Carcinoma of the papillary thyroid: causes, symptoms, stages and features of treatment
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 scares everyone who 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. 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 species. Malignant formation appears from a healthy tissue of the organ, is visualized as a cyst or an uneven tumor of large size. In 80% of all cases the patient manages to completely recover from a carcinoma of this kind.
If we talk about other types of cancer, then in comparison with them, papillary cancer has the property of a very long time to develop. Another feature - the metastases of the papillary thyroid carcinoma often spread to the lymph nodes.
As a rule, the patient finds only one node, in rare cases there are several. Most often suffer from this ailment at the age of 30-55 years, mostly women( but sometimes this diagnosis is also put to men).
Nobody yet can precisely determine why the thyroid cancer develops. Physicians suggest that, most likely, the reason lies in the mutation of cells. Why such mutations arise, too, can not be clarified.
Tumor develops after cells mutate. They begin to grow, gradually hitting the healthy tissue of the organ.
As scientists suggest, the papillary thyroid carcinoma develops due to:
- lack of iodine in the body;
- of ionizing radiation;
- disorders in the hormonal background;
- of congenital pathology;
- of bad habits( smoking, alcohol abuse);
- frequent viral and bacterial respiratory tract infections.
This form of cancer develops slowly, therefore at the initial stages it is determined by chance, and not from any symptoms. A person does not have discomfort, nothing hurts, he lives a full life. When the neoplasm begins to increase, it leads to painful sensations in the neck. A person can find for himself a foreign compaction.
In later stages of the carcinoma, the papillary thyroid causes such symptoms:
- an increase in cervical lymph nodes( in most cases, on the one hand, where there is a malignant tumor);
- pain in the neck;
- sensation of foreign body when swallowing;
- sometimes the voice becomes hoarse;
- breathing difficulties occur;
- when squeezing the neck( especially when the person lies on his side) feels a great discomfort.
Do somehow classify papillary thyroid cancer? Stages, the signs of which are the basis for diagnosis:
1. Age to 45 years:
- Stage I: the size of any education. Sometimes cancer cells spread to nearby tissues, lymph nodes. Metastases do not spread to other organs. The person does not feel any signs of the disease, but sometimes there is a slight hoarseness, a little 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( lungs, bones).Symptoms are quite pronounced, they can not be overlooked.
2. Age after 45 years:
- Stage I: tumor not more than 2 cm, no other organs affect papillary thyroid cancer. Symptoms of the stage: a person does not feel any particular changes, or signs are weakly expressed.
- II stage: the tumor does not exceed the limits of the thyroid gland, but the size reaches 4 cm.
- III stage: the size is more than 4 cm, the cancer cells hit the nearby organs.
General picture of
The appearance of a node or compaction is the first thing that starts thyroid cancer. Carcinoma of the papillary thyroid is characterized by single formations, in rare cases, multiple. If the node is deep, and its size is insignificant, then the person can not find it independently. Malignant tumors up to 1 cm can not be determined even by an endocrinologist. Only after ultrasonography such small formations are found or after the cancer cells began to spread to the lymph nodes, and those, in turn, increased.
With a small knot size, the disease is called "hidden papillary carcinoma."Such formations are not very dangerous, even at the stage of metastasis. The tumor freely moves in the thyroid gland, it can move during swallowing. But when cancer cells spread to surrounding tissues, malignant formation becomes immobile.
Metastases rarely spread to other organs( except lymph nodes).This happens only in advanced stages of the disease. Metastases have a property for a long time not to make itself felt. In most cases, papillary cancer affects the lymph nodes, less likely to spread to another portion of the thyroid gland.
Features of cells
The main characteristic of malignant formation:
- size - from several millimeters to several centimeters;In rare cases,
- has mitosis;
- centered on education may be calcium deposition or scarring;
- tumor is not encapsulated;
- cells do not have hormonal activity.
Initially, the doctor palpates the neck in the thyroid gland. The cervical lymph nodes are probed. If the doctor discovers something, the patient is sent to the ultrasound, with which it will be possible to determine the presence of formations, their size and structure.
The cytological picture of papillary thyroid carcinoma is the main task of the examination. To do this, a fine needle aspiration biopsy is used, which is performed strictly under the supervision of ultrasound.
To understand if there are metastases in other organs, the patient is not being given an x-ray.
Cytological papillary thyroid carcinoma is an incorrect definition that does not contain any sense. There are concepts of "cytological research"( determining the structure of cells for the purpose of revealing pathology) and "papillary carcinoma."
How to help a patient diagnosed with "papillary thyroid carcinoma"?Treatment consists in operative intervention. With this disease, thyroidectomy is used. There are two possible options for the operation:
- partial thyrotectomy;
- total thyroidectomy.
For the complete destruction of cancer cells, a radioactive iodine therapy is used, which is performed after the operation.
Surgical intervention of this type is indicated in patients with a small malignancy that is in one of the lobules of the organ. It is important that cancer cells no longer spread anywhere. 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 does not face the development of hypothyroidism, because the hormone synthesizes an unaffected share of the thyroid gland. Sometimes hormone replacement therapy is required.
The procedure involves the complete removal of the thyroid gland. Both parts of the organ are excised, as well as the isthmus that connects them. Sometimes there is a need to remove the cervical lymph nodes. This occurs when they are greatly enlarged, and metastases are found in them. The duration of the procedure is approximately 4 hours.
After such an operation, the patient will have to take hormone-containing preparations for life. After all, the body does not have thyroid tissue.
Therapy with radioactive iodine
This therapy is used when an operation has already been performed. It is aimed at destroying the remnants of cancer cells. Metastases that went beyond the body, went 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 itself after a partial thyrotectomy.
Even if cancer cells have spread to the lungs, then with the help of radioactive iodine therapy they can be successfully disposed of.
Thyroidectomy is a complex surgical intervention, but recovery after it is quite fast. Most patients who have to undergo such surgery do not feel much discomfort after the procedure. A person can return to the usual way of life immediately after discharge from the hospital.
Some people think that after the procedure it will not be possible to fully eat, drink water. But this is not so. The incision does not affect the swallowing of either solid or liquid food.
Possible complications of
In rare cases, the operation results in complications:
- Damage to the recurrent nerve, which is responsible for voice.
- Hoarseness of the voice or slight change in it. Sometimes the voice changes forever.
- Parathyroid gland damage. They are located behind the thyroid, so they can be affected during surgery. But this happens very rarely in inexperienced surgeons. Damage threatens the violation of the exchange of phosphorus and calcium. As a result, all this leads to hypoparathyroidism.
Than for a person can turn papillary carcinoma of the thyroid gland? The forecast is favorable in most cases. Even if the cancer cells have spread to the lymph nodes, the patient can live for a long time. Statistics show that after an operation the person lives:
- more than 20 years in 70% of cases;
- for more than 10 years in 85% of cases;
- more than 5 years in 95% of cases.
As you can see, not so terrible papillary carcinoma of the thyroid gland. Survival is high enough even in cases when the tumor has spread beyond the thyroid gland.
Further examination of
After a full course of treatment a person must regularly visit an endocrinologist. This is necessary in order to monitor the overall health. Sometimes the cancer returns, therefore every year you will have to undergo a complete examination:
- blood test( determine the effectiveness of substitution therapy, as well as the presence of malignant formations, the 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 you can completely get rid of it. The main method of treatment is surgery, after which it is necessary to resort to therapy with radioactive iodine.