A paraganglioma is a vascular tumor that onsets in nerve cells spread out through the body. Equally common in men and women, this complication can affect people of all ages, but is most common in individuals that fall between the ages of 25 and 50. This tumor is usually noncancerous and benign, but can move into other regions in the body and turn cancerous, as well as metastasize.
About half of paraganglioma tumors reported contain abnormal cells which produce hormones called catecholamines which in turn induces a fight-or-flight response. On the outside, this can manifests as high blood pressure, elevated heartbeat, sweating, flushed skin, tremors, and headaches.
Surgery is usually the preferred method to remove paraganglioma at low income health clinics as long as it is determined to be feasible. If left as it is, such a tumor can cause life-threatening damage, and even regress to a point where surgery is no longer an option. People carrying cancerous paraganglioma can have their disease and its symptoms contained through medicine and treatments.
In the event that a primary doctor suspects you have a paraganglioma, you may be referred to a medical oncologist, an endocrinologist, or even immediately to a surgeon. A number of tests are commonly required before you proceed, and one or more of these would be performed based on the resources available at a free health clinic.
- 24-hour urine test: A urine sample may be required from each time you urinate inside a 24-hour duration. This would help assess the level of hormone that is being secreted into the urine. The specialist would instruct you on storing, labeling, and returning the samples.
- Blood test: You may need to provide blood for lab testing so that they may check your hormone levels. Your doctor could tell you about any special preparations needed, like fasting or skipping a medication. Make sure you only do either or both after receiving specific instructions from a licensed medical practitioner.
- Imaging tests: An imaging test may be required to find out the placement of the tumor to a high level of accuracy. This could cover an MRI scan, CT scan, and even specialized scanning like PET.
- Genetic testing: Paraganglioma can be inherited, because some altered genes can carry the issue between generations. It would be normal for your doctor to check your blood for heredity reasons. If there is an altered gene present, you may be advised to see a genetic counselor at the earliest.
People suffering from paraganglioma require medical care of a kind only a multidisciplinary team can provide. If your doctor regularly treats this problem, then you can proceed with them. Otherwise, getting a second medical opinion is the way to go. Before choosing, look for someone specializing in rare neuroendocrine tumors.
Paraganglioma is only treatable based on the location of the growth, as well as how cancerous it is. It is malignant if it spreads to another part, but that is found to be rare in paraganglioma. Cancerous paraganglioma cells can migrate to bone, liver, lymph nodes, lungs, etc. If it gets that far, it is imperative to treat any elevated hormones or other symptoms as soon as possible.
- Medications: The first thing your doctor will do is try to bring the symptoms under control, including high blood pressure in case your paraganglioma produces hormones. Drugs prescribed to this purpose generally comprise beta and alpha blockers. Hormone-producing paraganglioma makes it critical to manage blood pressure right before surgery, or any other therapy.
- Radiation therapy: This treatment technique can help control the growth of the tumor, as well as improve other symptoms that onset post-surgery. If the tumor is located in the head, or close to one of the vital blood vessels or nerves, stereotactic body radiation therapy may be opted for. This is to minimize damage to healthy tissue in the area.
- Thermal ablation therapy: In some cases, you have specialized interventional radiologists working to destroy tumor deposits using a technique called thermal ablation therapy.
- Surgery: Surgical removal of the tumor is the most commonly preferred choice for treatment whenever feasible. If the tumor has expanded, surgery can also be done to reduce size. If hormone-producing paraganglioma tissue is disturbed, which a is possibility during surgery, these hormones can be released and end up causing the patient’s blood pressure to go up. This can be prevented with prior medication that nullifies hormone effects for up to two weeks before surgery. The procedure may include recording your blood pressure several times in a day, holding to a high-sodium diet, etc.
Surgery for paraganglioma is mostly performed while the patient is under general anesthesia, and requires the involvement of specialized anesthesiologists and surgeons. Afterwards, the patient would be required to stay at the hospital for up to several days, because tumors can recur; follow-ups are held to make sure that does not occur.