Parathyroid cancer is a very rare type of cancer that affects the parathyroid glands, which are small glands located in the neck near the thyroid. These glands regulate calcium levels in the body by producing parathyroid hormone (PTH). In older adults, early symptoms of parathyroid cancer often arise from the effects of excessive PTH production, which leads to high calcium levels in the blood, a condition called hypercalcemia.
The earliest signs can be subtle and easily mistaken for other common age-related issues, but they generally fall into several categories:
**1. Symptoms related to high calcium levels (hypercalcemia):**
– **Fatigue and weakness:** Older adults may feel unusually tired or weak without a clear cause. This happens because high calcium interferes with muscle function and energy metabolism.
– **Muscle pain or cramps:** Calcium imbalance affects muscle contraction, leading to cramps or generalized muscle aches.
– **Bone pain or fractures:** Excess PTH causes calcium to be released from bones, weakening them and increasing the risk of fractures or bone discomfort.
– **Kidney problems:** High calcium can cause kidney stones, frequent urination, and sometimes kidney dysfunction, which may present as back or flank pain.
– **Gastrointestinal issues:** Nausea, vomiting, constipation, and abdominal pain can occur due to calcium’s effect on smooth muscles and digestive processes.
– **Increased thirst and frequent urination:** The kidneys try to excrete excess calcium, leading to dehydration symptoms.
**2. Neuropsychiatric symptoms:**
– **Confusion or memory problems:** Older adults may experience cognitive decline, difficulty concentrating, or episodes of confusion, which can be mistaken for dementia or other neurological conditions.
– **Depression or anxiety:** Mood changes are common and may be overlooked as normal aging or psychological issues.
– **Irritability or lethargy:** These subtle changes in behavior or alertness can be early warning signs.
**3. Physical signs in the neck:**
– Sometimes a lump or nodule can be felt near the lower part of the neck, close to the thyroid gland. This may be painless and go unnoticed initially.
– If the tumor grows large enough, it might cause discomfort, difficulty swallowing, hoarseness, or a sensation of pressure in the neck, but these symptoms usually appear later.
**4. Laboratory abnormalities:**
– Blood tests often reveal very high calcium levels, sometimes several times above normal.
– PTH levels are elevated, which is unusual because normally high calcium suppresses PTH production.
– Alkaline phosphatase, an enzyme related to bone turnover, may also be elevated, indicating bone involvement.
Because parathyroid cancer is rare and its early symptoms overlap with many other conditions common in older adults, diagnosis can be challenging. Symptoms like fatigue, muscle weakness, or mild cognitive changes are often attributed to aging or other chronic illnesses. However, persistent or worsening symptoms, especially when combined with high calcium levels on blood tests, should prompt further evaluation.
Imaging studies such as ultrasound or specialized scans can help identify suspicious nodules in the parathyroid region. A biopsy or surgical exploration may be needed to confirm the diagnosis.
In summary, the early symptoms of parathyroid cancer in older adults primarily stem from **excessive calcium in the blood caused by overproduction of parathyroid hormone**. These include fatigue, muscle weakness, bone pain, kidney stones, gastrointestinal discomfort, neuropsychiatric changes, and sometimes a neck lump. Because these symptoms are nonspecific and develop gradually, awareness and careful medical evaluation are essential for early detection.