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Hyperparathyroidism (HPT) is a medical condition in which one or more of the parathyroid glands responsible for calcium regulation in the blood becomes enlarged. The affected gland then produces extra amounts of parathyroid hormone (PTH). This increases the level of calcium in the blood. Hyperparathyroidism is a treatable condition, especially when it is caught early. In rare instances, however, there is a link between hyperparathyroidism and cancer. If you have symptoms of hyperparathyroidism like brittle bones, stomach pain, and kidney stones, contact Dr. Babak Larian and the team at the CENTER for Advanced Parathyroid Surgery. Contact us today to learn more about your diagnosis and treatment options. For now, let’s look at the types of cancer that could be related to HPT. 

 

Types of Cancer Associated With Hyperparathyroidism

Hyperparathyroidism could be linked to several types of cancer, including parathyroid, skin, breast, and kidney cancer. Research also suggests a link between hyperparathyroidism and thyroid cancer. In this section, we’ll look at these relationships and see what we can learn from them. 

Hyperparathyroidism Cancer: Is It a Thing?

Hyperparathyroidism can be caused by parathyroid cancer. When a patient develops parathyroid cancer, this means the tumor on the parathyroid gland is malignant instead of benign. Benign growths cause the vast majority of HPT cases, but malignant parathyroid tumors are estimated to cause close toanywhere from 0.5% to 5% of them.

In other words, parathyroid cancer is rare. When it does happen, it means malignant cells are developing in parathyroid gland tissue. This causes the parathyroid gland to become hyperactive, resulting in high parathyroid hormone production. This prompts the bones — which store 99% of the body’s calcium reserves — to release too much calcium. It also causes the intestines to absorb more calcium from the foods we eat

The result is hypercalcemia, a medical condition in which calcium in the blood exceeds a normal level. In the case of parathyroid cancer, the calcium level can rise quickly and become extremely high. High calcium levels and cancer of the parathyroid can be severe and life-threatening. If you think you have parathyroid cancer and high calcium levels, seek medical attention immediately

What Causes Parathyroid Tumors?
We don’t know why some people develop parathyroid tumors, and others don’t. Similarly, there’s no way to predict who will develop a malignant vs. benign parathyroid tumor. However, some risk factors have been linked to parathyroid tumors. Past radiation therapy in your neck or head is thought to increase your risk of malignant and benign parathyroid tumors. 

Genetics most likely plays a role, too. Three genetic disorders are considered risk factors for parathyroid cancer: 

  • Hyperparathyroidism-jaw tumor syndrome: A condition in which a tumor develops due to mutations of the CDC73 gene, which makes a protein that serves as a tumor suppressor.
  • Multiple endocrine neoplasia type I (MEN1): A disorder that affects the endocrine system.
  • Familial isolated hyperparathyroidism (FIHP): A condition that weakens the body’s ability to govern cell growth and division.

 

What Are the Symptoms of Parathyroid Cancer?

Signs of parathyroid cancer look a lot like the symptoms of noncancerous hyperparathyroidism. That’s because parathyroid cancer and hyperparathyroidism cause hypercalcemia, or excess calcium in the blood. Signs of high calcium levels and cancer include muscle weakness, fatigue, nausea, excessive thirst, depression, cramping, and frequent urination. Some patients may feel a lump in their neck or experience difficulty swallowing. 

As with all cancers, parathyroid cancer has a better prognosis if caught and treated early. However, it can be difficult to diagnose. In addition, complete removal of the malignant parathyroid gland is the only way to treat the condition. The cancer will almost certainly return if the tumor isn’t completely removed

We recommend that patients with symptoms of parathyroid cancer see a board-certified otolaryngologist to receive an accurate diagnosis and specialized treatment. Our surgeon at the CENTER for Advanced Parathyroid Surgery, Dr. Babak Larian, has been board-certified in head and neck surgery since 2003. He has removed thousands of malignant and benign parathyroid tumors in his career using a minimally invasive parathyroidectomy and other surgical procedures. 

Is Hyperparathyroidism Linked to Other Types of Cancer?

When it comes to malignancies that aren’t directly related to the parathyroid glands, debates persist about the link between hyperparathyroidism and cancer. A study published in the European Journal of Internal Medicine shows there might be a correlation between hyperparathyroidism and abnormal growth of cells or tissue (neoplasia) in the breasts, skin, and kidneys.

In the study, researchers investigated neoplasia in patients with osteoporosis or hypercalcemia. Among these patients, 163 had primary HPT (PHPT). Researchers measured all the patients’ PTH and vitamin D levels, along with the presence of cancer cells, for 10 years prior to the study’s launch.

The study revealed that breast, skin, and kidney cancer rates were higher in patients with PHPT than in all other patients. The researchers acknowledged that the role of PTH in cancer development remains unclear. But, the fact that cancer may persist after a PHPT patient undergoes parathyroid gland treatment shows PTH may increase their risk of neoplasia, researchers indicated.

Along with breast, skin, and kidney cancer, hyperparathyroidism and thyroid cancer may also be linked. 

What Is Thyroid Cancer?

Thyroid cancer refers to cancer of the thyroid gland. The thyroid is a butterfly-shaped gland located at the front of the neck. People coping with thyroid cancer experience an overgrowth of abnormal cells in the thyroid gland.

The thyroid gland produces hormones that manage various body functions, including heart rate, blood pressure, and body temperature. If there is an overgrowth of cancer cells in the thyroid gland, it may start to malfunction. When this happens, body functions are affected, and thyroid cancer can develop.

There are four types of thyroid cancer:

  • Papillary thyroid: This form of thyroid cancer is the most common and tends to form in one lobe of the thyroid gland.
  • Follicular: Follicular cancer is more prevalent in people who lack sufficient iodine in their diets than others.
  • Medullary: A rare type of thyroid cancer, medullary cancer impacts C-cells, which make calcitonin that helps regulate the amount of calcium in the blood.
  • Anaplastic: This type of thyroid cancer can spread quickly to the neck and other parts of the body.

Common symptoms of thyroid cancer include a persistent cough, changes in a person’s voice, neck pain that reaches the ears, swelling in the neck, and difficulty breathing and swallowing. 

So, why do researchers think there’s a potential link between hyperparathyroidism and thyroid cancer? A study published in BMC Surgery was used to evaluate the presence of thyroid cancer in 217 patients with primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT). Among these patients, 75 PHPT patients underwent surgery to remove some or all of the thyroid gland (thyroidectomy), followed by a parathyroidectomy. Of that group, 31 SHPT patients received a thyroidectomy and a parathyroidectomy.

In the study, researchers found that papillary thyroid cancer (carcinomas) incidence was similar in PHPT and SHPT patients. Furthermore, researchers only discovered thyroid tumors above 1 cm in patients dealing with PHPT.

If thyroid cancer goes unaddressed, it can spread to the lungs, bones, and other body parts. Anyone experiencing symptoms of thyroid cancer should meet with a doctor for proper diagnosis or treatment. A doctor can also determine if a patient is experiencing thyroid cancer in combination with HPT.

Can Hyperparathyroidism and Thyroid Cancer Occur at the Same Time?

It’s possible. Research indicates that patients may simultaneously experience hyperparathyroidism and thyroid cancer.

In one study, researchers performed a retrospective review of patients who underwent surgery for HPT between 1975 and 1996. Researchers found that 21 patients had papillary carcinoma, and one patient had follicular carcinoma. These are both types of thyroid cancer. The researchers also indicated that patients with HPT and a history of head and neck irradiation faced a greater risk of thyroid carcinoma than others.

Comparatively, another study examined four patients with primary HPT (PHPT). The study indicated that PHPT patients might face an increased risk of thyroid cancer compared to others. Yet, false-positive results of thyroid cancer were reported in around 10% of PHPT cases. To alleviate this issue, researchers suggested that PHPT patients undergo a thyroid ultrasound to check for signs of cancer. They also stated that surgical flexibility is critical and that surgeons should get a thyroid nodule sample to properly diagnose and treat PHPT and thyroid cancer.

Taking the First Step to Treat Parathyroid and Thyroid Issues

A malfunctioning parathyroid or thyroid gland won’t correct itself. The longer an abnormal gland malfunctions, the more harm it can cause to the body. Over time, parathyroid and thyroid gland issues can cause HPT, cancer, and high calcium levels. Fortunately, a proactive approach to diagnosis and treatment can help patients receive the care they need to manage parathyroid and thyroid gland problems.

Dr. Babak Larian of the CENTER for Advanced Parathyroid Surgery is a parathyroid expert who knows how to safely and effectively treat HPT. He performs a minimally invasive parathyroidectomy (MIP) with a high success rate and causes minimal scarring. Plus, a MIP can usually be completed in under 20 minutes and is followed by a four-gland assessment that ensures patients can maximize their surgery results.

For those who believe they might be dealing with HPT, hypercalcemia, or cancer of the parathyroid glands or thyroid gland, Dr. Larian is available to help. By scheduling a consultation with Dr. Larian, a patient can receive a comprehensive evaluation and find out a MIP can be used to treat their symptoms. To learn more or to schedule a consultation with Dr. Larian, schedule an appointment online or call us today at 310-461-0300.

 

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