The parathyroid glands are four tiny glands attached to the thyroid. They are located under the Adam’s apple in your neck.
Parathyroid cancer, like other cancers, happens when cells grow out of control. Doctors don’t know exactly what causes it.
This is a rare type of slow-growing cancer. There are not even 100 cases a year in the United States. People who get it are usually 30 or older.
The thyroid helps control how your body uses calcium. Calcium makes bones strong. It helps muscles and nerves do their jobs. The parathyroid glands play a role in this process. They make a hormone that helps the body store and use calcium. It’s called PTH, for parathyroid hormone.
Signs of Parathyroid Trouble
There are many ways to tell if there’s too much calcium in your blood. It’s usually the way doctors find parathyroid cancer.
These can be symptoms:
- Feeling weak or tired
- Upset stomach and vomiting
- Stomach or back pain
- Poor appetite
- Weight loss
- Lots of peeing
- Trouble pooping
- Not thinking clearly
- A lump in the neck (rare)
- Bone pain
- Hoarse voice
- Trouble swallowing
- Kidney problems
These signs can point to problems that aren’t parathyroid-related too. That’s why it’s important to see your doctor if you think you might have this type of cancer. Your regular doctor may send you to other doctors who are experts in the thyroid and other glands (endocrinologist) or cancer (oncologist).
Possible Causes and Tests
Some possible causes of parathyroid cancer:
- Radiation (treatment with X-rays or other kinds of energy) to the neck
- Familial Isolated Hyperparathyroidism -- a condition that can cause kidney stones, nausea, vomiting, high blood pressure, weakness, and fatigue
- MEN1 syndrome (multiple endocrine neoplasia type 1) -- a condition connected to tumors of hormone-producing glands
These things can help your doctor find out what’s going on:
- Exam and history. Your doctor looks at you and checks for lumps or other things that don’t seem normal. She will also ask questions about your current health and your family’s medical history.
- Blood and urine tests. These look for high levels of calcium and PTH in your blood or your pee. Follow the doctor’s orders before the test to make sure you get the best results.
- Parathyroid scan. This test shows if the parathyroid makes too much PTH. This is done as an outpatient at the hospital. You will get a shot that contains radioactive material. Then you will lie still for about 30 minutes while pictures are taken of your head and neck. Later, more pictures will be taken and compared with the first set.
- CT (CAT) scan. A computer and X-rays are used to take detailed pictures inside your body.
- MRI (magnetic resonance imaging). It uses a computer, X-rays, and a magnet to create detailed pictures.
- Ultrasound. This uses special sound waves to make an image called a sonogram.
- Angiogram. A special dye is shot into a blood vessel. As it moves through your body, X-rays are taken to see if there are any blockages.
- Venous (vein) sampling. Blood is taken from different veins and tested to see which parathyroid gland is making more PTH than it should.
If your doctor finds parathyroid cancer, she will check to see if it’s spread. Sometimes cancer will break away and form a new tumor somewhere else in the body. Treatment is different in each case.
- Surgery is the most common treatment for parathyroid cancer. The surgeon may take out just the tumor or remove other tissues too, if the cancer has spread to other places.
- Radiation therapy uses X-rays and other strong energy to attack the cancer cells. Radiation may be used before or after surgery.
- Radiofrequency ablation uses heat to kill cancer cells. It also reduces the PTH level.
- Chemotherapy uses medicines to kill the cancer. The type of medicine depends on the tumor.
- Clinical trials are tests in which doctors try new drugs and methods. Ask your doctor if you’re a good candidate for one of these.
After treatment, your doctors will want you to come in for tests to be sure you’re doing well. It’s important to do this.
Any cancer is difficult. Your friends and family can help. But you might feel you need extra support. That’s normal. Your health care team can find people to help you, groups you can join, and ways to stay positive and focused on getting better.