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Parathyroid Cancer

Parathyroid cancers are extremely rare, and in most cases, one of the early symptoms of this disease is the increased levels of parathyroid hormone and calcium in the bloodstream.

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Overview

Parathyroid cancer happens when the cells in the parathyroid glands start dividing abnormally.

Parathyroid glands synthesise parathyroid hormone (PTH), whose key function is to regulate calcium levels in the blood and bones.

Parathyroid cancers are extremely rare, and in most cases, one of the early symptoms of this disease is the increased levels of parathyroid hormone and calcium in the bloodstream.

Its rare occurrence makes it one of the challenging diseases to diagnose accurately.

Symptoms

In a few cases, the patient may not show any symptoms. Usually, one of the first symptoms shown by parathyroid cancer patients is the increased levels of calcium. Following are main symptoms of parathyroid cancers that one must keep an eye on:

  • Sudden stomach pain
  • Bone pain
  • Extreme tiredness
  • Kidney problems – pain in the upper back and excessive urination
  • Presence of a lump in the neck
  • Difficulty with speaking
  • Change in the voice
  • Nausea and vomiting
  • Loss of appetite
  • Excessive thirst
  • Confusion and depression
  • Insomnia or sleeplessness
  • A general feeling of illness or discomfort
  • Constipation
  • Bone fractures
  • Hampered thinking capabilities

The above symptoms could be caused due to other illnesses as well; therefore, for a conclusive diagnosis, a thorough check-up needs to be done.

Causes

There are no known causes that are associated with parathyroid cancers. However, researchers have identified a few factors that can increase the risk of parathyroid cancers:

  • Certain Inherited Genetic Conditions: Those individuals diagnosed with a few inherited genetic disorders, namely multiple endocrine neoplasia (MEN1), multiple endocrine neoplasia type 2A (MEN2A), familial isolated hyperparathyroidism (FIHP), etc., are at a higher risk of developing parathyroid cancers.
  • Family History of Parathyroid Cancers: Those having a family history of parathyroid cancers are also at an increased risk of getting diagnosed with parathyroid cancers.
  • Hyperparathyroidism Jaw Tumour (HPT-JT): This is also an inherited condition wherein the parathyroid glands show overactivity. Those diagnosed with this condition are at an increased risk of developing parathyroid cancers.
  • Radiation Therapy to the Neck Region: Those who have received radiation therapy for cancers in the neck region are also at a higher risk of getting parathyroid cancers.

Diagnosis

There are multiple diagnostic methods used by doctors to detect and diagnose parathyroid cancers.

a. Medical History Assessment and Physical Exam: Before any test, the doctor thoroughly examines the patient for the signs of parathyroid cancers, such as the lump in the neck, pain or any other discomfort, etc. He/she may also study the patient’s medical history to know about underlying medical conditions, previous medical treatments, allergies, etc. If tumour growth is suspected, the doctor will recommend additional tests.

b. Blood Tests: The doctor may recommend blood tests in order to check for high levels of calcium, which is one of the symptoms of parathyroid cancers. The doctor may also recommend tests to check the levels of parathyroid hormone as high levels of this hormone could be caused by parathyroid cancer.

c. Imaging Tests: Imaging tests, namely CT scan, SPECT scan, ultrasound, etc., may be recommended in order to obtain detailed information on the structure and functioning of the parathyroid glands. These tests help doctors with crucial information like the exact location of the tumour, the tumour size, etc. The data from these tests help doctors in staging the disease, planning the treatment and monitoring the treatment response.

d. Venous Sampling: During this procedure, the blood sample is collected from a specific vein and analysed to determine the levels of specific components produced into the blood by surrounding organs and tissues. If imaging studies fail to reveal which parathyroid gland is overactive, blood samples from veins close to each parathyroid gland may be collected to determine which one is producing PTH (Parathyroid Hormone) in excess quantities.

e. Biopsy: During the biopsy, a small portion of the tissue is collected from the parathyroid gland and examined under a microscope for the presence of cancer cells.

Treatment

Upon receiving a confirmed diagnosis, the treatment planning for parathyroid cancers is made upon considering various factors, such as the stage of the disease, exact location, the patient’s age, his/her overall condition and preferences.

The main treatment options available for parathyroid cancers include surgery, radiation therapy and chemotherapy. The doctor may also recommend medications to regulate the calcium levels in the blood.

a. Surgery: Surgery removes the parathyroid tumour along with a small portion of healthy tissues. Before the surgery, the doctor may recommend medications to bring down the high levels of calcium.

In a few cases, the doctor may recommend the removal of the parathyroid gland depending on the severity of the condition.

b. Radiation Therapy: During radiation therapy, high-energy radiation beams are used to destroy the cancer cells. During parathyroid cancer treatment, radiation therapy may be administered after the surgery in order to destroy the residual cancer cells. It may also be recommended in order to alleviate pain and other symptoms caused by the disease.

c. Chemotherapy: During chemotherapy, powerful anticancer drugs are used to destroy cancer cells throughout the body. Chemotherapy may be administered orally, intravenously or intramuscularly. This treatment modality may be combined with other treatment options in order to enhance the effectiveness of the overall treatment.

Frequently Asked Questions

1. Are parathyroid cancers treatable?

Yes, parathyroid cancers are treatable. There are various treatment options available for the successful management of parathyroid cancers.

However, it is important for patients to not ignore any symptoms and seek medical attention if any symptoms last for more than two weeks. This is because delayed diagnosis negatively impacts the clinical outcomes and survival rates.

2. What are the side effects associated with parathyroid cancer treatment?

Depending on the treatment given the side effects may vary from patient to patient. Possible side effects include mouth sores, hair loss, nausea and vomiting and pain.

Most of the side effects wear off over time. Nevertheless, if the side effects are hard to manage or do not subside, the patient must seek medical help.

3. Do parathyroid cancers come back?

Yes, parathyroid cancers can come back. Their rare occurrence makes it one of the challenging cancers to treat when it recurs.

In order to reduce the risk of recurrence, patients need to diligently keep up their follow-up appointments after the treatment.

4. Can I prevent parathyroid cancer?

Parathyroid cancers are not associated with any major environmental or lifestyle risk factors, and therefore, there are no known ways to prevent parathyroid cancers.

However, if you are a high-risk individual, i.e., if you are diagnosed with Hyperparathyroidism Jaw Tumour (HPT-JT), or have a family history of genetic disorders, namely MEN1 and MEN2A or have received radiation therapy to the neck region, you may have to talk to your doctor to understand the best practices that can help you reduce your risk of developing parathyroid cancers.

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