathyroid carcinoma: evaluation and interdisciplinary management. Cancer 100 (5): 900-5, 2004.
Munson ND, Foote RL, Northcutt RC, et al.: Parathyroid carcinoma: is there a role for adjuvant radiation therapy? Cancer 98 (11): 2378-84, 2003.
Chow E, Tsang RW, Brierley JD, et al.: Parathyroid carcinoma--the Princess Margaret Hospital experience. Int J Radiat Oncol Biol Phys 41 (3): 569-72, 1998.
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