FOLLICULAR THYROID CANCER REVIEW

What is Follicular Thyroid Cancer?

Follicular thyroid cancer (FTC) is the second most common type of cancer that affects the thyroid, a small gland located in the front part of your neck, that creates some crucial hormones: triiodothyronine (T3) and thyroxine (T4); which are responsible for maintaining the body metabolism regulation. Usually, this type of cancer has a good prognosis. However, since its vascular invasion potential, spreading to other organs is possible, making it more aggressive than papillary thyroid carcinoma.

Follicular Thyroid Cancer Signs and Symptoms

FTC doesn’t cause any signs or symptoms in the early stages of the disease. Signs and symptoms appear as part of the progressive growth of the nodule in the thyroid, including:

  • A lump sensation in the front part of your neck.
  • Difficulty to swallow or breath.
  • Mild pain in your neck.
  • Hoarseness and voice changes.
  • Swollen lymph nodes around the thyroid.

Follicular Thyroid Cancer Causes

As well as papillary thyroid cancer, FTC also arises from the follicular cells of the thyroid, which are responsible for the production and storage of the thyroid hormones. This type of cancer occurs after an abnormal mutation in the follicular cells that will growth and accumulate, forming a tumor.

There is a subtype of FTC, the Hurthle cell cancer, which is very rare and more aggressive than follicular.

There are some risk factors associated with FTC, including:

  • Female gender.
  • Age around 50 and older.
  • Thyroid cancer family history.

Follicular Thyroid Cancer Diagnosis

Most of the times, the suspicion of FTC starts as an accidental discovery during a routine physical exam of your neck. Your doctor will notice a lump or a nodule in your thyroid and will run some additional tests to confirm its nature. Those tests include:

  • Blood test. In order to detect your thyroid gland functionality.
  • Thyroid ultrasonography. This technique provides good quality information about the shape of the nodule and helps doctors determining its malignant characteristics.
  • Fine-needle aspiration (FNA) biopsy. During the procedure, your doctor will insert a very fine needle into the suspicious nodule and will remove a sample of cells for microscopic analysis to look after cancer cells.

Follicular Thyroid Cancer Treatment

FTC has a high rate of cure after a proper treatment -near 95% in young people. However, this rate decreases with advanced age. The treatment involves the following options:

Surgery

Your doctor will suggest the removal of the thyroid -thyroidectomy-, could be unilateral (hemi thyroidectomy) or bilateral (total thyroidectomy) in order to remove the malignant nodule and eliminate any possibility for additional cancerous nodule formation. Also, your doctor will remove any lymph node around your neck that looks suspicious.

Radioactive Iodine Ablation

As a way to make sure to completely destroy any remaining microscopic areas of thyroid cancer that weren’t removed during surgery, your doctor will suggest taking a radioactive iodine dose. Usually, this is a one-time treatment where you take a pill containing radioactive iodine that causes the thyroid cells to shrink and eventually destroyed them.

Thyroid Hormone Supplementation Therapy

In order to provide your body with the important thyroid hormones that you won’t any longer produce after total thyroidectomy, you will need to take a daily and life-long supplementary thyroid hormone treatment, a medication called levothyroxine.

Long-Term Follow Up

After surviving FTC, all patients are followed lifelong for their disease and to monitor thyroglobulin levels, which is a thyroid hormone that indicates the presence of thyroid tissue. If any level of thyroglobulin is detected in the future, it might mean that cancer is back.

 

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