Papillary Thyroid Cancer
Papillary carcinoma of the thyroid is the most common cancer of the thyroid gland. About 80% of all thyroid cancers are the papillary carcinoma type and its more common in women than in men. It may occur in childhood, but is most often seen in adults around the age of 45.
Causes
- The cause of this cancer is unknown
- A genetic defect may be involved
- Radiation increases the risk of developing thyroid cancer
- Exposure may occur from:Radiation given through a vein (through an IV) during medical tests and treatments does not increase the risk of developing thyroid cancer.
- High-dose external radiation treatments to the neck, especially during childhood, used to treat childhood cancer or some benign childhood conditions
- Radiation due to atomic bomb testing in the Marshall Islands and the 1986 Chernobyl nuclear disaster in the Ukraine, mostly in children
Symptoms
- Thyroid cancer usually begins as a small lump (nodule) in the thyroid gland, which is located at the center part of the front of the neck
- While some small lumps may be cancer, most thyroid nodules are harmless and are not cancerous
- Most of the time, there are no other symptoms
Exams and Tests
- If you have a lump on your thyroid, your doctor will order blood tests and possibly an ultrasound of the thyroid gland
- If the ultrasound shows that the lump is bigger than 1 centimetre, a special biopsy called a fine needle aspiration (FNA) will be performed – this test helps determine if the lump is cancerous
- Thyroid function tests are usually normal in patients with thyroid cancer
Treatment
There are three types of thyroid cancer treatment:
Surgery
- Surgery is done to remove the cancer
- Frequently, the entire thyroid gland is taken out
Radiation therapy
- After the surgery, most patients should receive radioactive iodine, which is usually taken by mouth
- This substance kills any remaining thyroid tissue
- It also helps make medical images more clear, so doctors can see if there is any additional cancer
- If surgery is not an option, external radiation therapy can be useful
Medication
After surgery or radioactive iodine, the patient will need to take medication called levothyroxine sodium for the rest of their life. This replaces the hormone that the thyroid would normally make.
Follow-up
Most patients who had thyroid cancer need to a blood test every 6 – 12 months to check thyroid levels. Other follow-up tests that may done after treatment for thyroid cancer include:
- Ultrasound of the thyroid done in the first year
- An imaging test called a radioactive iodine uptake scan
Outlook and Prognosis
The survival rate for papillary thyroid cancer is excellent. More than 95% of adults with such cancer survive at least 10 years. The prognosis is better for patients younger than 40 and for those with smaller tumours.
The following factors may decrease the survival rate:
- Age over 45
- Cancer has spread to distant parts of the body
- Cancer has spread to soft tissue
- A large tumour
If you have any questions about thyroid or parathyroid surgery, you should speak to your local doctor, who will arrange to contact your thyroid surgeon.
