PAPILLARY THYROID CANCER REVIEW

 

What is Papillary Thyroid Cancer?

Papillary thyroid cancer (PTC) is the most common type of cancer that affects the thyroid gland, which is 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. This type of cancer starts as a slow-growing thyroid nodule and most of the time, the prognosis is excellent.

Papillary Thyroid Cancer Signs and Symptoms

PTC cancer doesn’t cause any signs or symptoms in the early stages of the disease. Over time, and as part of the progressive growth of the gland, the following symptoms can be associated:

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

Papillary Thyroid Cancer Causes

PTC arises from follicular cells, which are a specific type of cell in the thyroid that produces and stores the thyroid hormones. Even though the main cause of papillary thyroid cancer is not clear, is well-known that PTC occurs after an abnormal mutation and growth of the follicular cells.

There are some risk factors associated with PTC, including:

  • Female gender.
  • Age between 30-50.
  • Thyroid cancer family history.
  • Head and neck radiation exposure.

 

Papillary Thyroid Cancer Diagnosis

Usually, the first approach for the diagnosis of PTC 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 function.
  • Thyroid ultrasonography. This technique provides 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 thin needle into the suspicious nodule and will remove a sample of cells for microscopic analysis to look after cancer cells.

Papillary Thyroid Cancer Treatment

Fortunately, PTC is a type of cancer that has an excellent response to treatment, with high curation rates. The treatment involves the following consideration:

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

This option is used in most cases after thyroidectomy to make sure to destroy any remaining healthy thyroid tissue, as well as microscopic areas of thyroid cancer that weren’t removed during surgery. This is typically a one-time treatment where you take a pill with radioactive iodine that causes the thyroid cells to shrink and eventually destroyed them.

Thyroid Hormone Supplementation Therapy

As a way 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

All PTC 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.