Oncological processes in the thyroid gland are rare. They can develop in several histological forms: follicular, anaplastic, medullary, papillary, etc.
The most common type of thyroid cancer is the papillary form. Papillary thyroid cancer is an uneven cystic carcinoma formed from healthy glandular tissues and.
Papillary formation is characterized by the presence of a number of protrusions( papilla - papilla), sometimes it resembles a fern leaf. The share of papillary malignant oncology of the thyroid gland accounts for about 75-80% of cases, and in the female population such a tumor is detected much more often.
Timely therapy in more than 90% of cases leads to complete recovery, the life expectancy of such patients often exceeds the 25-year period.
Causes of development of
Papillary thyroid cancer is a highly differentiated tumor, the cellular structures of which are similar to healthy cells.
Cancer cells do not die at the end of the life cycle, they multiply slowly and grow, forming a tumor and attacking healthy organs.
Important factors in the development of thyroid cancer are factors such as:
- Radiation exposure. Shchitovidka is particularly sensitive to ionizing effects. Thus, nuclear power plant employees often have thyroid gland tumors.
- Passing the course of radiation therapy, frequent X-ray procedures also increase the likelihood of developing malignant papillary oncology;
- Presence of chronic processes like thyroid, digestive or urogenital pathologies;
- The presence in the family of cases of goiter thyroid;
- Iodine Deficiency;
- Dysfunctional oncogenic heredity;
- If a woman already has a benign formation in the gland tissues and she takes oral contraceptives, then this can provoke malignancy of the tumor;
- Unhealthy addictions like alcohol, tobacco, etc.;
- Affiliation to the female sex. Scientists have proven that the papillary form of thyroid cancer is more affected by women 30-50 years of age.
Patients over the age of 50 are susceptible to more aggressive types of papillary oncology. If the thyroid cancer begins to be treated on time, then the patient has every chance of a long remission and definitive cure.
Symptoms of papillary thyroid cancer
Symptomatic manifestations of thyroid cancer are conventionally divided into two categories: nonspecific and characteristic.
Nonspecific symptoms can be observed in other pathological processes, so they can not reliably indicate the development of thyroid cancer.
Such attributes include:
- Presence of compaction in the neck;
- Discomfortable sensations behind the ears and in the larynx;
- Noticeable swelling of the cervical lymph nodes;
- Unexplained hyperthermia;
- Difficulty in swallowing, coughing and hoarseness, respiratory difficulties;
- If the resulting compaction presses on the vascular parathyroid passages, a vascular network is formed on the neck;
- If the formation presses on the vagus nerve in the larynx, then the patient experiences a voice dysphonia.
Initially, the development of thyroid cancer is hidden. When endocrinological examination in patients are found typical for oncopathology signs:
- In the tissues of the thyroid gland, a nodal compaction is probed from a certain side, having a papilliform surface and not causing discomfort;
- In ultrasound diagnostics, the formation of a glandular capsule and neighboring tissues is shown to germinate;
- Slow growth of the tumor is observed;
- On the part of education there is a characteristic increase in lymph nodes;
- At laboratory research of a blood the raised maintenance of a thyreoglobulin - onkomarkera in the presence of a cancer is revealed. In addition, the level of CEA has been elevated in the blood;
- Disorders of thyroid activity in papillary cancer are usually absent.
Metastasis spreads through the thyroid gland, then to the lymph nodes. Remote metastasis in malignant oncology of the thyroid gland practically does not occur.
Degrees and their prognosis
Papillary thyroid cancer is formed in 4 stages:
- First degree - the node has a local location, the thyroid capsule does not change, does not give metastases;
- Second degree a - a single, nonmetastatic formation, changing the shape of the thyroid gland;
- Second degree b - single tumor with metastases on one side;
- The third stage is a tumor that extends beyond the boundaries of the glandular capsule or presses against adjacent structures, lymph node metastases are located on either side of the thyroid;
- Fourth stage - there is a germination of the tumor in the nearest and distant organic structures.
In the detection and treatment of oncopathology at stage 1-2, the five-year survival rate reaches almost 100% of the level. If the tumor is detected in stage 3, the survival rate will be about 95%, and in 4 stages - 45%.
How is carcinoma diagnosed?
Diagnosis of thyroid cancer begins with an endocrinological examination, after which the doctor sends the patient to additional procedures like:
- Ultrasound diagnosis, which allows you to determine the boundaries and structure of the thyroid gland;
- Aspiration biopsy - mandatory diagnosis, which allows to determine the degree of tumor malignancy;
- Tomographic techniques such as PET, MRI or CT that visualize thyroid tissue and tumors and can determine the presence of metastasis;
- Radioisotope scanning, which is usually prescribed for the hyperfunctionality of the thyroid gland;
- Laboratory diagnosis - it includes blood tests for oncomarkers, the level of pituitary and thyroid hormones, etc.;
- Histology study of biopsy.
Treatment and life expectancy of patients after surgery
Thyroid cancer is one of the few oncopathologies from which one can completely cure or achieve a long-term remission.
The scope of operative manipulation is determined by a specialist on an individual basis on the basis of data on tumor size, metastasis, etc.
- Papillary thyroid cancer belongs to the category of the least aggressive formations, therefore, with a small amount of formation( less than a centimeter), partial removal of the gland is allowed.
- For larger sizes 1-4 cm without metastasis, doctors try to leave as little as possible an insignificant part of the gland in order to minimize the intake of hormonal drugs.
- If the tumor is more than 4 cm, then the thyroid gland is removed completely.
- In the presence of lymphatic metastasis, removal of the affected lymph nodes is indicated.
Additional radiation therapy is recommended for the destruction of the remaining cancer cells after surgery.
An effective way in anti-cancer thyroid therapy for papillary type of tumor is treatment with radioactive iodine, which accumulates in the localization of cancer cells and kills them. If the tumor in the thyroid gland is very large and inoperable, then as the palliative therapy is prescribed the introduction of anti-cancer drugs( chemotherapy).
After treatment, patients have every chance of a long life. With papillary thyroid cancer, about 80-90% of patients live more than 10 years. If there was metastasis in the pulmonary and bone tissues, the prognosis seriously worsens, however, a positive outcome is quite possible.
Cases of death after removal of the tumor occurred only after the repeated formation of cancer on a piece of thyroid after surgery. After the removal of the gland, the quality of life of cancer patients does not suffer at all, except that the voice may change somewhat, and then temporarily.
Relapse of papillary thyroid cancer
To avoid recurrence, patients after the operation must undergo an annual endocrinological examination.
The probability of recurrence for papillary cancer is about 30%, and the repeated tumor can develop even after ten or more years after the operation to remove it .
Relapse symptoms can be expressed by symptoms such as soreness, dyspnea, wheezing and coughing, voice disorders, etc.
Therefore, you need to regularly visit an endocrinologist and systematically check blood for cancer markers, then a relapse can be prevented.
Video about the surgical treatment of papillary thyroid cancer in high-risk patients: