Osteoporosis

Hyperparathyroidism (HPT) is a medical condition in which the parathyroid glands produce excessive amounts of parathyroid hormone (PTH) in the blood. HPT has many difficult symptoms, including muscle weakness, bone and joint pain, concentration and memory issues, abdominal pain, and frequent urination. Some patients with HPT may also feel a lump in the neck.

HPT is treatable, especially if caught early, but leaving it untreated can lead to life-threatening complications such as osteoporosis and kidney disease. Not only that, but HPT is also linked to several types of cancers. In this article, we’ll explore the connection between hyperparathyroidism and cancer.

What is Hyperparathyroidism?

PTH maintains steady levels of calcium in the blood. HPT occurs when one or more of the parathyroid glands become enlarged and produce large amounts of parathyroid hormone. A high level of PTH leads to high calcium levels in the blood, impacting various body systems including the bones and muscles, brain, gastrointestinal system, and kidneys.

Hyperparathyroidism in Cancer Patients

A growing body of scientific evidence tells us that HPT is associated with numerous cancer types, including parathyroid cancer and thyroid cancer as well as skin, breast, colon, rectal, and kidney cancers. Studies also show that HPT increases the risk of malignant cancers. A study based on data from the Danish cancer care registry showed that patients with HPT have 25% increased risk of cancers.

Hyperparathyroidism and Parathyroid Cancers

Around 0.5% to 5% of HPT is caused by parathyroid cancer—that is, by a malignant tumor in the parathyroid. As of now, we know that certain factors, such as radiation therapy in the head, neck or breast region, and genetic disorders like hyperparathyroidism-jaw tumor syndrome, multiple endocrine neoplasia type I (MEN1) and familial isolated hyperparathyroidism (FIHP), increase the risk of parathyroid cancer.

High calcium levels in blood is one of the chief indicators of HPT, and thus the risk of parathyroid cancer. If your blood reports show high serum calcium levels or if you experience any of the symptoms discussed above, you should get a consult from a board-certified parathyroid specialist.

Parathyroid cancers are aggressive cancers and should be caught and treated early. For this condition, the only treatment is the complete removal of the affected parathyroid gland. If the tumor isn’t removed completely, recurrence of the cancer is extremely likely.

Hyperparathyroidism and Thyroid Cancer

A study published in BMC Surgery showed that the incidence of papillary thyroid cancer is high in patients with primary and secondary HPT. Papillary thyroid cancer is the most common type of thyroid cancer, which usually forms on one lobe of the thyroid gland. The study also found that thyroid tumors more than 1 cm in size were seen only in patients with primary hyperparathyroidism.

Thyroid cancer spreads very fast and can affect the lungs, bones and other body parts. Its symptoms include persistent cough, hoarseness of voice, neck pain which radiates to the ear, swelling in the neck, and difficulty breathing and swallowing. If you experience any of these symptoms alongside the symptoms of HPT described above, it is likely your HPT may have led to thyroid cancer. Consult a thyroid specialist immediately.

Hyperparathyroidism and Breast Cancer

Breast cancer is among the leading cancers in women in the US. Around 30-40% of women with malignant breast cancers do show high calcium levels in blood at some point during their illness. In these cases, high calcium levels in blood usually indicate spread of cancer to the bones, but it may also be caused by primary hyperparathyroidism. Moreover, women with primary hyperparathyroidism are more likely to have breast cancer than women who don’t. In women with breast cancer and high serum calcium levels, parathyroid hormone levels are usually checked to find out if the underlying cause of high calcium levels is HPT.

The Hyperparathyroidism and Cancer Connection—Possible Theories

So, we know that HPT and cancers are associated, but how do we explain the link between them? There are several theories that have been proposed so far.

Some research shows that high calcium levels in blood triggers cell division. Cancer cells, by nature, do not stop multiplying or die off, so runaway cell division caused by high blood calcium levels could conceivably lead to cancerous growth.

A few studies have also pointed out that high parathyroid hormone levels promote tumor development and inhibit cell death. Some other studies say that low levels of vitamin D, which is a prominent feature of HPT, may also increase cancer risk.

The evidence shared by these studies, however, is unfortunately not yet definitive. Scientists are still trying to find out the exact mechanisms that explain why cancer and HPT coexist, so for the moment these theories are not yet proven.

When to See a Doctor about HPT

As noted above, untreated HPT may lead to serious health issues. Many studies have shown that in addition to cancer, HPT is also linked with life threatening heart and kidney disease. Hence, it is important to be watchful for hyperparathyroidism symptoms and signs, and if you have HPT, get it treated early to prevent complications.

If you experience symptoms of HPT and your blood reports show alterations in P and calcium levels, you should get an appointment with a parathyroid expert. Dr. Babak Larian of the CENTER for Advanced Parathyroid Surgery is a parathyroid expert in treating HPT safely and effectively. He performs a minimally invasive parathyroidectomy (MIP) with a high success rate and minimal scarring. An 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.

References:

1. HyperparathyroidMD. Is there a connection between hyperparathyroidism and cancer. Available at:

2. Pickard AL, Gridley G, Mellemkjae L, Johansen C, Kofoed-Enevoldsen A, Cantor KP, Brinton LA. Hyperparathyroidism and subsequent cancer risk in Denmark. Cancer. 2002 Oct 15;95(8):1611-7. doi: 10.0.3.234/cncr.10846. PMID: 12365007.

3. Serena Palmieri, Letizia Roggero, Elisa Cairoli, Valentina Morelli, Alfredo Scillitani, Iacopo Chiodini, Cristina Eller-Vainicher . Occurrence of malignant neoplasia in patients with primary hyperparathyroidism. European Journal of Internal Medicine. Volume 43, September 2017, Pages 77-82

4. Michels KB, Xue F, Brandt L, Ekbom A. Hyperparathyroidism and subsequent incidence of breast cancer. Int J Cancer. 2004 Jun 20;110(3):449-51. doi: 10.0.3.234/ijc.20155. PMID: 15095313.

5. Rodrigo Arrangoiz, et al. Is Breast Cancer Associated with Primary Hyperparathyroidism?. American Journal of Otolaryngology and Head and Neck Surgery.2019. Volume 2(1). Article 1033

6. Goswami S, Ghosh S. Hyperparathyroidism: cancer and mortality. Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S217-20. doi: 10.0.16.7/2230-8210.104042. PMID: 23565381; PMCID: PMC3603029.

7. Karaköse M, Kocabaş M, Can M, Çalışkan Burgucu H, Çordan İ, Kulaksızoğlu M, Karakurt F. Increased incidence of malignancy in patients with primary hyperparathyroidism. Turk J Med Sci. 2021 Aug 30;51(4):2023-2028. doi: 10.0.15.66/sag-2012-18. PMID: 33957725; PMCID: PMC8569777.

Hi, my name is Shotzeegator_50. I'm here because of my bipolar, borderline personality, old, cptsd, autism spectrum disorder, anxiety, depression, fibromyalgia, rh and osteoporosis arthritis, to relieve support and to understand my borderline personality disorder better.

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I was diagnosed with Fibromyalgia at 24,now 55 in September. I also have Osteoporosis! I'm being treated with Evenity 2 shots once a month! Since the first injections my Fibromyalgia has gotten Significantly Worse!! I was wondering if anyone might have had a similar experience!! Thank Y'all!! 💜💜💜

I am not sure if this is where I should post, but I could really really use some advice on flares. I have been "flaring " going on 3 weeks. I don't know which illness is flaring? Fibromyalgia, Chronic Pain Syndrome, ME/CFS, Primary Sjögren's syndrome, osteoarthritis, refractory migraines, Lupus and RA are being tested. I have been in this pain circus for 17 years....
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Hi!

Still learning to navigate this site. I'm liking it so far. I was recently diagnosed with BPD, last week, so I'm learning as much as I can. The diagnosis sucks, but it has been so insightful for me to know why I've been this way since I was a teenager. I'm 57 now.

My children grew up with a crazy mom flying off the handle with rage. Yelling for the stupidest things. Throwing things. Hiding in my room. I was the child.

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I'm on my 3rd divorce we've been apart for 13+ yrs. married 24. He purchased this foreclosure home said I could fix it up and live in it. Use his benefits when he passed, he lives with his gf for 13 yrs. This past Nov. I was blindsided by divorce pprs claiming I owe him all this money, he claims he's in debt he's taken out multiple loans & credit cards he took out most of the equity in the house I'm fixing up. In our state I'm responsible for half his debts. I'm on a low fixed income .
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Since Christmas, I have been struggling with BPV, a type of virtigo caused by the crystals in your inner ear getting out of whack. I have had it before, and know it can be fairly quickly resolved with an exercise called the Epley Maneuver.

HOWEVER, nothing is simple when you are dealing with multiple health conditions. My osteoporosis has led to breaking both shoulders, which limits me from leaning on my arms as required by the Epley Maneuver. I also have a fall phobia which makes the virtigo much more unpleasant.

I want the PBV to go away as soon as possible, and have no way to do so on my own. My doctor referred me to a PT, but I was sceptical they could deal with my complicated little self.

Boy, did I underestimate the skill of a good PT! Not only is she helping me through the Epley Maneuver, but she has a whole bag of tricks to help with both the virtigo and the fall phobia. Thank God for therapists!