Oncology is one of the main ills of modern mankind. Despite the high level of progress in the field of medicine, malignant diseases continue to develop in the bodies of children and adults, taking the lives of many of them. Oncology comes in many different forms. So, for example, there is medullary thyroid cancer. About him and will be discussed below.
Concept of the disease
Medullary cancer (the second name is thyroid) is a type of thyroid oncology in which the tumor begins to produce a huge amount of calcitonin. It is one of the most aggressive pathologies of the endocrine system.
The insidiousness of the disease is that for a long time it does not cause any pronounced symptoms. For example, significant violations in the work of the gland make themselves felt only at the last, fourth stage.
Statistics
Medullary cancer ranks third in prevalence among other thyroid oncologies. This disease has a tendency to rapid development and metastasis. The main group of patients are women over 45 years old.
Medullary cancer is a fairly rare disease. For 5,000 cancer patients, only 1 patient with this pathology falls.
Cancer development mechanism
Normally, thyroid cells are produced as needed to replace old ones that can no longer cope with their functions. However, under the influence of some factors (including hereditary), uncontrolled cell division begins, and they form a whole node consisting of undifferentiated cells with cancerous properties. Thus, this formation becomes a malignant tumor.
Development reasons
It is still not known exactly what exactly serves as an impetus for the development of oncology. Nevertheless, scientists suggest that there are a number of factors contributing to this.
- Hereditary predisposition. It has long been proven that there is a gene responsible for stopping tumor growth. His defeat is inherited. Therefore, if a person has a close relative with oncology, he has increased risks of developing cancer in his body. In particular, this applies to the disease to which this article is devoted.
- Age after 45 years. As the body ages, cell division processes may be disrupted in it, which increases the risk of cancer.
- Bad habits. It is proved that nicotine and alcohol have a pronounced carcinogenic effect. By refusing to use these substances, you can largely protect yourself from oncology.
- Professional factor. People who have been in contact with chemicals for a long time are especially susceptible to malignant processes. This is especially true for workers in the pharmaceutical, chemical and similar industries.
- Irradiation. Everyone knows that exposure to radiation is detrimental to body cells. In oncology, there are cases when a patient underwent radiation therapy to treat any form of oncology, after which he developed the development of medullary cancer.
- Stress. It is known that under stress, the body undergoes significant changes, as a result of which cell division can be disrupted.
Despite a huge number of factors, medullary cancer occurs, as a rule, under the influence of a hereditary predisposition. If a person has it, then in this case, maintaining a healthy lifestyle does not guarantee anything.
Symptoms
For medullary cancer, a long latent period is characteristic. In the first stages, a person feels absolutely healthy. As a rule, cancer at this stage is detected randomly at a routine medical examination of an otorhinolaryngologist.
At this stage, the tumor can affect the regional lymph nodes, they slightly increase in size. On this, the symptoms of medullary thyroid cancer of the first stage end.
However, if at this stage the disease is overlooked, it begins its rapid growth and spread of metastases.
In the second stage, the tumor becomes larger in size and begins to put pressure on neighboring tissues, as a result of which the patient's voice tone may change, he may complain of pressing pains in the larynx, problems with the process of swallowing food, and systematic digestive upset. Then, as medullary cancer progresses, the synthesis of calcitonin is significantly impaired in a person, resulting in a large loss of calcium in the body. This causes the rapid development of osteoporosis, thinning of bones and a change in the proportions of the body.
At the fourth stage, the patient acquires a characteristic appearance - there is a growth on the neck (goiter or struma). This tumor is capable of rapid malignancy (metastasis). Metastases continue to spread throughout the body, the functions of the affected organs are significantly impaired. Most often, the liver, lungs and brain are affected. Even at this stage, the patient may not have severe symptoms, but gradually he begins to notice a cough, pain in the chest, right hypochondrium, headaches and dizziness.
Diagnostic Methods
To make an accurate diagnosis, it is advisable to prescribe several types of examinations of the patient, who suspected the development of oncology.
- First of all, such a person should pass a blood test for calcitonin - an oncomarker of thyroid pathology. This is the most reliable type of study that can accurately confirm the presence or absence of medullary thyroid cancer. Clinical recommendations state that the level of this substance in the patient’s blood after surgery directly indicates the prognosis of the patient’s life. However, based on the results of the analysis alone, it is impossible to make a final diagnosis.
- Therefore, an ultrasound examination of the thyroid gland is additionally prescribed - a simple and quick examination method that gives images of the organ itself and regional lymph nodes. Ultrasound is able to give an answer about the size of education and its boundaries, but not about the degree of its malignancy.
- To do this, there is such a survey method as a biopsy. It provides comprehensive data on the nature of the tumor, its structure. This is the most accurate way, since the probability of error does not exceed 2%.
- Other diagnostic methods for medullary thyroid cancer are CT (computed tomography) and MRI (magnetic resonance imaging). They can also be used to make a diagnosis or evaluate the effectiveness of treatment. In addition, these methods provide the most clear image of the tumor, which allows the oncologist to get a complete picture of the disease.
Treatment of medullary thyroid cancer
As with many other forms of cancer, radiation therapy or chemotherapy can be used to treat this pathology. However, the priority and most effective method will be the removal of the tumor or the entire organ.
Surgery
This method is especially effective in the early stages of the disease, which gives the patient every chance of recovery.
The surgeon cuts out the affected areas of the thyroid gland, as well as adjacent lymph nodes. This is to prevent a possible relapse of the disease. There are cases when, in order to save the patient's life, the operating doctor is forced to perform a complete resection of the organ. In any case, after the operation, the patient’s body can no longer fully produce the necessary hormones, so the person is forced to take thyroxine-based drugs (l-thyroxine and the like) for the rest of his life.
In the event that the tumor spread beyond the thyroid gland and gave a large number of metastases, the operation does not make sense. Chemotherapy is prescribed for such patients.
Radiation therapy
Its use is relevant in cases where the results of a biopsy indicate the presence of malignant cells in the tissues adjacent to the thyroid gland. To prevent their spread, oncologists irradiate parts of the neck (in particular the throat) with gamma rays. In addition, this method is relevant for patients in the postoperative period. All this will help increase the chances of a full recovery.
Chemotherapy
This treatment method is the use of drugs of the protein kinase inhibitor group. Drugs significantly inhibit the activity of this enzyme, which has the ability to provoke the repeated spread of cancer cells due to the formation of proteins with an abnormal structure. The most commonly used drugs are Axitinib, Gefitinib and the like. They have a systemic effect, so they often cause nausea, vomiting, indigestion in the form of diarrhea, disorders of the cardiovascular system and increased pressure. Oncologists should warn the patient about this and carry out symptomatic therapy in the treatment of medullary thyroid cancer. New research, however, argues that surgery is the only effective treatment for the disease.
Forecast
The prognosis of medullary thyroid cancer after surgery is the most favorable. That is, those patients who were operated on for the removal of the gland or its part in the first or second stage of the disease have the greatest chances of survival. Particularly increased chances of recovery with additional radiation therapy. The success of treatment can be judged by a blood test for calcitonin levels. If this indicator decreased, then the disease receded.
In addition, the presence of metastases has a significant impact on the prognosis. As mentioned above, medullary thyroid cancer is characterized by high aggressiveness and the rate of spread of secondary foci. If they are found only in regional lymph nodes, then the prognosis is five-year survival in 80% of patients. In the presence of metastases in the separated organs, this figure does not exceed 20%. At the same time, women, as a rule, have slightly higher chances of recovery than men.
Conclusion
Thyroid medullary cancer is an insidious disease characterized by a long asymptomatic course and high mortality. Therefore, it is very important to monitor your health and the health of your loved ones, regularly undergo preventive medical examinations and medical examinations. This is especially true for people with a hereditary predisposition to the development of this pathology. Timely diagnosis and immediate treatment is the only possible option for a full recovery and the continuation of a full life.