Symptoms of parathyroid cancer
Symptoms of parathyroid cancer are like those caused by benign parathyroid gland tumours. These symptoms are caused by having a high level of calcium in the blood (hypercalcaemia).
Symptoms of hypercalcaemia include:
- feeling thirsty and passing more urine (pee) than usual
- tiredness
- feeling sick or being sick (vomiting)
- changes in mood – feeling low, depressed, irritable or nervous
- pain in the tummy (abdomen) or back
- indigestion
- loss of appetite
- constipation
- muscle weakness
- memory loss and difficulty concentrating.
If hypercalcaemia is not treated, it can cause bone thinning (osteoporosis). This is because the bones are losing calcium. This can damage the bones and increase the risk of broken bones (fractures) and pain.
High calcium levels in the blood can affect the kidneys. Some people develop kidney stones, or their kidneys may become damaged and not work as well.
Parathyroid cancer is more likely to be diagnosed in people who have a lump or swelling in their neck. This sometimes causes difficulty swallowing and a hoarse voice.
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Causes of parathyroid cancer
Parathyroid cancer is very rare. We do not know what causes most parathyroid cancers.
Sometimes, rare types of gene changes (mutations) can slightly increase the risk of parathyroid cancer. These include familial hyperparathyroidism and hyperparathyroidism-jaw tumour syndrome.
People who have had radiotherapy treatment to their neck area have an increased risk of developing non-cancerous (benign) parathyroid tumours. They may also have a higher risk of developing cancer of the parathyroid gland.
Diagnosis of parathyroid cancer
You usually start by seeing your GP. They will examine you and ask about your symptoms and general health. Your GP may arrange tests. They will refer you to a hospital for specialist advice and treatment if they:
- are unsure what the problem is
- think your symptoms could be caused by cancer.
It is often difficult to diagnose parathyroid cancer from tests and scans. This is because the symptoms are like those caused by non-cancerous tumours. It may not be diagnosed until after surgery to remove the tumours in the parathyroid glands.
Parathyroid cancer is sometimes diagnosed following a routine blood test. You may have no symptoms at all. If the blood test shows a very high calcium level, it may suggest a parathyroid tumour.
Tests for parathyroid cancer may include the following.
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Blood and urine tests
You will have samples of blood and urine taken to check your calcium and PTH levels. For the urine test, your doctor may ask you to collect all the urine you pass in 24 hours. For some blood tests, the doctor will ask you to not eat (to fast) overnight before they take the sample. You should follow any instructions carefully to get clear results.
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Ultrasound scan
An ultrasound scan uses sound waves to build up a picture of the parathyroid glands and other structures inside the neck. You lie on your back for the scan. When you are lying comfortably, the person doing the scan spreads a gel over your neck. They move a small hand-held device, like a microphone, around the skin on your neck area. A picture of the inside of your neck shows up on a screen. An ultrasound scan only takes a few minutes and is painless.
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Parathyroid scan (sestaMIBI scan)
This scan shows the size and position of the parathyroid glands and any abnormal areas. You will visit the hospital scanning department twice on the same day when having this scan.
Before the scan, you have an injection of a radioactive substance (called sestaMIBI). The radiation dose is low and unlikely to harm you. But always tell your doctor or staff in the scanning department before the scan if:
- you are, or think you could be, pregnant
- you are breastfeeding.
The person doing the scan injects the radioactive substance into a vein in your arm. Then you wait for about 10 minutes for your parathyroid glands to absorb the substance. After this, a camera that detects radioactivity (a gamma camera) moves around your head and takes pictures of your neck. You need to lie still for about 40 minutes while this happens. Tell your doctor or the staff doing the scan if:
- you think you might not be able to lie still
- you find it difficult to be in closed-in spaces (claustrophobia).
After the first part of the scan, you can leave the scanning department. You then go back after 2 to 3 hours to have more pictures taken of your neck. This may take 30 to 40 minutes.
If you are taking thyroid medications, you may need to stop taking them before you have the scan. Your doctor will advise you about this.
You should avoid close contact with pregnant women and very young children for 24 hours after this test. This is because your body will release a small amount of radioactivity. The staff doing the test can tell you more about this.
Further tests
You may have further tests to see if there are signs the cancer has spread outside the parathyroid glands.
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CT scan
A CT scan takes a series of x-rays. These build up a three-dimensional picture of the inside of the body.
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MRI scan
MRI uses magnetism instead of x-rays to build up a detailed picture of areas of your body.
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PET scan
A PET scan uses low-dose radioactive glucose (a type of sugar) to measure the activity of cells in different parts of the body.
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Stages of parathyroid cancer
Staging describes if the cancer has spread from where it first started to other parts of the body.
Parathyroid cancer is staged as localised or metastatic.
Localised parathyroid cancer
Localised parathyroid cancer is in a parathyroid gland and may have spread to nearby tissues such as the:
- thyroid
- gullet (oesophagus)
- nerve for the voicebox (recurrent laryngeal nerve)
- nearby muscle.
Metastatic parathyroid cancer
This is also called secondary or advanced cancer. It means the cancer has spread to other parts of the body, such as the:
- the lymph nodes
- lungs
- liver
- bones.
Treatment for parathyroid cancer
The treatment you have depends on the stage of the cancer and your general health. Your team will discuss your treatment options with you.
Your doctor usually meets with other specialists to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT). This includes your oncology team.
After parathyroid cancer treatment
Follow-up
You will have regular follow-up appointments after your treatment has finished. This includes blood tests, and you may have ultrasound scans of your neck area.
These will probably continue for several years. Because parathyroid cancer is rare, you are usually followed up by a team who specialise in hormones (specialist endocrinology team).
If you have any problems or notice any symptoms between appointments, tell your doctor or specialist nurse as soon as possible.
Further support
There are also other organisations that can give you information and support. These include:
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Date reviewed
This content is currently being reviewed. New information will be coming soon.
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