Parathyroid Cancer

Parathyroid cancer starts in one of the four tiny parathyroid glands, which sit behind the thyroid gland in the front of your neck. These glands help control the level of calcium in your body.

Parathyroid cancer is very rare. It is often found because it causes high levels of calcium in the blood.

Types & Stages

There are two main forms of parathyroid cancer:

• Functioning tumors. These are the more common form. They cause the parathyroid gland to make too much parathyroid hormone, which raises the calcium level in the blood.
   
• Non-functioning tumors. These are very rare. They do not raise parathyroid hormone or calcium levels.

After diagnosis, parathyroid cancer is usually described in one of three ways:

• Localized. The cancer is found in the parathyroid gland and may have grown into nearby tissue.
   
• Metastatic. The cancer has spread to other parts of the body, such as the lungs, bones, or liver.
   
• Recurrent. The cancer has come back after treatment. This can happen years later, so long-term follow-up is important.

Signs & Symptoms

Many symptoms of parathyroid cancer come from high calcium levels in the blood. These may include:

• Frequent urination
• Increased thirst
• Nausea or vomiting
• Poor appetite
• Constipation
• Fatigue
• Feeling depressed
• Memory problems or forgetfulness
• Muscle weakness, aches or cramps

Other possible symptoms include:

• A lump in the neck
• Voice changes or hoarseness
• Trouble swallowing

Many of these symptoms can be caused by conditions that are not cancer. Still, if a symptom is new, lasting, or worries you, talk with a healthcare provider.

Diagnosis

Parathyroid cancer can be hard to diagnose before surgery, because benign (noncancerous) and cancerous tumors can look very much alike. In many cases, the diagnosis is confirmed only after the overactive gland is removed and the tissue is examined.

Tests and procedures used to help diagnose parathyroid cancer may include:

• Blood calcium test. This checks whether your calcium level is too high.
   
• Blood parathyroid hormone (PTH) test. This measures the level of parathyroid hormone in your blood.
   
• Parathyroid scan. An ultrasound or a nuclear scan can help locate an overactive or enlarged gland.
   
• Other imaging tests. A CT, MRI, or PET scan may be used when needed to see whether the cancer has spread.

Treatment

Surgery is the main treatment for parathyroid cancer. Your care team can help explain the benefits and risks of each option.
Treatment may include:

• Removal of the affected gland. The surgeon removes the cancerous parathyroid gland along with nearby tissue. In some cases, part of the thyroid or other nearby tissue may also be removed.
   
• Removing as much tumor as possible. If the tumor cannot be fully and safely removed, the surgeon takes out as much as possible to help control the cancer.
   
• Surgery to remove spread. In select cases, surgery may be used to remove cancer that has spread to other areas, such as the lungs.

When the cancer cannot be fully removed or has spread, other treatments may also be considered. Clinical trials may be an option as well. These studies test new treatments or new ways to use current ones. Ask your care team whether a clinical trial may be right for you.

Causes & Risk Factors

The exact cause of parathyroid cancer is not known. Some factors may raise the risk, including:

• Age. It usually occurs in people older than 30.
   
• Radiation exposure. Past radiation to the head and neck, or radiation exposure in the workplace, may increase risk.
   
• Rare inherited disorders. Some genetic conditions passed down in families can raise the risk, including:
  • Multiple endocrine neoplasia type 1 (MEN1)
  • Familial isolated hyperparathyroidism (FIHP)
  • Hyperparathyroidism-jaw tumor syndrome

Having a risk factor does not mean you will develop parathyroid cancer, and many people with the disease have no clear risk factors. Talk with your healthcare provider about your personal risk.

Screening

There is no routine screening test for parathyroid cancer.
Because there is no screening test, it is important to pay attention to your body and report any symptoms, such as those linked to high calcium levels or a lump in the neck. Regular checkups with your doctor can also help catch problems early.
If you have symptoms that are new, lasting, or unusual for you, talk with a healthcare provider about whether further evaluation is needed.
This information is for general education only and is not a substitute for medical advice. Please consult a qualified healthcare provider for diagnosis, treatment recommendations, and guidance based on your personal health history.