Thyroid cancer

The causes of thyroid cancer are based on major human tragedies associated with atomic facilities technological disasters. Such inhumanly extracted evidence removed many medical questions, but revealed the technical problems of the present and the future.

Is Lack of Iodine the Cause of Cancer?

For a long time, iodine deficiency, which was characteristic of continental areas and manifested in the form of goiter, was considered guilty of the development of thyroid cancer. But today in most countries iodine deficiency has been safely overcome thanks to government measures for the use of iodized salt.

In favor of the theory of iodine deficiency as a cause of thyroid cancer, the frequent development of follicular cancer in goitre remains, as well as the coincidence of age-related fluctuations in the incidence of women with cancer, thyrotoxicosis and autoimmune thyroiditis. All these pathologies predominantly suffer from women 30–35 years old and over 60 years old. By the way, iodine deficiency does not explain at all the development of the autoimmune process.

Is Bad Heredity the Cause of the Disease?

In every twentieth patient, the cause of the disease of the medullary form of cancer is the inheritance of a mutation in the RET gene. Detection of familial cancer fundamentally affects the fate of a person, such a hereditary form is much more aggressive than a similar in structure but spontaneously developed malignant tumor.
Often, the medullary cancer is combined with endocrine neoplasms of the adrenal gland and parathyroid glands, which control the exchange of calcium in the bones.

These genetic syndromes of multiple endocrine neoplasia (MEN) have specific and characteristic clinical manifestations, often severe. Early genetic diagnosis of the MEH eliminates this cause from the list of fatal ones for an individual. Some types of mutations of the causative gene RET require the removal of the thyroid gland already in the first year of life; with the MEN-2A mutation, the operation is postponed until the fifth anniversary.

Papillary thyroid cancer can also be familial, and if a non-hereditary process of a similar cellular structure flows quite favorably, then genetically determined forms several malignant nodes in different parts of the organ, often recur after surgery and metastasize.

Can Irradiation of the Neck Become the Cause of Cancer?

As it turned out after the bombings of Hiroshima and Nagasaki, confirmed by the Chernobyl disaster, radioactivity and irradiation of the neck can cause cancer. The Chernobyl radioactive cloud, precipitated to Belarus and Ukraine, increased the cancer incidence of the female population 12-fold. Why women are predominantly affected is unknown, but men get sick at times less.

Irradiation of the neck 50-fold increases the likelihood of illness after a 10-year interval, after a 30-year period the risk of developing cancer significantly decreases, but does not disappear altogether.

In any form of thyroid cancer, it will not be superfluous to take care of your loved ones and bring them to genetic diagnosis. At the 24/7 Medicine Clinic, these tests are performed on-site, the patient receives the result and detailed explanations of the clinical perspective. Already ill with cancer in the Clinic will offer not only high-tech treatment based on the modern possibilities of medical science, but also individual mapping of the tumor for the selection of optimal therapy. Sign up for a consultation: +7 (495) 151-14-47

Thyroid cancer is two extremes — the patient will be either very good, or vice versa, it all depends on prognostic factors, which include age and gender, cell shape and only after that the size of the tumor.

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Thyroid Cancer Stages

Staging of a malignant tumor of the thyroid gland is not easy, the size of the node does not have a decisive importance, the morphological — more importantly, the cellular structure, the germination of the gland’s own capsule with cancer and its introduction into the surrounding organs with the formation of metastases in lymph nodes and other organs.

A prognosis II — III stage of papillary cancer fundamentally differs from medullary or anaplastic forms. Stage IV of follicular cancer may not affect the life expectancy of the patient, while stage I medullary cancer does not promise well-being.

Neoplasm of one structure at the same stage in a man, especially after 45 years, and in a woman — two different diseases with different perspectives. Yes, and «female» cancer in 25 years and after 50 years also does not promise «equality», a more mature woman will always have a worse and more malignant course of the disease than a young woman, with absolute equality in size, node structure and tumor spread.

Therefore, even in clinical recommendations for oncologists, the distribution by stages is not mentioned, treatment is based on the morphology of the process.

Symptoms of thyroid cancer may not manifest for decades, which allows a person to live in peace, unaware of the disease. Nine out of ten malignant tumors of the thyroid gland have a good prognosis without any death of cancer prospect.

Thyroid Cancer Variants

In most cases, thyroid cancer flows favorably, and the younger the patient, the better the life perspective, if you do not take into account life-long replacement therapy. Older patients are more likely to develop aggressive forms that are resistant to therapeutic effects.

  • The most common form that affects six out of ten, papillary carcinoma develops three times more often in women between 30 and 40 years. Often does not damage the organ capsule, but can give metastases to the lymph nodes, which do not worsen the prognosis. In older women, the course of the disease is more aggressive.
  • Follicular form occurs in every sixth patient with thyroid cancer, mainly in adulthood. Metastasizes to the bones and lungs, but most have a very good prognosis.
  • Mixed follicular-papillary form has the features of both options, or the prevailing component.
  • Medullary cancer can be genetically inherited, affects the young, develops rapidly and may be accompanied by another pathology of the endocrine glands. Survival is twice as bad as with the common variants.

The anaplastic variant is characteristic for the elderly, its course is aggressive with early symptoms of compression of the anatomical structures of the neck.

Early Onset Cancer Symptoms

small-size tumor which is, in total, almost three-quarters of all thyroid neoplasms found on examination, does not have any clinical symptoms. There are no signs of cancer because the tumor tissue of the thyroid gland does not produce biologically active substances, with the exception of the medullary variant; the level of thyroid stimulating hormone (TSH) does not often increase with cancer. Due to the lack of functional activity during scanning, malignant tumors produce a «cold» node.

Only rapidly progressive medullary and anaplastic forms in a short time go from minimal to a clinically obvious pathological process with symptoms of compression of the organs and anatomical structures of the neck.

Widespread Thyroid Cancer Symptoms

With a significant increase in neoplasm — walnut size, by reducing the volume of normally functioning tissue, the total hormone production decreases, which is manifested by symptoms of hypothyroidism: constant drowsy lethargy, swelling of the face and weight gain, falling hair and dry skin.

The follicular variant may be accompanied by an increase in hormonal production, which will give symptoms of hyperthyroidism: excessive physical activity and weight loss, nervousness to shivering and hysterics, increased heartbeat and symptoms of over-stimulation of the cardiovascular system. The volume of peri-orbital tissue increases, due to that the eyes become bulging.

On the lateral surface of the neck, chains of enlarged lymph nodes can be determined, which are able to merge into painful stationary «packages».

In the case of a medullary and anaplastic form of thyroid cancer, the neck is massive, like a lumpy collar, bluish in color. The blockage of lymph and blood outflow causes swelling of the face. The tumor can germinate the capsule and penetrate into the surrounding tissues, limiting their mobility, squeezing the neurovascular trunks and larynx, causing hoarseness and stridor when the patient’s breathing is heard at a distance due to the narrow glottis, as if a damaged transistor is inside. The condition is severe due to hypoxia, the position is forced — sitting with a support on hands.

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Metastatic Stage Symptoms

Simultaneously with metastases, no more than 8% of cancer is diagnosed. In most cases, metastases appear after the initial treatment of highly malignant forms. Clinical symptoms are determined by the organ in which metastases develop. Most often affects the lungs and bones. Pulmonary metastases cause shortness of breath and cough, with progression of lead to pulmonary heart failure. Bone lesions are manifested by pain, physical impairment and even fractures.

Cancer progression leads to weakness, weight loss, the addition of inflammation on the background of reduced immunity. In the Clinic Medicine 24/7 they know how to help the patient in this condition, they will offer an optimal antitumor treatment with a recovery program, reduce the symptoms of a malignant process and improve the quality of life. Sign up for a consultation: +7 (495) 151-14-47

Papillary Thyroid Cancer Treatment

The most favorable current version of the disease, especially at a young age and in women. Surgical — the only radical and ample treatment.

An operation for a benign adenoma is often performed, but a histological examination gives «cancer." If there are no signs of aggressiveness and the node is less than 4 cm, then a re-expanded intervention is not necessary, it is enough to observe with the regular determination of thyroid hormones and receive thyroxine. This drug inhibits the inevitable increase in pituitary gland production of a growth hormone. The smaller the glandular tissue, the lower the level of the hormones it synthesizes, the more it is secreted by the pituitary gland of the stimulant, which is not necessary at all in a malignant process.

When papillary cancer is assumed before surgery, an extensive operation is performed, leaving a minimal amount of glandular tissue or an empty space. Clinical studies have shown that metastases in the lymph nodes, which are removed simultaneously with the gland, do not affect life expectancy at all.

This volume is quite enough, the survival rate even with metastases in the lymph nodes is close to 100%.

Follicular Form treatment

Also prognostically favorable cancer variant. Even with a small tumor, the entire gland is removed, since microscopic cancer foci in the opposite lobe and isthmus are possible, the operation is called total thyroidectomy.

The ability of a tumor to seize iodine is determined, which will allow for radioiodine therapy and timely detection of a disease recurrence. In case of doubts about the radical nature of the surgical stage, a large tumor with metastases is treated with radioactive iodine. Anti-hormone therapy is also performed.

The return of the disease is also treated with iodine, and chemotherapy in this variant is not used because of complete and unconditional insensitivity, using targeted therapy with sorafenib, which does not apply to cytostatics.

If a tumor poorly captures iodine, then with a doubtful radical operation for a large tumor with signs of a high degree of malignancy, the area of operation is irradiated and hormone production is suppressed. With the development of metastases, the use of sorafenib is possible.

Thyroid Cancer Aggressive Variants Treatment

With operable cancer, total thyroidectomy is performed with bilateral removal of lymph nodes. As a rule, aggressive forms do not accumulate iodine; therefore, it remains to observe the course of life.

When the medullary form, producing CEA and calcitonin, their level is regularly determined, with an increase in the concentration of markers, a relapse in the bed of the removed organ or metastasis is assumed. Relapse is treated surgically with radiation or radiation therapy only; prophylactic chemotherapy has no meaning. Unremoved relapse, as well as primary tumor and distant metastases, can be treated with vandetanib.

The anaplastic variant of the disease is rarely operated, in most cases the oncologist is referred to in an inoperable stage. Ways of treatment remains on the agenda, but the Clinic Medicine 24/7 will be able to offer palliative treatment that improves the quality of life and facilitates the severity of the patient’s condition. Therapy for thyroid cancer is always individual, and this approach requires the highest qualification of specialists and great opportunities, all this is in Medicine 24/7. Sign up for a consultation: +7 (495) 151-14-47

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