What is a parathyroid tumor?

Cancer starts when cells change (mutate) and 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. They can spread to other parts of the body, too. This is called metastasis.

A parathyroid tumor is a growth inside a parathyroid gland. Most parathyroid tumors are not cancer (they're benign). Parathyroid cancers are very rare. You have four 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 aren't 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 (FIHP) or multiple endocrine neoplasia types 1 or 2 (MEN1 or MEN2).

Talk with your health care 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.

What are the symptoms of a parathyroid tumor?

The symptoms may include:

• Aches and pains, especially in your bones.

• Kidney problems, including kidney stones and pain in your upper back or side.

• Depression.

• High blood pressure.

• Loss of appetite.

• Intense thirst.

• Nausea.

• Vomiting.

• Feeling very tired, even after rest.

• Constipation.

• Frequent urination.

• Confusion and memory problems.

• Weakness.

• A lump in the neck.

• Trouble sleeping.

• Voice changes, like hoarseness.

• Bone thinning (osteoporosis).

• Problems swallowing.

• Irregular heart rhythm.

• Losing weight loss without trying to.

Most symptoms of parathyroid tumor are caused by hypercalcemia (high levels of calcium in the blood). But many of these may be caused by other health problems. It’s important to see a health care 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 health care provider because of symptoms that aren’t getting better. Your provider will ask you about your health history, symptoms, risk factors, and family history of disease. You will also have 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. They can also help give an idea of your overall health and organ function.

• Imaging tests. These include X-rays, ultrasound, CT scans, and MRIs. They can help look for tumors and find out how big they are.

• 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 collects there. An X-ray can then show the buildup in the gland. This scan can also help find tumors in other parts of your body.

After a diagnosis of parathyroid tumor, you’ll need more tests. For instance, a biopsy may be done. This is when tiny pieces of tissue (called samples) are taken from the tumor. These samples are sent to a lab and tested to see if there are cancer cells in them.

These tests help your health care providers learn whether the tumor is cancer. Sometimes you won’t know if the tumor is cancer until after surgery. Then tests can be used to find the stage of the cancer. The stage is how much cancer there is and how far it 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 provider will talk with you about what the stage means for your treatment. Be sure to ask your provider to explain the details 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, how your body will look and work after treatment, and your personal choices will also be considered.

Treatment is used 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 most common treatment for parathyroid tumors. The goal is to remove as much of the tumor as possible. Before surgery, you may be given medicine to control the amount of calcium in your blood until surgery is done. After surgery, you'll need regular blood tests to be sure your calcium levels don't get too low.

In some cases, a benign (not cancer) parathyroid tumor doesn’t need to be taken out. It may need to be removed only if your calcium level has reached a certain level or if you have severe symptoms. Some people with hyperparathyroidism (high parathyroid hormone levels) need surgery if they develop thinning of their bones (osteoporosis), kidney stones, or their kidneys don’t work correctly.

If the tumor is cancer, you'll need surgery to remove the gland and tissues around it. After surgery, you may also need:

• Radiation therapy. This local treatment kills the cancer cells and helps keep them from growing and spreading. It might be used to help decrease the chance that the cancer will come back. Sometimes it's used if surgery can't be done.

• Chemotherapy. These systemic medicines kill cancer cells. They're not a common part of parathyroid cancer treatment at this time.

Talk with your health care 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 provider before making a decision.

What are treatment side effects? 

Cancer treatments like chemotherapy and radiation can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting.

Talk with your health care provider about side effects from your treatment. There are often ways to manage them. Be sure to tell your care team what side effects you have. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.

Coping with a parathyroid tumor 

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your care 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 some tips:

• Talk with your family or friends.

• Ask your care team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual adviser, such as a minister or rabbi.

• Ask your care 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 care team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should you call your health care provider?

Your health care provider will talk with you about when to call. You may be told to call if you have:

• 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 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 one or more of the four parathyroid glands in the body. These glands are found in the neck or upper chest near the thyroid gland.

• Parathyroid tumors are often benign (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.

Next steps

Tips to help you get the most from a visit to your health care 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 don't take the medicine or don't 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 or concerning signs and symptoms. Is there a different number to call after office hours or on weekends and holidays?