Medical statistics show that thyroid diseases at the present time are one of the most common. They are diagnosed in every third person, especially in old age. The most dangerous disease is cancer (carcinoma) of the thyroid gland. This diagnosis frightens everyone who only hears such words. But in fact, everything is not as scary as it seems. Modern medicine is so developed that it allows you to identify the disease at an early stage and successfully get rid of it. Let us consider in detail one of the types of cancer, which is called "papillary thyroid carcinoma".
Features of the disease
Papillary cancer is more common than other types. A malignant formation appears from a he althy tissue of an organ, is visualized as a cyst or an uneven large tumor. In 80% of all cases, the patient manages to completely recover from this kind of carcinoma.
If we talk about other types of cancer, then in comparison with them, papillary cancer hasproperty takes a long time to develop. Another feature is that metastases of papillary thyroid carcinoma often spread to the lymph nodes.
As a rule, only 1 node is found in a patient, in rare cases there are several. Most often suffer from this disease at the age of 30-55, mostly women (but sometimes men are also diagnosed with this disease).
Reasons
So far, no one can exactly determine why thyroid cancer develops. Doctors suggest that, most likely, the reason lies in cell mutation. Why such mutations occur is also unclear.
Tumor develops after the cells have mutated. They begin to grow, gradually affecting the he althy tissue of the organ.
As scientists suggest, papillary thyroid carcinoma develops due to:
- insufficient amount of iodine in the body;
- environment;
- ionizing radiation;
- hormonal disorders;
- congenital pathology;
- bad habits (smoking, alcohol abuse);
- frequent viral and bacterial infections of the respiratory tract.
Signs
This form of cancer develops slowly, so in the early stages it is determined by chance, and not from any symptoms. A person does not experience discomfort, nothing hurts, he lives a full life. When the tumor begins to grow, it leads to pain in the neck. A person can feel for himselfforeign seal.
In later stages, papillary thyroid carcinoma causes the following symptoms:
- enlargement of the cervical lymph nodes (in most cases on the one side where there is a malignant tumor);
- pain in the neck;
- Foreign body sensation when swallowing;
- sometimes voice gets hoarse;
- breathing difficulties appear;
- when squeezing the neck (especially when a person is lying on his side), significant discomfort is felt.
Stages
Is papillary thyroid cancer classified somehow? Stages, the signs of which are the basis for the diagnosis:
1. Age under 45:
- I stage: the size of education any. Sometimes cancer cells spread to nearby tissues, such as lymph nodes. Metastases do not spread to other organs. The person does not feel any signs of illness, but sometimes there is a slight hoarseness, slight pain in the neck.
- II stage: stronger growth of cancer cells. Metastases affect both lymph nodes and organs that are located close to the thyroid gland (lungs, bones). Signs are strong enough to be noticed.
2. Age over 45:
- I stage: the tumor is no more than 2 cm, no other organs affect papillary thyroid cancer. Symptoms of the stage: the person does not feel much change, or the signs are mild.
- II stage: the tumor does not go beyond the bordersthyroid, but the size reaches 4 cm.
- Stage III: larger than 4 cm, cancer cells infect nearby organs.
The big picture
The appearance of a knot or seal is the first thing that starts thyroid cancer. Carcinoma of the papillary thyroid gland is characterized by single formations, in rare cases multiple. If the node is deep, and its size is insignificant, then a person cannot find it on his own. Malignant tumors up to 1 cm cannot be determined even by an endocrinologist. Only after ultrasound do they find such small formations or after the cancer cells began to spread to the lymph nodes, and they, in turn, increased.
With a small size of the nodes, the disease is called "hidden papillary carcinoma". Such formations are not very dangerous, even at the stage of metastasis. The tumor moves freely in the thyroid gland, can be displaced during swallowing. But when the cancer cells spread to the surrounding tissues, the malignancy becomes immobile.
Metastases very rarely spread to other organs (except lymph nodes). This happens only in the advanced stages of the disease. Metastases tend not to make themselves felt for a long time. In most cases, papillary cancer affects the lymph nodes, rarely spreads to another lobe of the thyroid gland.
Features of cells
Main characteristic of malignancy:
- size - from a few millimeters to several centimeters;
- on rare occasionsmitoses observed;
- the center of the formation may be calcium deposition or cicatricial change;
- tumor not encapsulated;
- cells have no hormonal activity.
Examination
Initially, the doctor palpates the neck in the area of the thyroid gland. The cervical lymph nodes are also palpable. If the doctor detects something, then the patient is sent for an ultrasound, which will help determine the presence of formations, their size and structure.
The cytological picture of papillary thyroid carcinoma is the main task of the examination. For this, a fine-needle aspiration biopsy is used, which is carried out strictly under ultrasound guidance.
To understand if there are metastases in other organs, the patient is not sent an x-ray.
Important
Cytological papillary thyroid carcinoma is an incorrect definition that does not make sense. There are concepts of "cytological examination" (determination of the structure of cells in order to detect pathology) and "papillary carcinoma".
Treatment
How to help a patient diagnosed with papillary thyroid carcinoma? Treatment consists of surgical intervention. With such a disease, a thyroidectomy is used. There are two options for the operation:
- partial thyroidectomy;
- total thyroidectomy.
To completely destroy cancer cells, they resort toradioactive iodine therapy after surgery.
Partial thyroidectomy
Surgical intervention of this type is indicated for patients with a small size of a malignant tumor, which is located in one of the lobules of the organ. It is important that cancer cells do not spread anywhere else. As a rule, in such cases, the node does not exceed 1 cm in diameter. The duration of the procedure is no more than 2 hours.
The patient is not threatened with the development of hypothyroidism, because the hormone is synthesized by the unaffected lobe of the thyroid gland. Sometimes hormone replacement therapy is required.
Total thyroidectomy
The procedure involves the complete removal of the thyroid gland. Both lobes of the organ are excised, as well as the isthmus that connects them. Sometimes it becomes necessary to remove the cervical lymph nodes. This happens in those cases when they are greatly enlarged, and metastases are found in them. The duration of the procedure is approximately 4 hours.
After this kind of surgery, the patient will have to take hormone-containing drugs for life. After all, there is no thyroid tissue left in the body.
Radioiodine Therapy
This therapy is used when the operation has already been done. It is aimed at destroying the remnants of cancer cells. Metastases that have gone beyond the organ, gone to the lymph nodes, are very dangerous. With the help of radioactive iodine, it is possible to kill such cells. Often they remain in the thyroid gland itself after a partial thyroidectomy.
Even if cancer cells have spread to the lungs, radioactive iodine therapy can successfully get rid of them.
Post-operative period
Thyroectomy is a complex surgical intervention, but the recovery after it is quite fast. Most patients who have to undergo such an operation do not feel much discomfort after the procedure. A person can return to their usual lifestyle immediately after being discharged from the hospital.
Some people think that after the procedure it will not be possible to fully eat, drink water. But it's not. The incision does not affect the swallowing of both solid and liquid food.
Possible Complications
In rare cases, the operation ends with complications:
- Damage to the recurrent nerve, which is responsible for the voice.
- Hoarseness or slight change in voice. Sometimes the voice changes forever.
- Injury to the parathyroid glands. They are located behind the thyroid gland, so they can be affected during the operation. But this happens very rarely in inexperienced surgeons. Damage threatens to disrupt the exchange of phosphorus and calcium. As a result, all this leads to hypoparathyroidism.
Forecast
What can papillary thyroid carcinoma turn out to be for a person? The prognosis is favorable in most cases. Even if cancer cells have spread to the lymph nodes, the patient can live for a long time. Statistics show that after surgery a person lives:
- over 20 years in 70% of cases;
- over 10 years in 85% of cases;
- over 5 years 95% of the time.
As you can see, papillary thyroid carcinoma is not so terrible. The survival rate is quite high even in cases where the tumor has spread beyond the thyroid gland.
Further examination
After a full course of treatment, a person should regularly visit an endocrinologist. This is necessary in order to monitor the general state of he alth. Sometimes the cancer comes back, so you will have to undergo a full examination every year:
- blood test (the effectiveness of replacement therapy is determined, as well as the presence of malignant tumors, remaining metastases);
- Ultrasound of the thyroid gland and lymph nodes;
- body scan with iodine.
Papillary thyroid cancer is a dangerous disease, but in most cases it can be completely eliminated. The main method of treatment is surgery, after which it is necessary to resort to radioactive iodine therapy.
