Surgery for parathyroid cancer

Surgery is often the only treatment needed for parathyroid cancer. It can also be used to treat cancer that has come back.

About surgery for parathyroid cancer

Surgery is the main treatment for parathyroid cancer. It is often the only treatment needed. This operation is called a parathyroidectomy.

During a parathyroidectomy a surgeon will remove the parathyroid gland containing the cancer cells, and any nearby affected areas.

They may also remove:

  • half of the thyroid gland on the same side as the cancer
  • some nearby lymph nodes in the neck.

Surgery can also be used to treat cancer that comes back again, or if the cancer spreads to other areas of the body.

Your surgeon will give you more information about the operation.

Before your operation for parathyroid cancer

You may go to a pre-assessment clinic before your operation. You will have some tests to check your general health. These may include:

You will see a member of the surgical team. In some hospitals you may also see a specialist nurse. They will talk to you about your operation. This is a good time to ask questions and talk about any concerns you have.

You will see the doctor who gives you your anaesthetic (the anaesthetist) either at a clinic or when you are admitted to hospital. You are usually admitted to hospital on the morning of your operation.

Checking your vocal cords

Before and after surgery, a doctor will check your vocal cords. This is because the nerves that control your vocal cords are close to the parathyroid glands. The doctor may use a local anaesthetic spray to numb your nose and throat. They then pass a thin, flexible tube with a small camera at the end (nasendoscope) through your nose. They use this to look at how your vocal cords move. This can be a little uncomfortable, but it should not be painful.

You may be asked to avoid eating or drinking for a few hours after the test. This is until the local anaesthetic wears off.

After your operation for parathyroid cancer

The nurses on the ward will help you to lie in a fairly upright position, supported by pillows. This helps to reduce swelling in your neck area.

You will probably have some pain or discomfort. Your doctor will prescribe painkillers for you. Tell your doctor or nurse about any pain you have. Your neck will feel stiff after surgery. Your nurse, surgeon or physiotherapist will show you some neck exercises to help with this.

You may have a drip (intravenous infusion) going into your arm to replace your body’s fluids. You should be able to start drinking an hour or so after your operation. You may find it painful to swallow at first. This should improve over the next two or three days.

You may also have 1 or 2 tubes (drains) to drain fluid from your wound. These are usually removed within 24 to 48 hours.

After surgery to remove a parathyroid gland, the level of calcium in your blood may become low. It can take 2 or 3 days for the calcium level to go back to normal after surgery.

You will have regular blood tests to check your calcium levels. If the level is too low, your doctor will prescribe extra calcium. You usually have the calcium as tablets, or sometimes you have it by injection into a vein (intravenously). Your doctor may also prescribe vitamin D supplements, to help your body absorb calcium from the food you eat.

You will probably have some small scars on your neck after the operation. These usually fade as they heal.

Rarely, surgery can damage a nerve in the neck. This can cause hoarseness or problems with how you swallow. If this happens, your doctor or specialist nurse will talk to you about how long these effects may last. Very rarely, you may need support from a speech and language therapist who can help with swallowing problems.

Drips and drains

You may have a drip (intravenous infusion) going into your arm to replace your body’s fluids. You should be able to start drinking an hour or so after your operation. You may find it painful to swallow at first. This should improve over the next 2 or 3 days.

You may also have 1 or 2 tubes (drains) to remove fluid from your wound. These are usually taken out within 24 to 48 hours.

Change in calcium levels

After surgery to remove a parathyroid gland, the level of calcium in your blood may become low. It can take 2 or 3 days for the calcium level to go back to normal after surgery.

You will have regular blood tests to check your calcium levels. If the level is too low, your doctor will give you extra calcium. You usually have the calcium as tablets, or sometimes by injection into a vein (intravenously). Your doctor may also give you vitamin D supplements, to help your body absorb calcium from the food you eat.

Scar

You will have a small scar on your neck after the operation. This usually fades as it heals.

Hoarse voice and problems swallowing

Rarely, surgery can damage a nerve in the neck. This can cause hoarseness or problems with swallowing. If this happens, your doctor or specialist nurse will talk to you about how long these effects may last. Very rarely, you may need support from a speech and language therapist who can help with swallowing problems.

About our information

  • References

    Below is a sample of the sources used in our parathyroid cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Fingeret, A. Contemporary evaluation and management of parathyroid carcinoma. Journal of Clinical Oncology. 2020. Vol 1 (17) P.17-22.

    Long, K, and Sippel, R. Current and future treatments for parathyroid carcinoma. International Journal of Endocrine Oncology. 2018. Vol 5 (1).

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

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