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Prognosis and survival for parathyroid cancer
People with parathyroid cancer may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a person’s medical history, type of cancer, stage, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor’s best estimate of how cancer will affect a person, and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic factors for parathyroid cancer. Neither tumour size nor lymph node status appears to play a role in prognosis.
Early diagnosis of parathyroid cancer, before or during surgery, is important for planning treatment. The disease may be diagnosed late because it is difficult to tell benign and malignant tumours apart and parathyroid cancer tends to be slow growing (indolent). Early recognition of parathyroid cancer indicates a more favourable prognosis.
Complete surgical removal of the tumour
Successful removal of the entire tumour during the first surgery is the most important prognostic factor.
- During surgery, the doctor examines the tumour. If the doctor believes that the tumour is cancerous based on its size and texture, then an en bloc excision is done to reduce the risk of recurrence and improve long-term control of the disease.
- A parathyroidectomy, which only removes the affected parathyroid gland, has a much higher recurrence rate compared with en bloc excision.
- It is important to avoid breaking the tumour capsule during surgery. If the capsule breaks, there is a high risk that the tumour cells will spread and cause persistent or recurrent disease.
Parathyroid cancer often comes back (recurs). It usually recurs years after initial symptoms appear. Recurrence within 2 years of diagnosis indicates a less favourable prognosis.
Control of the calcium level in the blood is important to maintain health. Most deaths due to parathyroid cancer result from the effects of hypercalcemia.
A person’s general health
A person’s general health has an impact on how well they tolerate treatment, such as surgery. Surgery is used as a primary treatment and to treat recurrent disease.