Papillary thyroid cancer occurs in seventy percent of cases of cancer of the endocrine system. Such cancer often metastasizes, although it is characterized by rather good survival if it is detected on time. Why does this pathology develop, what are its symptoms? How is this disease treated? And what is the forecast? All of this will be discussed in this article.
Features of the disease
Papillary thyroid cancer is formed from organ cells. This is a tight single knot. Its size can reach five centimeters and more, and the structure, in turn, is papillary. This type of cancer is relatively peaceful, as it slowly increases and is treatable. Only adjacent tissue with lymph nodes affects papillary cancer. Distant metastases can be found extremely rarely, in most situations they affect the lungs.
Patients between thirty and fifty years old are usually at risk, although there are cases of this disease in children. Women are twice as likely to suffer from such cancer as men.
The prognosis after surgery for papillary thyroid cancer will be considered at the end of the article.
Main reasons
The causes of thyroid cancer are not exactly known, but in oncology there are several factors that can affect the occurrence of such a tumor:
- The effect on the human body of radiation and all kinds of radiation along with chemical carcinogens.
- The presence of bad habits in the form of smoking and alcoholism, which significantly reduce immunity, weakening the protection of the whole organism as a whole.
- Hereditary factor. For example, if a gene that provokes the appearance of thyroid cancer is transmitted by inheritance to a person, then the chance of getting it is one hundred percent.
- Deficiency in the body of iodine.
- The presence of diseases of the organs responsible for the production of hormones. For example, the pathology of the ovaries, mammary gland or the thyroid gland itself, all kinds of inflammatory processes in the body.
- The presence of hormonal changes in the form of menopause, pregnancy and so on.
- Body susceptibility to depression.
At risk are especially elderly people and those who have received radiation therapy. A malignant tumor of this organ can develop from a benign mass. The cause of papillary thyroid cancer are metastases of other organs.
Symptomatology
The curability of the disease depends on its stage and the size of the formation. Therefore, it is extremely important to identify this pathology in a timely manner. To do this, you need to know the main signs of the development of papillary cancer:
- The presence of a node in the neck that can be felt. This is one of the main symptoms. Sometimes the node is visible visually. Over time, it increases and becomes more noticeable.
- A noticeable increase in cervical lymph nodes. This is also an early sign, but it is often overlooked.
- The appearance of unpleasant sensations during swallowing or respiratory movements. In this case, a lump in the throat is felt.
- Presence of pain, hoarseness, and causeless cough.
The last signs may appear when the node reaches a large size and begins to squeeze the esophagus. A person can even change his voice because of this. At the last stage, the general condition of the patient worsens significantly, he may lose his appetite and lose weight dramatically. You may also experience fever with weakness and fatigue.
In general, the symptoms of papillary thyroid cancer in the initial stages are almost absent. This is the greatest danger, so you should always be careful and undergo regular examinations.
Benign tumors are often found in adults, and cancer is diagnosed in only 5% of cases. But if a person notices a knot on his neck, then he must visit a specialist. This is especially true for children, since they cannot have a benign education.
Pathology stages
The following four stages of papillary thyroid cancer are distinguished:
- In the first stage, the tumor is small, up to two centimeters. It does not have metastasis and does not fall outside the capsule of the thyroid gland. At the first stage, this cancer responds well to treatment, although it is difficult to detect so early.
- In the second stage, the node increases to four centimeters, but still does not extend beyond the organ. At this stage, it is often detected by palpation, and the patient at this time in the throat begins to feel discomfort. Metastases are still missing. This degree of papillary thyroid cancer is successfully treated in ninety-five percent of cases.
- In the third stage, the size of the tumor is more than four centimeters. She goes beyond the thyroid gland and begins to put pressure on neighboring organs. The patient's condition worsens, new symptoms appear in the form of shortness of breath, pain, shortness of breath and hoarseness. This stage is also characterized by an increase in lymph nodes and the presence of bilateral metastases.
- At the fourth stage, the tumor is large, due to which the thyroid gland is deformed, which becomes immobile. The presence of metastases in nearby tissues is noted, they spread to other organs. Patients have a new symptomatology, which depends on which organ is affected.
The prognosis after surgery for papillary thyroid cancer is of interest to many.
Treatment, surgery and replacement therapy
After determining the diagnosis, it is necessary to immediately begin treatment. Almost always, therapy involves surgery to remove the tumor. Total thyroidectomy is preferred, in which the thyroid gland is completely removed. Nearby tissues with lymph nodes can also be removed if they are affected. Such measures are required to prevent relapse of the disease.
In the event that the size of the tumor is small, up to one centimeter, then they may undergo incomplete thyroidectomy. During this operation, only the affected lobes of the gland with the isthmus are removed. This method is considered less traumatic, but at the same time it is dangerous because some cells may still remain. The operation to remove papillary thyroid cancer is carried out from one to three hours. The rehabilitation period is usually short and lasts only three days. Reviews of papillary thyroid cancer confirm this.
After a total thyroidectomy, patients need replacement therapy, as the body requires thyroid hormones. Such therapy involves the use of synthetic or animal hormones. After incomplete thyroidectomy, replacement therapy may also be required, but the dosage of the drugs will be much lower. To accurately determine it, doctors are constantly analyzing hormone levels.
A person who has undergone surgery requires constant monitoring. After six weeks, you need to undergo a scan with radioactive iodine, which reflects the presence of residual metastases. Six months later, the patient submits an analysis for tumor markers, and he also examines the level of hormones. Such examinations are required to be carried out regularly every six months. Three years after the operation, a full body scan is additionally done. All of these procedures are aimed at detecting cancer that may return again. The prognosis after the operation, as a rule, is good, such people can begin their previous work, and women have the opportunity to give birth to a child.
Postoperative treatment
Treatment after surgery for follicular-papillary thyroid cancer is carried out two months after surgery, using radioactive iodine. This method is used in cases where the tumor was large and was accompanied by the presence of metastases in the surrounding tissues and lymph nodes. Therapy with radioactive iodine is needed to completely eliminate the remaining pathological cells.
Complications and relapses
With thyroidectomy, patients have a risk of developing such complications:
- During surgery, the surgeon can damage the laryngeal nerves, which are responsible for the work of the ligaments, which as a result will lead to a change in voice and the appearance of hoarseness. Most often, this is temporary, but sometimes the voice can change for the rest of your life.
- Inaccurate actions by the surgeon can have a negative effect on the parathyroid glands, which are very close.
- There is a risk of hypoparathyroidism, however, this condition is corrected after treatment with calcium preparations.
- The appearance of bleeding and swelling. This phenomenon can also be eliminated with the help of medications.
Disability against the background of papillary thyroid cancer occurs only in cases of significant damage to the recurrent nerve. In addition, a patient who has constant relapses, and therapy does not give any results, can be recognized as disabled. Such complications do not appear too often, their probability is only two percent, provided that the operation was performed in a specialized professional department.
Relapses after papillary thyroid cancer surgery can occur if the surgeon does not completely remove the tumor. True, it happens that the cancer returns even after complete removal, which will indicate the aggressiveness of the pathology. Relapses usually occur after years and even after decades. Often, a tumor can reappear in the lymph nodes and other organs, for example, in the lungs. But in time, the cancer found is again treatable. It is carried out according to the same scheme as the primary pathology, however, the risk of complications will already be much higher.
Thus, relapses occur in most cases when the thyroid gland has not been completely removed. A tumor is usually diagnosed in a different lobe of the organ. Other factors that can influence the return of cancer are the large tumor size, along with extensive and multifocal lesions. In addition, the risk of relapse increases with age.
The prognosis in the presence of the first two stages is usually favorable. In this case, complete remission occurs in eighty-five percent of cases of total therapy. It is contraindicated for people who have undergone surgery to expose their body to any radiation, it is impossible to work with heavy loads.
What is the prognosis of papillary thyroid cancer after surgery?
Papillary thyroid carcinoma has a good prognosis, especially when compared with other types of tumors. The life expectancy of the patient depends on several of the following factors:
- Stage of the disease.
- The size of the pathological neoplasm.
- The vastness of metastases.
- Age category of the patient.
- The effectiveness of therapy.
The prognosis of papillary thyroid cancer is usually made individually according to special assessment tables. In the event that the cancer was detected in the first stage, then the mortality rate is almost zero. Five-year survival at this stage is 97%. Ten-year survival is 90%. Over ten years, 75% of patients live. And in the event that the tumor in the thyroid gland was very small, then you can live twenty-five years, but you will have to constantly be treated, being monitored by a doctor.
For the second stage, five-year survival is only 55%. In the third stage, only 35% of patients can live another five years after surgery. And at the fourth stage, five years after surgery, only 15% of patients can live. With the occurrence of relapses, life expectancy is greatly reduced.
The prognosis will be even worse for those patients who have found distant metastases or a tumor of more than five centimeters. The main cause of death in thyroid cancer is metastases to other organs.
Prophylaxis
What should be done to prevent this disease?
- If possible, radiation should be avoided.
- It is advisable to take potassium iodide.
- A genetic examination should be done to identify the genes that cause thyroid cancer.
- Eat foods that contain iodine or use iodized salt.
- It is necessary to timely treat hormonal and inflammatory pathologies.
- Important is the rejection of bad habits.
- You need enough rest and proper nutrition.
- Stress and unnecessary stress should be avoided.
Patient Reviews
Reviews of papillary thyroid cancer after surgery are abundant. It is well known that the main thing with this disease is to identify it in a timely manner.
As patients who have been diagnosed with this disease write: first of all, you need to find a good specialist for further treatment of papillary thyroid cancer.
For example, those patients who were diagnosed with thyroid cancer in the first stage, write that they easily underwent surgery, after which they were at home four days later.
Reviews of papillary thyroid cancer surgery are also mostly positive.
After this, patients are prescribed hormonal treatment and constant monitoring by the attending physician. Confidence in tomorrow for such patients gives the fact that papillary thyroid cancer is not the most dangerous type of cancer.
But, nevertheless, this pathology is nevertheless oncological in nature, and on the forums you can often find soothing and supportive words that in any case you should not give up, you need to deal with treatment and believe in the best.