Treatment
Treatment of parathyroid cancer and parathyroid adenomas usually consists of palliative treatments to reduce the effects of hypercalcemia, and surgery to remove the malignant or overactive gland. Chemotherapy and radiation therapy are generally ineffective against this cancer. The doctor may recommend any of the following treatments for parathyroid cancer.
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Surgery
Surgery is the primary treatment for parathyroid cancer, and the only way to effectively cure the disease. The doctor usually makes an incision in the neck, locates the malignant parathyroid gland, and examines the thyroid gland and other nearby tissue for any signs of involvement. The doctor then removes the parathyroid tumor, along with nearby lymph nodes, half of the thyroid gland, and any muscles, tissues, or nerves that the cancer has invaded. By removing these nearby tissues, the doctor can reduce the chance of a recurrence. The doctor may also surgically remove any tumors that have spread to other parts of the body. Surgery is also the primary treatment for any metastatic or recurrent tumors, as this disease is usually slow-growing. Removing any metastatic or recurrent tumors can greatly reduce the effect of hypercalcemia.
Chemotherapy
Chemotherapy is the use of drugs to target rapidly growing cells in an effort to eliminate cancer cells. Most of these medications are given through the vein (intravenously). Chemotherapy may be given before and after surgery for bone cancer to decrease the chances of the cancer recurring. Chemotherapy may also be given to patients whose cancer has metastasized (spread) to other parts of the body.
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Radiation Therapy
Radiation therapy uses waves of high-energy rays produced by a machine to kill cancer cells. Radiation therapy is generally ineffective in treating parathyroid cancer, but may be used after surgery to reduce the risk of a recurrence. It may also be used as a palliative treatment to shrink any tumor that has grown into nearby structures.
Palliative Treatments
Treatment for parathyroid cancer almost always includes palliative treatments to combat the effects of hypercalcemia. The hypercalcemia caused by parathyroid cancer is usually more dangerous than the tumor itself, and can lead to life-threatening complications, such as coma, irregular heartbeats, and kidney dysfunction. The doctor may recommend IV fluids to re-hydrate the patient, or medications such as bisphosphonates, calcitonin, or denosumab to help lower and control the levels of calcium in the blood. Cinacalcet is approved in the management of parathyroid carcinoma. It is an oral drug that helps lowering parathyroid hormone levels and thus lowering the calcium.
Clinical Trials
Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.
