Treatment of recurrent parathyroid cancer
The following are treatment options for recurrent parathyroid cancer. The types of treatments given are based on the unique needs of the person with cancer.
Approximately 40%–60% of the time, the parathyroid cancer comes back (recurs) after treatment. Recurrence usually happens 2–5 years after the first surgery.
Treatment for recurrent parathyroid cancer will depend on where the tumour is located. Usually, it recurs in the neck tissue or in the lymph nodes in the neck.
Surgery may be offered for recurrent parathyroid cancer. The types of surgery are:
- surgical re-excision for recurrence in the neck tissues
- Sometimes repeat excisions are necessary to control the hypercalcemia caused by tumour growth.
- lymphadenectomy for recurrence in the lymph nodes in the neck
- removal of metastases if the recurrence occurs in the lungs, liver or bones
- bring calcium in the blood to normal levels before surgery
- control hypercalcemia in people with disease that cannot be removed by surgery (unresectable disease)
Cinacalcet is a medication used alone or with other drugs to treat hypercalcemia in recurrent or metastatic parathyroid cancer (it is not used to treat other forms of hypercalcemia). This drug is in a class of medications called calcimimetics. It works by signalling the body to produce less parathyroid hormone, which in turn decreases the amount of calcium in the blood.
Radiation therapy may be offered for recurrent parathyroid cancer. External beam radiation therapy may be given:
- following surgery to reduce the chance of further local recurrences
- for local metastases in the neck if surgery is not an option
- for distant metastases to the lungs, liver or bones
Chemotherapy may be offered for recurrent parathyroid cancer when the cancer cannot be completely removed by surgery. The types of chemotherapy are:
- dacarbazine (DTIC) alone
- drug combinations
- 5-fluorouracil (Adrucil, 5-FU), cyclophosphamide (Cytoxan, Procytox) and paclitaxel (Taxol)
- 5-fluorouracil, cyclophosphamide and dacarbazine
People with parathyroid cancer may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.