Treatment Options for Parathyroid Cancer
Parathyroid cancer, or parathyroid carcinoma, is a rare cancer that begins in the parathyroid glands, which regulate calcium levels through the release of parathyroid hormone (PTH). It occurs when abnormal cells in these glands multiply and form a tumor.
The objectives of treating parathyroid cancer are different depending on the individual's situation. These objectives include:
- Cure the cancer: The main goal, when possible, is to remove all cancerous tissue to achieve a complete cure. This is usually attempted through surgery, aiming to remove the tumor entirely.
- Control cancer growth: If a full cure isn’t possible, treatment focuses on slowing the cancer’s spread. Surgery to remove as much of the tumor as possible, followed by chemotherapy or radiation therapy, may help limit growth and manage the disease.
- Manage symptoms and calcium levels: Because parathyroid cancer often leads to high calcium levels (hypercalcemia), treatment also aims to relieve symptoms like fatigue, nausea, and bone pain. Medications taken orally or through IV can lower calcium levels and prevent bone breakdown, providing symptom relief and better quality of life.
- Prevent cancer recurrence: In some cases, additional treatments, such as chemotherapy or radiation, are used after surgery to kill any remaining cancer cells and decrease the risk of the cancer returning.
- Provide supportive care for recurrence: For cases where the cancer returns, options include additional surgeries, radiation, chemotherapy, and medications to control calcium levels. Supportive care can also help manage symptoms and improve comfort.
Each treatment goal is personalized based on the individual’s needs, and patients are encouraged to discuss options with their healthcare team to understand the best approach for their situation.
The recommended potential treatments for parathyroid cancer include:
- Surgery: Surgery is considered the only effective therapy for parathyroid cancer. The main surgical procedure for parathyroid cancer is called en bloc resection. This involves removing the tumor along with any potential areas of invasion during the initial operation. En bloc resection has been shown to have a lower incidence of local recurrence compared to standard parathyroidectomy.
- Medical management of hypercalcemia: For parathyroid cancer, controlling high blood calcium levels (hypercalcemia) is essential. Treatments include IV fluids, diuretics, and medications like bisphosphonates, gallium, or mithramycin. These treatments lower calcium levels and relieve symptoms caused by hypercalcemia.
- Calcimimetic agents: These drugs reduce parathyroid hormone production, helping manage calcium levels. Calcimimetics offer a newer treatment option for controlling primary hyperparathyroidism (HPT) associated with parathyroid cancer.
- Radiation therapy: Radiation therapy may be used as a treatment option for parathyroid cancer tumors located in one location or in cases where the cancer has come back. It involves using high-energy radiation beams to target and destroy cancer cells. Radiation therapy can be used alone or in combination with surgery to improve outcomes.
- Supportive care: Supportive care focuses on managing symptoms and complications associated with parathyroid cancer, particularly hypercalcemia. It includes measures to treat excessive calcium levels in the blood and maintain overall well-being.
It's important to note that these are potential treatments for parathyroid cancer, and the specific treatment plan should be determined by a healthcare professional based on individual circumstances. As always, it's recommended to consult with a doctor before starting any new treatment or medication.