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 often the only treatment needed for parathyroid cancer. This operation is called a parathyroidectomy. Surgery can also be used to treat cancer that has come back in the neck area, or if the cancer spreads to other areas of the body. A surgeon will remove the parathyroid gland containing the cancer and any nearby affected areas. They may also remove half of the thyroid gland on the same side as the cancer, and some nearby lymph nodes in the neck. Your specialist can give you more information.

Before your operation

You may visit 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 and, in some hospitals, a specialist nurse. They will talk to you about your operation. This is a good opportunity 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.

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. Then they will pass a thin, flexible tube with a small camera at the end (nasendoscope) through your nose to look at how your vocal cords move. This can be a little uncomfortable, but it should not be painful.

You may be asked not to eat or drink for a few hours after the test, until the local anaesthetic wears off. You will see the doctor who gives you your anaesthetic (the anaesthetist) either at a clinic or when you are admitted to hospital.

You will usually be admitted to hospital the day before or on the morning of your operation. The nurses may give you elastic stockings (TED stockings) to wear during and after the operation. These help prevent blood clots forming in your legs.

After your operation

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.

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