tumors of the parathyroid glandsParateriodny cancer develops in the cells of the parathyroid glands. He is a rare enough, the tumor is characterized by slow growth.

Parathyroid glands are part of the endocrine system that synthesizes hormones. Most people - 4 parathyroid glands, 2 - on each side of the thyroid gland. Some people have noted an increasing number of parathyroid glands in other parts of the neck or the chest. They are synthesized parathyroid hormone that controls calcium levels in the blood.

The majority of patients with this diagnosis - middle-aged people, equally men and women.

Our company, a medical service «Tlv.Hospital», offers the organization of diagnosis and treatment of cancer of the parathyroid glands in the leading medical centers in Israel:

  1. Accurate and individual selection of highly qualified doctors and clinics the opportunity to get a "second opinion."
  2. High speed organization of the whole process of treatment and stay in the country.
  3. Cost of services is similar to the rates for self-treatment of the patient.
  4. Comfortable conditions of stay in Israel, the organization of support after treatment.

Reasons for parathyroid cancer

Researchers distinguish the following risk factors that contribute to the development of the disease:

  • Multiple endocrine neoplasia - a group of hereditary genetic disorders that affect the endocrine system. Neoplasia can cause tumors in the endocrine glands that affect the hormones in the body. Last control certain functions - metabolism, growth and reproduction. For this type of cancer are more prone people with type 1 multiple endocrine neoplasia.
  • hyperparathyroidism syndrome with swelling in the lower jaw - a rare hereditary disease. It stimulates the development of several tumors of the parathyroid glands. This is mainly benign tumors, but there are malignant.
  • Family isolated hyperparathyroidism - a rare genetic disease in which the parathyroid glands in the form of tumor. They cause hyperparathyroidism, which leads to an excess of hormone TSH.

Possible risk factors include:

  • Genetic mutations - in the CDC73 gene that tells the body to the need for protein parafibromina. It is important for cell growth and division. Mutations in CDC73 gene cause changes in quantity and quality parafibromina, resulting in abnormal growth of parathyroid cells. It is also known about the genetic mutation in BRCA 2.
  • Radiation therapy to the head and neck can cause tumors of the parathyroid glands.

symptoms of cancer of the parathyroid glands

Signs of malignant tumors develop because of the excess synthesis of hormone glands. This condition is called hyperparathyroidism. Increased content of substances causing hypercalcemia, which is shown in the following symptoms:

  • fatigue;
  • muscle weakness;
  • increased thirst;
  • problems with urination;
  • frequent urination;
  • excessive amount of urine (polyuria);
  • bone pain;
  • poor appetite;
  • nausea, vomiting;
  • weight loss;
  • dehydration;
  • constipation;
  • problems with clarity of thought;
  • bone fractures;
  • tumor in the neck;
  • voice changes (hoarseness, for example);
  • trouble swallowing;
  • disturbances in the kidney - stones, kidney disease;
  • stomach ulcer;
  • inflammation of the pancreas.

Diagnosis of cancer of the parathyroid glands in Israel

Israeli clinic equipped with modern medical equipment, highly professional doctors provide accurate and reliable diagnosis of the disease.

Possible tests are needed to confirm the diagnosis of malignant tumors of the parathyroid glands:

  1. The doctor starts examination with anamnesis, queries about symptoms, risk factors and other diseases, family history.
  2. Biochemical analysis of blood is required for the diagnosis of cancer of the parathyroid glands. blood calcium levels above 14 mg / dL, and the amount of parathyroid hormone is 2 times higher than normal - suggest oncology.
  3. Scintigraphy - the most common visualization tool for the assessment of the parathyroid glands. He is the most sensitive and detects changes in metabolic activity. Scintigraphy was used to determine the size and location glands verify their operation. This test can be performed with single-photon emission computed tomography (SPECT), which adds the three-dimensional image.
  4. An ultrasound is used to examine the neck and lymph nodes; identify the tumor, invading the surrounding tissues.
  5. CT is used to assess the state of the mediastinum, detecting distant metastases.
  6. MRI evaluates the central portion of the chest cavity, is used to find secondary foci.
  7. Catheterization with selective venous blood sampling requires blood samples from veins near each parathyroid gland. Measured amount of parathyroid hormone thus determined hyperactive glands.
  8. X-rays are used to check the lungs or the presence of metastases in the bones.
  9. PET allows to detect changes in metabolic activity of body tissues. Used for the diagnosis of disease recurrence.

Treatment of cancer of the parathyroid glands in Israel

Since the patient has a team of highly qualified oncologists who specialize in different areas - surgery, radiotherapy, chemotherapy. In the development of treatment programs take into account the unique needs of each organism, stage of disease and the level of calcium in the blood.

Treatment options for this type of cancer:

  1. Surgery - the main method of therapy aimed at the removal of the tumor and surrounding tissue.
  2. Supportive therapy, whose main objective - to control hypercalcemia.
  3. Radiation therapy can be recommended for the treatment of postoperative recurrence or metastatic cancer.
  4. Chemotherapy is also requested to return the disease and the availability of secondary foci.

Operations on parathyroid cancer

Surgery - this is the basic method of treatment. Indications for him:

  1. Cure cancer with the help of the complete removal of the glands and surrounding tissue.
  2. Remove relapse.
  3. Resect metastases.

En bloc resection - operation on parathyroid cancer

This is the preferred type of surgery for this disease. Resection reduces the risk of local recurrence in more than parathyroidectomy (removing only the parathyroid gland).

parathyroid cancer often affects the thyroid gland on the side where the tumor is located. En bloc resection involves removing part of the thyroid gland, the muscles around the neck, the tissues around the trachea and the recurrent laryngeal nerve.

Doctors taking care not to rupture the capsule of the tumor during surgery due to the high risk of the spread of tumor cells in the neck region.

Repeated surgical resection - surgery on the parathyroid glands in cancer

Used for local recurrence in the neck, providing a long-term control of the disease.

In most cases, relapse is a multifocal, meaning the occurrence of tumors in many areas of the neck. Cancer affects the recurrent laryngeal nerve, trachea, esophagus and blood vessels of the neck and mediastinum. The surgeon removes as much of the tumor process, as much as possible, trying to preserve the recurrent laryngeal nerve and avoid the paralysis of the vocal cords. Sometimes laryngeal nerve is removed, if there is a single recurrent tumor. In this case, the benefits of surgery outweigh the parathyroid glands removal nerve side effects, which may include vocal cord paralysis. In some cases, re-surgical excision is required to control the hypercalcemia caused by tumor growth.

Excision of lymph nodes - operation on parathyroid cancer

Lymphadenectomy (removal of the lymph nodes) is executed only if the lymph nodes in the neck area is enlarged or a seal which assumes the presence of the disease. Such an operation is not considered as a standard, since parathyroid tumors grow very slowly, have low propagation velocity to the lymph nodes. Lymphadenectomy also called cervical lymph node dissection.

removal of metastases

Since this type of cancer is increasing slowly, surgery to remove the local metastases or lymph nodes of the neck, as well as remote secondary foci in the lung, liver, or bone, will provide good control of the disease.

supportive care

Symptoms and related health problems caused by cancer is almost always caused by an increase in the level of calcium in the blood, because the glands produce excessive amounts of hormone. A parathyroid hormone regulates calcium levels in the blood.

Hypercalcemia - a condition triggered by an increase in the amount of calcium. The goal of treatment is to reduce the secretion of PTH.

Radiation therapy

At present there is not certain the role of radiotherapy in the treatment of this disease.

Sometimes irradiation is used after surgery to remove the remaining cancer cells and reduce the likelihood of recurrence. External radiation therapy is used. Linear accelerator directs radiation to the area where the tumor and some surrounding tissue is removed.

Chemotherapy

Cytotoxic drugs are rarely used in the treatment of this disease. Since it is a rare type of cancer, very few clinical trials have confirmed the effectiveness of chemotherapy in the treatment of certain tumors of the parathyroid glands.

Activated systemic chemotherapy, intravenous infusion. Medicines are distributed through the bloodstream, circulate throughout the body, destroying cancer cells.

Indications for chemotherapy:

  1. If the tumor can not be completely removed by surgery.
  2. Relapse or metastatic cancer.

recommended chemotherapy drug dacarbazine (DTIC) for the treatment of this cancer. Schemes of cytostatics:

  • 5-fluorouracil (Adrucil, 5-FU), cyclophosphamide (Cytoxan, Procytox) and paclitaxel (Taxol);
  • 5-fluorouracil, cyclophosphamide and dacarbazine.

localized cancer treatment in Israel

If the tumor is localized parathyroid glands, no secondary outbreaks, the following therapies may be recommended:

  1. Surgery - basic method. Applicable en bloc resection, lymphadenectomy.
  2. Supportive therapy treats hypercalcemia to normalize the amount of calcium prior to surgery.
  3. Radiation therapy may be recommended after surgery to reduce the chance of the disease returning.

metastatic cancer treatment in Israel

The following methods may be proposed, taking into account individual characteristics of each case of disease.

  1. Surgery is used to remove local metastases or lymph nodes of the neck, as well as remote secondary foci - lung, liver, or bone.
  2. Supportive therapy is directed at the treatment of hypercalcemia:

- to normalize blood sugar levels before surgery;

- control hypercalcemia, when the disease is inoperable. Tsinakaltset given alone or in combination with other drugs for recurrent or metastatic tumors of the parathyroid glands.

  1. Radiation therapy is recommended when local metastases in the neck area, if the operation is not considered as an embodiment, and also at distant secondary foci in the lung, liver, or bone.
  2. Chemotherapy is offered in metastatic tumor process, which can not be completely removed surgically. Applied dacarbazine alone. chemotherapy schemes are also used: 5-fluorouracil (Adrucil, 5-FU), cyclophosphamide (Cytoxan, Procytox) and paclitaxel (Taxol); 5-fluorouracil, cyclophosphamide and dacarbazine.

relapse treatment in Israel

Approximately 40-60% of cases recur after treatment. Cancer returned in about 2-5 years after the first operation. therapy program will depend on where the tumor is located. As a rule, relapses occur more frequently in the neck or in the lymph nodes.

Use the following method:

  1. Surgery - repeated surgical excision, lymph node dissection, the removal of distant metastases.
  2. Supportive therapy.
  3. Radiation therapy after surgery is recommended; with local metastases in the neck due to an inoperable tumor; at distant secondary foci.
  4. Chemotherapy is offered when the cancer can not be removed surgically.

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