Thyroid cancer

WHAT IS THYROID CANCER?

Thyroid cancer is a rare malignancy, affecting the thyroid gland - a small gland, located in the neck area. There are four main types of thyroid cancer:

  • Papillary carcinoma - the most common type, responsible for 4 from everyone 5 the case of thyroid cancer. It most often occurs in women under 40 years of age.
  • Follicular carcinoma - such are 1 to everybody 10 case of thyroid cancer. It most often affects the elderly.
  • Medullary carcinoma - is characteristic of it, that it has a strong genetic component and is often generically focused. Yeah, they're like that 1 to everybody 20 case.
  • Aplastic cancer - this is the rarest and most aggressive of the four types. Its frequency is around 1:100, occurs mostly between 60 and 80 years.

Рисковите фактори за появата на рак на щитовидната жлеза са възли или други заболявания на щитовидната жлеза, a relative with glandular cancer (for medullary cancers) and radiation exposure.

The most common symptom of thyroid cancer is the appearance of a painless swelling in the neck. At a more advanced stage, inexplicable hoarseness of the voice appears, difficulty breathing, swallowing, swelling of the cervical lymph nodes or neck pain.

DIAGNOSTICS

Diagnosis of thyroid cancer is based on physical examination and a number of tests and examinations, the most important of which are the thyroid function test and aspiration cytology. The thyroid function test measures the levels of thyroid hormones - thyroxine and triiodothyronine. High levels are indicative of hyperthyroidism, low - for hypothyroidism. Normal levels of hormones on the background of swelling in the gland require an aspiration test. To him, using a thin needle, a sample of cells from the swelling is taken for examination under a microscope. This allows the detection of malignant cells, if there are any in the gland. In some cases it may be necessary to conduct additional imaging studies - ultrasound, computed tomography or magnetic resonance imaging.

Стадирането на щитовидните тумори често се прави според т.нар. TNM classification, wherein:

T - indicates the size of the tumor.

N - indicates whether the tumor has spread to the surrounding lymph nodes.

M - indicates whether the tumor has reached other organs, ie. whether it has metastasized.

There are also more complex staging systems, which also take into account the type and degree of differentiation of tumor cells. The staging of differentiated tumors, such as papillary and follicular, is different for different age groups, because in older patients these tumors are usually more aggressive. Under the age of 45, only two stages of differentiated tumors are distinguished:

  • Stage I - the tumor has not metastasized;
  • Stage II - the tumor has metastasized.

A 4-stage system is used for differentiated tumors after the age of 45 and for all medullary tumors.:

  • Stage I - the tumor is under 2 centimeters in diameter and has not reached the surrounding lymph nodes.
  • Stage II - the tumor is between 2 and 4 centimeters in diameter, but is still limited in the gland.
  • Stage III - the neoplasia has reached the surrounding lymph nodes.
  • Stage IVA - the tumor has left the surrounding lymph nodes and reached other tissues in the neck or lymph nodes in the chest.
  • Stage IVB - the tumor has entered tissues around the spine.
  • Stage IVC - the tumor has reached other organs, most often the bones, lung or both.

TREATMENT

Surgical treatment in most cases gives excellent results and often leads to a complete cure. When the tumor is removed, part or all of the thyroid gland may need to be removed. In this case, patients have to take hormonal tablets with thyroxine for the rest of their lives as a replacement therapy because of the removed thyroid gland..

Radioactive iodine therapy for thyroid cancer is usually recommended after surgery. This method is painless and aims to remove any cancer cells left in the body. Due to the use of radioactive substances for treatment, it must be held in a hospital with special requirements to protect others. Patients must strictly follow the instructions for treatment, to prevent the danger of exposing other people.

Radiotherapy and chemotherapy are less commonly used in the treatment of thyroid cancer, in more severe cases.

Hormone replacement therapy with thyroxine tablets is required in these patients, in which the entire thyroid gland is removed. Periodically, patients undergoing such treatment are tested to determine the level of hormones in the blood..

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