Surgery for parathyroid cancer
Surgery is often the only treatment needed for parathyroid cancer. It can also be used to treat the cancer if it has come back in the same area.
What is 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.
It can also be used to treat the cancer if it has come back in the same area. Rarely, it is used if the cancer has spread to other organs in the body, such as the liver or lungs.
A surgeon will remove the parathyroid gland containing the cancer cells and an area of clear tissue around it (margin). This helps to reduce the risk of the cancer coming back. They may also remove:
- half of the thyroid gland on the same side as the cancer
- some nearby lymph nodes in the neck.
The surgeon usually makes a small cut (incision) between 5cm to 8cm in your neck. This allows them to see all 4 parathyroid glands clearly. They can remove the affected gland and any other affected areas.
Your surgeon will explain the type of surgery that is right for you. They will give you more information about your operation.
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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 meet with a member of the surgical team. In some hospitals you may also meet with 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 meet with 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 through your nose. This is called a nasendoscope.
The doctor will 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.
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After your operation for parathyroid cancer
The nurses on the ward will help you to lie in a nearly upright position, supported by pillows. This helps to reduce swelling in your neck area.
You may have some pain or discomfort. Your doctor will prescribe painkillers to manage this. Always tell your doctor or nurse about any pain you have. Your neck will feel stiff after surgery. Your nurse or physiotherapist will show you some neck exercises to help with this.
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 about 1 hour 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 drain fluid from your wound. A nurse will usually remove them 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 prescribe extra calcium. You usually have the calcium as tablets, or sometimes 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.
Scarring
You will have a scar or scars on your neck after the operation. This usually becomes less noticeable as it heals.
Hoarse voice and problems swallowing
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.
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Recovering after surgery
Recovery takes time and it is faster for some people than others. Try to pace yourself and do not do too much too soon.
Your doctor and nurse will give you advice on what you can do to help your recovery. Try to eat healthily and get enough rest. You can slowly build up your strength and fitness with light exercise, such as short walks.
Going home after a parathyroidectomy
How long you are in hospital will depend on the operation you had and your recovery. You might be ready to go home about 1 to 2 days after your operation.
Recovery takes time and it is faster for some people than others. Try to pace yourself and do not do too much too soon. Follow the advice your cancer team give you. This usually includes things like:
- Do not lift heavy items for a minimum of 4 weeks to avoid any strain on your neck wound.
- Avoid putting your wound completely under water until at least a couple of weeks after surgery or until your surgeon says it is okay.
- Do any neck exercises you have been shown and carry on with these for a few weeks even if you have full movement and strength back.
- Take painkillers as explained by your doctor, nurse or pharmacist.
- Avoid direct sunlight to your wound and when the wound is healed always use a high sun protection factor (SPF) to protect the skin.
If it was not possible for the surgeon to remove all of the cancer, you may need to take medicines to keep your calcium levels stable.
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About our information
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.
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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
informationproductionteam@macmillan.org.uk
Fingeret A. Contemporary evaluation and management of parathyroid carcinoma. Journal of Clinical Oncology. 2020. Vol 1 (17) P.17-22. Available from: www.ascopubs.org/doi/pdfdirect/10.1200/JOP.19.00540
Rodrigo JP, Hernandez-Prera JC, et al. Parathyroid cancer: An update. 2020. Cancer Treatment Reviews, Vol. 86, 102012. Available from: www.doi.org/10.1016/j.ctrv.2020.102012
Petranović Ovčariček P, Giovanella L, et al. The EANM practice guidelines for parathyroid imaging. 2021. European Journal of Nuclear Medicine and Molecular Imaging. Vol 48 (9): P. 2801-2822. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8263421
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