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The Center for Endocrine Tumors at Massachusetts General Hospital Cancer Center is a comprehensive program specializing in the treatment of all types of benign and malignant endocrine tumors.
Specialists from the Thyroid Nodule Program in the Department of General and Gastrointestinal Surgery at Massachusetts General Hospital answer frequently asked questions about thyroid nodules and goiters.
What is a parathyroid tumor?
Cancer is made of changed cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.
A parathyroid tumor is a growth inside a parathyroid gland. Most parathyroid tumors are not cancer (benign). Parathyroid cancers are very rare. You have 4 parathyroid glands. They are small, pea-sized glands in your neck or upper chest near the thyroid gland. They’re part of the endocrine system. This system controls hormones in your body.
The parathyroid glands make parathyroid hormone. This hormone controls the levels of calcium and phosphorus in your blood. Parathyroid tumors that are not cancer may cause high levels of this hormone. This increases the amount of calcium in your blood. Parathyroid cancer causes very high levels of the hormone. This can lead to dangerously high levels of calcium in your blood. This is called hypercalcemia.
Who is at risk for a parathyroid tumor?
A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Sometimes you can control risk factors, like using sunscreen to lower your risk for skin cancer. But risk factors for parathyroid tumors are not in your control.
Anyone can get a parathyroid tumor. But you are more at risk for one if you:
Had radiation therapy to your neck
Were exposed to high doses of radiation from nuclear power plants
Have a family history of parathyroid tumors
Have certain inherited conditions, such as familial isolated hyperparathyroidism or multiple endocrine neoplasia, types 1 or 2
Talk with your healthcare provider about your risk factors for parathyroid tumors and what you can do about them.
Can a parathyroid tumor be prevented?
Experts aren’t exactly sure what causes parathyroid tumors. At this time, there’s no known way to prevent them.
Are there screening tests for a parathyroid tumor?
There are no routine screening tests for parathyroid tumors in people at average risk. Screening is done to check for disease in people who don’t have symptoms.
What are the symptoms of a parathyroid tumor?
The symptoms of parathyroid tumor are caused by hypercalcemia. They may include:
Aches and pains, especially in your bones
Kidney problems, including kidney stones and pain in your upper back or side
Loss of appetite
Feeling very tired
Confusion and memory problems
A lump in the neck
Many of these may be caused by other health problems. But it’s important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have a tumor or cancer.
How is a parathyroid tumor diagnosed?
Parathyroid problems are often found when you see a doctor because of symptoms that aren’t getting better. Your healthcare provider will ask you about your health history, symptoms, risk factors, and family history of disease. He or she will do a physical exam. You may also need one or more of these tests:
Blood or urine tests. These can detect high levels of calcium or parathyroid hormone in your body.
Imaging tests. These include X-rays, ultrasound, CT scans, and MRIs. They can help find out the size of the tumor.
Sestamibi/SPECT scan. This test can show if you have an overactive parathyroid gland. A radioactive substance is put into your blood through a vein in your arm. The substance travels to the overactive gland and build ups there. An X-ray can show the buildup in the gland. It can also help find tumors in other parts of your body.
After a diagnosis of parathyroid tumor, you’ll likely need other tests. For instance, a biopsy may be done. This is when small pieces of tissue are taken from the tumor. These samples can be removed with a needle and checked under a microscope to see if there are cancer cells.
These tests help your healthcare providers learn whether the tumor is cancer. Sometimes you won’t know if the tumor is cancer until after surgery. The tests can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It’s one of the most important things to know when deciding how to treat cancer.
Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.
How is a parathyroid tumor treated?
Your treatment choices depend on the type of parathyroid tumor you have, test results, the stage of the cancer, whether your blood calcium levels can be controlled, and whether the tumor can be removed with surgery. Your overall health and personal choices will also be taken into account. Treatment is planned to destroy the tumor and control your blood calcium levels. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.
Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy and targeted therapy are systemic treatments. You may have just one treatment or a combination of treatments.
Surgery is the best and most common treatment for parathyroid tumors. The goal is to remove as much of the tumor as possible. Before surgery, you may need treatment with medicines to control the amount of calcium in your blood until surgery is done. After surgery, you will need tests to be sure the calcium level does not get too low.
In some cases, a benign parathyroid tumor doesn’t need to be taken out. It may only need to be removed if your calcium level has reached a certain point or if you have severe symptoms. Some people with hyperparathyroidism need surgery if they develop thinning of their bones (osteoporosis) or if they develop kidney stones or their kidneys don’t work correctly.
If the tumor is cancer, you will need surgery to remove the gland and tissues around it. You may also need:
Radiation therapy. This kills the cancer cells and helps keep them from growing and spreading.
Chemotherapy. These medicines also kill cancer cells.
Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.
What are treatment side effects?
Cancer treatment such as chemotherapy and radiation can damage normal cells. This can cause side effects such as hair loss, mouth sores, and vomiting.
Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.
Coping with a parathyroid tumor
Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be tough on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.
Here are tips:
Talk with your family or friends.
Ask your healthcare team or social worker for help.
Speak with a counselor.
Talk with a spiritual advisor, such as a minister or rabbi.
Ask your healthcare team about medicines for depression or anxiety.
Keep socially active.
Join a cancer support group.
Cancer treatment is also hard on the body. To help yourself stay healthier, try to:
Eat a healthy diet, with a focus on high-protein foods.
Drink plenty of water, fruit juices, and other liquids.
Keep physically active.
Rest as much as needed.
Talk with your healthcare team about ways to manage treatment side effects.
Take your medicines as directed by your team.
When should I call my healthcare provider?
Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:
New symptoms or symptoms that get worse
Signs of an infection, such as a fever
Side effects of treatment that affect your daily function or don’t get better with treatment
Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.
Key points about a parathyroid tumor
A parathyroid tumor is a growth inside 1 of the 4 parathyroid glands in the body. These glands are located in the neck or upper chest near the thyroid gland.
Parathyroid tumors are often not cancer. But some can be cancer.
These tumors can cause hypercalcemia, a serious condition in which the body has too much calcium in it.
The exact cause of these tumors is not known. But a family history may raise the risk for them.
The main treatment is surgery to remove the tumor even if it’s not cancer.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.
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