Most people ask this question because they are trained to think “cancer” and want to know if the parathyroid tumor we remove is cancerous. The good news is that parathyroid cancer is extremely rare. We have removed over 55,000 parathyroid tumors and we have seen parathyroid cancer about 3-4 times. That is one in 12,000 — so please don’t ask if it is cancerous. It is not.
Its all about the hormone, not the biopsy
Parathyroid tumors don’t cause problems because they are cancerous, they cause problems because of the parathyroid hormone they produce. Thus this entire operation is based upon hormone levels (before the operation, during the operation, and after the operation for years to come).
Our surgeons take a very small “shave” biopsy (like the head of a pin) of the normal parathyroid glands to see if they are normal or abnormal, and to measure how much parathyroid hormone (PTH) they are producing. These small biopsies go to the pathologist who generates a report that simply says “parathyroid tissue identified”. This tiny biopsy helps make sure the glands have been identified, and they help make sure that normal glands are not removed like happens in most cases where the surgeon removes a gland so they can measure the hormone drop in the blood. Editorial comment: That is the dumbest thing in the world and surgeons who are doing this are hurting patients.
Thyroid nodules are common! Most people have thyroid nodules, and within our patient population (average age 60), about 70 percent of our patients have one or more thyroid nodules. We evaluate EVERYBODY’S thyroid during their parathyroid operation (something most other surgeons in the world do not do, because they only operate to remove the one parathyroid that shows on a scan and they don’t check anything else). That’s why you are here at our center–we have the hood open to change the oil, and will will check the fan belts while we are there.
We remove thyroid growths and nodules in about 25% of the parathyroid operations we perform. These are always examined by the pathologists to examine for cancer. This biopsy process by the pathologists takes about 2-3 days to perform. Occasionally, this can take a week or even two if we need to have other specialists look at it.
Historically, only about 3% of the thyroid nodules or growths we remove have cancer in them—we error on the side of not leaving a cancer in you, thus over 95% of the nodules we remove are not cancerous. But it will help you avoid getting routine ultrasound scans on your neck every 6-12 months to see if the nodule grows. It can’t grow if we remove it! We do not want you to worry about any thyroid nodule we remove. We will call you if there is any bad or worrisome news. No news is good news!
What if my thyroid nodule is cancerous?
Did you know that in late 2016 the Norman Parathyroid Center recruited the number 1 thyroid cancer surgeon in the US to join our team? Dr Gary Clayman was the Chief of Surgical Oncology at MD Anderson for 17 years before coming to Tampa to open the Clayman Thyroid Cancer Center. We work side by side Dr Clayman and his team and if any of our patients need the world’s best thyroid surgeons, we have them right next door! Read more about Dr Clayman here: www.thyroidcancer.com/dr-gary-clayman-md. If you want to read more about thyroid nodules, go here: www.thyroidcancer.com/thyroid-nodule/. If you want to know more about thyroid surgery, go to the front page of this great website: www.thyroidcancer.com
Don’t worry about the pathology reports–more than 95% of our pathology reports are boring. If there is anything exciting in your report we will contact you, and your doctors will get a copy as well. If we do find a thyroid cancer during your parathyroid operation we will deal with it then, or develop a plan to have it addressed in the future. Remember, you came to our center because are the best in the world at this, and we have far more experience than any other doctors at these issues. It’s pretty safe to say we have seen every situation before and we know how to deal with virtually anything that can arise. That’s why you are here!