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Parathyroid Cancer - Introduction

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Parathyroid Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this entire guide.

About the parathyroid glands

The parathyroid glands are 4 small glands. They are located near the thyroid gland in the neck or chest, which is also called the upper mediastinum. They are part of the endocrine system. Like all parts of the endocrine system, the parathyroid glands play an important role in regulating hormones in the body. These glands make parathyroid hormone (PTH), which regulates the levels of calcium and phosphorus in the blood.

About parathyroid cancer

Cancer begins when healthy cells change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. A parathyroid tumor usually develops in 1 of the 4 parathyroid glands.

A parathyroid tumor, whether it is benign or malignant, can cause significant problems because this type of tumor causes the amount of calcium in the blood to rise, resulting in a serious condition called hypercalcemia. The doctor may need to quickly treat hypercalcemia if the person is having life-threatening symptoms.

This section covers tumors found in the parathyroid glands. Learn more about tumors that begin in the thyroid gland in a separate guide on this same website.

Looking for More of an Introduction? 

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net: 

Cancer.Net En Español: Read about parathyroid cancer in Spanish. Infórmase sobre cáncer de paratiroides en español.

The next section in this guide is Statistics. It helps explain the number of people who are diagnosed with parathyroid cancer and general survival rates. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 11/2020

ON THIS PAGE: You will find a drawing of the main body parts affected by parathyroid cancer. Use the menu to see other pages.

The image is a drawing showing the location of the thyroid gland in the human body and the thyroid’s anatomy. The thyroid is located in the front of the neck. It has 2 lobes, 1 on each side of the neck, joined by a narrow strip of tissue called the isthmus, with a small pyramidal lobe above the isthmus. The right and left lobes each have 2 small parathyroid glands located at the back of the lobe, a superior (upper) and inferior (lower) gland, for a total of 4 parathyroid glands. Copyright 2004 American Society of Clinical Oncology. Robert Morreale/Visual Explanations, LLC.

The next section in this guide is Risk Factors. It explains the factors that may increase the chance of developing parathyroid cancer. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Statistics

Approved by the Cancer.Net Editorial Board, 03/2023

ON THIS PAGE: You will find information about the estimated number of people who will be diagnosed with parathyroid cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors, and no 2 people with cancer are the same. Use the menu to see other pages.

Every person is different, with different factors influencing their risk of being diagnosed with this cancer and the chance of recovery after a diagnosis. It is important to talk with your doctor about any questions you have around the general statistics provided below and what they may mean for you individually. The original sources for these statistics are provided at the bottom of this page.

How many people are diagnosed with parathyroid cancer?

Nearly all tumors that develop in the parathyroid gland are benign. It is important to note that even benign parathyroid tumors need prompt medical care. If they are not removed completely or properly, they can come back and be very difficult to control. This type of tumor may result in hypercalcemia of the blood that is difficult to control or could cause death.

Parathyroid cancer is quite rare. There are likely fewer than 100 cases diagnosed each year in the United States. The disease is most often diagnosed in people older than 30. Men and women are equally affected. Women have a slightly better prognosis, which is the chance of recovery.

What is the survival rate for parathyroid cancer?

There are different types of statistics that can help doctors evaluate a person’s chance of recovery from parathyroid cancer. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having cancer may affect life expectancy. Relative survival rate looks at how likely people with parathyroid cancer are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this cancer.

Example: Here is an example to help explain what a relative survival rate means. Please note this is only an example and not specific to this type of cancer. Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years. Also imagine there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.

It is important to remember that statistics on the survival rates for people with parathyroid cancer are only an estimate. They cannot tell an individual person if cancer will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.

The 10-year relative survival rate for parathyroid cancer ranges broadly, from 80% to 15%. The survival rates for parathyroid cancer vary based on several factors, including stage of cancer, a person’s age and general health, and how well the treatment plan works.

Experts measure relative survival rate statistics for parathyroid cancer every 5 years. This means the estimate may not reflect the results of advancements in how parathyroid cancer is diagnosed or treated from the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society website and Lawrence Kim, MD, "Parathyroid Carcinoma," (updated August 3, 2021). (Both sources accessed March 2023.)

The next section in this guide is Risk Factors. It explains the factors that may increase the chance of developing parathyroid cancer. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Risk Factors

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will find out more about the factors that increase the chance of developing parathyroid cancer. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause the cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

There are no known causes for most parathyroid tumors. However, the following risk factor may increase a person’s chance of developing parathyroid tumors and parathyroid cancer:

  • Family history. A history of parathyroid tumors in a family may raise a person’s risk of developing a parathyroid tumor. A hereditary, or inherited, condition known as multiple endocrine neoplasia may raise an individual’s risk for benign parathyroid tumors. For more information, visit the sections describing multiple endocrine neoplasia type 1 (MEN1) and multiple endocrine neoplasia type 2 (MEN2). All MEN-related parathyroid tumors are benign.

  • Hyperparathyroidism jaw tumor (HPT-JT). This is an inherited condition that causes increased activity in the parathyroid glands. HPT-JT is caused by mutations, or changes, to the CDC73 gene and puts people at a higher risk of developing parathyroid cancer.

There are no known risk factors for people who do not have a family history of parathyroid tumors.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems parathyroid cancer can cause. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will find out more about changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

A person with a parathyroid tumor may experience the following symptoms or signs. Symptoms are changes that you can feel in your body. Signs are changes in something measured, like by taking your blood pressure or doing a lab test. Together, symptoms and signs can help describe a medical problem. Sometimes, a person with a parathyroid tumor does not have any of the symptoms and signs described below. Or, the cause of a symptom may be a medical condition that is not a tumor.

  • Bone pain

  • Kidney problems, including pain in the upper back and excessive urination

  • Stomach pain

  • History of gastroduodenal ulcers, which are ulcers found in the stomach and/or small intestine

  • Weakness

  • Difficulty speaking

  • Vomiting

  • Depression

  • Fatigue

  • Confusion

  • A lump in the neck

  • Insomnia, which is trouble sleeping

  • Malaise, a general feeling of discomfort or illness

The doctor may discover a problem if a blood test shows an increased level of calcium in the blood, a condition called hypercalcemia.

If you are concerned about any changes you experience, please talk with your doctor. You doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

If a parathyroid tumor is diagnosed, relieving symptoms remains an important part of care and treatment. Managing symptoms may also be called "palliative care" or "supportive care." It is often started soon after diagnosis and continued throughout treatment. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Diagnosis

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, a tumor. They also do tests to learn if it is cancerous, and if so, whether it has spread to another part of the body from where it started. If a cancerous tumor has spread, it is called metastasis. Doctors may also do tests to learn which treatments could work best.

For most types of tumors, a biopsy is the only sure way for the doctor to know whether an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. However, for parathyroid cancer, a biopsy is not usually needed to make a diagnosis (see Surgery, below).

How parathyroid cancer is diagnosed

There are many tests used for diagnosing parathyroid cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of tumor suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose a parathyroid tumor:

  • Blood/urine tests. Many types of blood or urine tests may be done if a person has problems with their parathyroid glands. The most common test is a serum calcium test. Elevated serum calcium levels can suggest the presence of a parathyroid tumor or hyperplasia, which are overactive cells, on 1 or more glands. Another common laboratory test looks for elevated levels of the parathyroid hormone (PTH) and phosphorus levels in the blood. Doctors may suspect parathyroid cancer if these blood tests find a very high level of calcium and/or PTH.

  • Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these images into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Sestamibi/SPECT scan. SPECT is a type of CT scan (see above), and it stands for “single proton emission computed tomography.” A sestamibi/SPECT scan is a procedure in which a specific protein, called sestamibi, is mixed with a radioactive material and injected into the patient’s vein. A parathyroid tumor will absorb the material, and the tumor will be visible on an x-ray of the neck. A sestamibi/SPECT scan may be recommended if laboratory tests show an elevated level of PTH or it may be used to evaluate parathyroid cancer that has spread to distant parts of the body or come back after treatment. See the Stages section for a full description of these stages.

  • Ultrasound. An ultrasound uses sound waves to create a picture of internal organs. An ultrasound is very useful for locating a tumor in or around the thyroid gland. However, it has limitations if the tumor is located lower in the neck or upper chest.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow. An MRI is not usually used to diagnose parathyroid cancer.

  • Surgery. Removing the entire tumor during a surgical operation is the most common way to diagnose both benign and cancerous parathyroid tumors. The tumor is then analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. Parathyroid cancer is usually suspected before an operation is done, based on a high serum calcium level, tumor size, and imaging scans. A biopsy is generally not recommended as a separate procedure from surgery for a parathyroid tumor.

Often, test results showing a higher level of PTH or obvious symptoms of hypercalcemia are signs that cancer may be present. Imaging, such as a CT scan, can also show if cancer has developed. In some instances, a biopsy of the neck can be done, if surgery is not recommended by surgeons experienced in treating parathyroid tumors.

After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is a cancerous parathyroid tumor, these results can also help the doctor describe the tumor. This is called staging.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of a cancerous parathyroid tumor. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Stages

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

What is cancer staging?

Staging is a way of describing where a cancerous tumor is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor recommend the best kind of treatment, and it can help predict a patient’s prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer. For parathyroid cancer, the cancer is typically described as localized, metastatic, or recurrent.

  • Localized. The cancer is only located in the parathyroid gland and has not spread to nearby tissues or organs.

  • Metastatic. The cancer has spread to lymph nodes in the head and neck area or to other parts of the body, such as the lungs, liver, or bone. Lymph nodes are small, bean-shaped organs that help fight infection.

  • Recurrent. Recurrent cancer is cancer that has come back after treatment. The most common place of recurrence is in the neck. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Source: National Cancer Institute.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Types of Treatment

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with parathyroid cancer. Use the menu to see other pages.

This section explains the types of treatments, also known as therapies, that are the standard of care for a parathyroid tumor. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to discuss with your doctor whether clinical trials are an option. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

How parathyroid cancer is treated

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. It is very important that the health care team has experience treating parathyroid cancer. Cancer care teams include a variety of other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Your treatment plan will include efforts to both eliminate the tumor and control the amount of calcium in your bloodstream, called hypercalcemia. The most common types of treatments used for a parathyroid tumor are surgery and treatment for hypercalcemia. Chemotherapy and radiation therapy may also be recommended. Newer treatments, like immunotherapy and other new drugs, are being studied in clinical trials. Your care plan will also include treatment for symptoms and side effects, an important part of cancer care.

Treatment options and recommendations depend on several factors, including the type and stage of the tumor, possible side effects, and the patient’s preferences and overall health. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. These types of talks are called “shared decision-making.” Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is particularly important for parathyroid cancer because there are different treatment options. Learn more about making treatment decisions.

The common types of treatments used for parathyroid cancer are described below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.

Treating hypercalcemia

As explained in the Introduction, a parathyroid tumor can cause high levels of calcium in the blood. This is called hypercalcemia. Having too much calcium in the blood can cause serious problems. It may need immediate treatment.

There are a number of medications that can be used to reduce calcium levels in the blood or stop bones from breaking down due to hypercalcemia. Some of the drugs that are used to treat hypercalcemia are:

  • Bisphosphonates. Common types of this medication include pamidronate (Aredia), clodronate (Bonefos), ibandronate (Boniva), or zolendronic acid (Zometa).

  • Calcitonin (multiple brand names)

  • Cinacalcet (Sensipar)

  • Denosumab (Prolia, Xgeva)

  • Gallium nitrate (Ganite)

Most of these drugs are only used for short periods until treatment to remove the tumor can be started. Talk with your doctor about which hypercalcemia treatment will be recommended for you and for how long.

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Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. Surgery is the main treatment for a parathyroid tumor, whether the tumor is benign or cancerous. A surgical endocrine oncologist is a doctor who specializes in treating an endocrine tumor using surgery. Because parathyroid cancer is so rare and it cannot be cured if it recurs, it is very important that surgery to remove it is performed by a surgical endocrine oncologist who has extensive expertise in thyroid and parathyroid surgery whenever parathyroid cancer is suspected.

It is difficult to know before surgery whether a parathyroid tumor is benign or malignant. Parathyroid cancer is the likely diagnosis whenever a patient has profound hypercalcemia, defined as a calcium level higher than 13 mg/dL, or a large parathyroid tumor, defined as larger than 3 centimeters. If this is the case, the parathyroid gland and surrounding structures should be removed. Those surrounding structures should include the same side of the thyroid gland, fatty tissue and lymph nodes surrounding the parathyroid tumor, and the overlying muscle of the center of the neck, called the sternothyroid muscle. This type of surgery is called en bloc resection. The doctor may also recommend radiation therapy (see below) after surgery to the affected area of the neck.

Surgery for a benign parathyroid tumor is called a parathyroidectomy. If a surgeon finds out that the tumor is benign during surgery, it is common to check the patient’s level of PTH in the blood during the operation. If necessary, the surgeon will then put back 1 of the normal parathyroid glands that had been removed earlier in the operation. However, if the tumor is cancerous, the gland should not be put back to avoid any chance of putting cancer cells back into the body.

Before surgery, talk with your surgeon about what to expect, how long recovery will take, and the possible short- and long-term side effects. Learn more about the basics of cancer surgery.

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Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen, which is your treatment plan, usually consists of a specific number of treatments given over a set period of time. This may also be called a schedule.

Occasionally, radiation therapy may be recommended after surgery for parathyroid cancer. Radiation therapy may help reduce the risk of parathyroid cancer recurring in the neck, but it is difficult to evaluate whether this treatment is beneficial because this type of cancer is so rare. Radiation therapy may also be recommended if surgery is not possible.

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Talk with your doctor about how side effects can be relieved or managed during treatment. Most side effects go away soon after treatment has finished. Learn more about the basics of radiation therapy.

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Therapies using medication

Treatments using medication are used to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.  

This type of medication is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication.

The treatment plan may include medications to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.  

This treatment is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication.

The medications used to treat tumors are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications, causing unwanted side effects or reduced effectiveness. Learn more about your prescriptions by using searchable drug databases.

Currently, when medication is used for treating parathyroid cancer, the approach is chemotherapy. Other types of medication, such as immunotherapy, are being studied in clinical trials.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells. A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. More clinical trials are needed to find out the best use of chemotherapy to treat parathyroid cancer. Chemotherapy rarely works for metastatic or recurrent parathyroid cancer.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.

Learn more about the basics of chemotherapy.

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Physical, emotional, and social effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the recommended treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative and supportive care options. Many patients also benefit from talking with a social worker and participating in support groups. Ask your doctor about these resources, too. 

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.

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Metastatic parathyroid cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include a combination of surgery, chemotherapy, and radiation therapy. Palliative care will also be important to help relieve symptoms and side effects.

For most people, a diagnosis of metastatic cancer is very stressful and difficult. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of your health care team. It may also be helpful to talk with other patients, such as through a support group or other peer support program.

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Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the tumor returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if it does return. Learn more about coping with the fear of recurrence.

If the tumor returns after the original treatment, it is called a recurrent tumor. It may come back in the same place, meaning it is a local recurrence, or nearby, which is a regional recurrence. If it comes back in another place, it is a distant recurrence.

The first sign of recurrence after treatment may be a high blood calcium level. Therefore, you may have regular tests to watch for PTH and calcium level changes, as well as ultrasounds of the neck (see Diagnosis).

If a recurrence happens, a new cycle of testing will begin again to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above, such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat recurrent parathyroid cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent disease sometimes experience emotions such as disbelief or fear. People are encouraged to talk with the health care team about these feelings and ask about support services to help you cope. Learn more about dealing with recurrence.

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If treatment does not work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

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The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are studied to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for people with parathyroid cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Clinical trials are used for all types and stages of parathyroid cancer. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. People who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and the chance that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects.

Deciding to join a clinical trial

People decide to participate in clinical trials for many reasons. For some, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Others volunteer for clinical trials because they know that these studies are a way to contribute to the progress in treating parathyroid cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future people with parathyroid cancer.

Insurance coverage and the costs of clinical trials differ by location and by study. In some programs, some of the expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” When used, placebos are usually combined with standard treatment in most cancer clinical trials. Study participants will always be told when a placebo is used in a study. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, people must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the treatment options so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different than the risks of standard treatment.

  • Explain what will be required of each person in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

  • Describe the purposes of the clinical trial and what researchers are trying to learn. 

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together. You will need to meet all of the eligibility criteria in order to participate in a clinical trial. Learn more about eligibility criteria in clinical trials.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that people participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if they choose to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for a parathyroid tumor, learn more in the Latest Research section.

Cancer.Net offers more information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

The next section in this guide is Latest Research. It explains areas of scientific research for parathyroid cancer. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will read about the scientific research being done to learn more about this type of tumor and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about parathyroid cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. Finding a health care team with experience treating this disease is important, as well as one with active collaborations across specialties and participation in clinical trials.

The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you.

  • Better treatment for hypercalcemia. Researchers are exploring new medications to reduce high calcium levels in the blood.

  • New cancer drugs. New medications, including immunotherapy, may be future treatment approaches for this type of cancer. Learn more about the basics of immunotherapy.

  • Tumor genetics. Researchers are looking at the genes, molecular structure, and other features of parathyroid tumors to learn more about them.

  • Family genetics. Researchers are working to learn more about why this type of tumor can run in certain families (see Risk Factors).

  • Palliative care/supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current parathyroid cancer treatments to improve comfort and quality of life for patients.

Looking for More About the Latest Research?

If you would like more information about the latest areas of research in parathyroid tumor, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance in how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. This part of cancer treatment is called palliative care or supportive care. It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for a parathyroid tumor are described in the Types of Treatment section. Learn more about side effects, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Talk with your health care team regularly about how you are feeling. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening.

You may find it helpful to keep track of your side effects so it is easier to talk about any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, side effects can last after treatment ends. Doctors call these long-term side effects. Side effects that occur months or years after treatment are called late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects as well after a diagnosis. This may include dealing with a variety of emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with the costs of medical care

Medical treatment can be expensive. It may be a source of stress and anxiety for people with a parathyroid tumor and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care stops them from following or completing their treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

Coping with barriers to care 

Some groups of people experience different rates of new cancer cases and experience different outcomes from their cancer diagnosis. These differences are called “cancer disparities.” Disparities are caused in part by real-world barriers to quality medical care and social determinants of health, such as where a person lives and whether they have access to food and health care. Cancer disparities more often negatively affect racial and ethnic minorities, people with fewer financial resources, sexual and gender minorities (LGBTQ+), adolescent and young adult populations, older adults, and people who live in rural areas or other underserved communities.  

If you are having difficulty getting the care you need, talk with a member of your health care team or explore other resources that help support medically underserved people.  

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

  • When and who should we call about side effects?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, social, and financial effects of cancer.

Caring for a loved one with a parathyroid tumor

Family members and friends often play an important role in taking care of a person with a parathyroid tumor. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away. Being a caregiver can also be stressful and emotionally challenging. One of the most important tasks for caregivers is caring for themselves

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

A caregiving plan can help caregivers stay organized and help identify opportunities to delegate tasks to others. It may be helpful to ask the health care team how much care will be needed at home and with daily tasks during and after treatment. Use this 1-page fact sheet to help make a caregiving action plan. This free fact sheet is available as a PDF, so it is easy to print.  

Learn more about caregiving or read the ASCO Answers Guide to Caring for a Loved One With Cancer in English or Spanish.  

Looking for More on How to Track Side Effects?

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Fact Sheets: Read 1-page fact sheets on anxiety and depression, constipation, diarrhea, and rash that provide a tracking sheet to record the timing and severity of the side effect. These free fact sheets are available as a PDF, so they are easy to print, fill out, and give to your health care team.

The next section in this guide is Follow-up Care. It explains the importance of checkups after cancer treatment is finished. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Follow-Up Care

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will read about your medical care after treatment for the tumor is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with a parathyroid tunor does not end when active treatment has finished. Your health care team will continue to check that the tumor has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, occupational therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the tumor has come back. When parathyroid cancer does recur, it typically reappears between 2 and 5 years after the first surgery, although there is always a risk of recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.

During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. You will have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given. This should include blood tests to watch for rising PTH and calcium levels (see Diagnosis).

Follow-up care should also include imaging scans, such as an ultrasound of the neck, to watch for signs that the tumor has returned.

The anticipation before having a follow-up test or waiting for test results may add stress to you or a family member. This is sometimes called “scanxiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to have side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years after treatment has ended. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on your diagnosis, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your treatment for the parathyroid tumor will lead your follow-up care, be sure to share your treatment summary and survivorship care plan forms with them and with all future health care providers. Details about this treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a diagnosis of parathyroid cancer. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Survivorship

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” is complicated because it means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and continues during treatment and through the rest of a person's life.

For some, even the term “survivorship” does not feel right, and they prefer to use different language to describe and define their experience. Sometimes extended treatment will be used for months or years to manage or control cancer. Living with cancer indefinitely is not easy, and the health care team can help you manage the challenges that come with it. Everyone has to find their own path to name and navigate the changes and challenges that are the results of their cancer diagnosis and treatment. 

Survivors may experience a mixture of feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life. Feelings of fear and anxiety may still occur as time passes, but these emotions should not be a constant part of your daily life. If they persist, be sure to talk with a member of your health care team.  

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health and fertility concerns, and financial and workplace issues.  

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires: 

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make lifestyle changes.

People recovering from a parathyroid tumor are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, exercising regularly, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health.

Talk with your health care team to develop a survivorship care plan that is best for your needs.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net: 

  • ASCO Answers Guide to Cancer Survivorship: Get this 48-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.

  • Survivorship Resources: Cancer.Net offers information and resources to help survivors cope, including specific sections for children, teens and young adults, and people over age 65. There is also a main section on survivorship for people of all ages.  

The next section offers Questions to Ask the Health Care Team to help start conversations with your medical care team. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with the health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment. It may also be helpful to ask a family member or friend to come with you to appointments to take notes. 

Questions to ask after getting a diagnosis

  • Could my parathyroid tumor be cancerous?

  • Can you explain my pathology report, or laboratory test results, to me?

  • Are more tests needed to find out if the tumor is cancerous?

  • Will I be treated for hypercalcemia? If so, why is this important?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options to remove the tumor?

  • If needed, what are my treatment options for hypercalcemia?

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • Which treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the tumor, help me feel better, or both?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • What are the possible side effects of this treatment, both in the short term and the long term?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before treatment begins?

  • If I am worried about managing the costs of medical care, who can help me?

  • If I have questions or problems, who should I call?

Questions to ask about having surgery

  • How many parathyroid operations does my surgeon perform every year?

  • What type of surgery do you recommend? Can you describe it? How extensive will the surgery be?

  • Are there other surgical options available for me that may be less invasive?

  • Could surgery affect my appearance?

  • Is the rapid “parathyroid test” available in the operating room to find out if all of the abnormal tissue has been removed?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term effects of having this surgery?

Questions to ask about having radiation therapy or therapies using medication

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • Will I receive this treatment at a hospital or clinic? Or will I take it at home?

  • What side effects can I expect during treatment?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term or late effects of having this treatment?

  • What can be done to prevent or relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the treatment I received?

  • What follow-up tests will I need, and how often will those tests be needed?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers some more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Parathyroid Cancer - Additional Resources

Approved by the Cancer.Net Editorial Board, 06/2022

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Parathyroid Cancer. Use the menu to see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Parathyroid Cancer. Use the menu to choose a different section to read this guide.