On rare occasions, cancer may develop within the parathyroid gland. Parathyroid cancer is almost always associated with extremely high parathyroid hormone (PTH) levels — typically in the thousands. It is also occasionally associated with a genetic defect and can run in families.
If you are diagnosed with parathyroid cancer, your prognosis depends on whether the cancer is contained within the parathyroid gland or has spread (metastasized) to other areas, such as the lymph nodes or lungs. Parathyroid cancer, however, is usually not aggressive.
Treatment for parathyroid cancer
Two kinds of treatment are available for parathyroid cancer: surgery and/or radiation therapy. Surgery is the most common treatment and is by far the preferred strategy.
Surgery involves removing your parathyroid gland and the half of your thyroid on the same side as your cancer. The decision to operate, however, depends on the size of the tumor, its location, and whether or not the cancer has spread to other tissues.
To determine whether the cancer has spread to your lymph nodes, your doctor will take tissue samples. If your doctor finds enlarged lymph nodes, he or she will remove all of the lymph nodes in that part of your neck.
Although radiation therapy is used in many cases to kill cancer cells and shrink tumors, it is rarely used in the initial treatment of parathyroid cancer. If your cancer reappears after some time has passed, or if it has grown into other structures at the time of the initial operation, your doctor may choose radiation as an additional therapy.
Radio-guided parathyroid surgery
Minimally invasive radio-guided parathyroid surgery works extremely well for parathyroid cancer. During this therapy, your doctor makes your parathyroid cells radioactive by injecting a mild radioactive substance that is absorbed by the overactive cells. Then, using a very small, pencil-sized radiation detector, he or she can tell where the overactive parathyroid cells are located in your body.
Your surgeon will then make a small, 0.5 inch to 2 inch incision directly over your parathyroid gland. After removing the enlarged gland, your surgeon will perform a blood test to check your parathyroid hormone level. This will take place in the operating room while you are still under anesthesia. The blood test will enable your surgeon to confirm that all enlarged parathyroid glands have been removed before you leave the operating room.
Because malignant, over-active parathyroid cells produce parathyroid hormone, your doctor will take a blood sample each year to measure your level of this hormone. If your level of parathyroid hormone is unusually high, you may need to undergo another radio-guided parathyroid operation to rid yourself of the cancer.
We can help
Our parathyroid cancer specialists function as part of The Tisch Cancer Institute — a multi-disciplinary research and clinical care institution whose membership encompasses all Mount Sinai physicians and researchers whose work involves cancer. Call us today to make an appointment. We care, and we can make a difference.