Papillary thyroid cancer (patient information)
Papillary thyroid cancer
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The thyroid gland, a butterfly-shaped gland in the neck, produces body-regulating hormones. Papillary thyroid cancer starts in the thyroid gland and manifests without early-stage symptoms. As the cancer further develops, noticeable symptoms begin to arise, such as vocal hoarseness, difficulty swallowing, a lump in the neck, which can be felt through the skin, neck or throat pain, and swollen lymph nodes. Treatment options include surgery, radiation therapy, chemotherapy, and thyroid hormone therapy.
What are the symptoms of papillary thyroid cancer?
While patients with early papillary thyroid cancer do not present with any symptoms, as the tumor grows larger people may notice one or more of the following symptoms:
- A nodule, lump, or swelling in the neck, which may be perceptible by touch
- Pain in the throat/neck
- Vocal hoarseness
- Difficulty swallowing
- Swollen lymph nodes
What causes papillary thyroid cancer?
- While the exact cause of papillary thyroid cancer is unknown, certain genetic mutations are suspected to be associated with the disease.
- People who have had radiation therapy to the neck area, or as children, are at higher risk for developing papillary thyroid cancer. Radiation therapy was commonly used in the 1950's to treat skin disorders and enlarged thymus glands, adenoids, and tonsils.
Who is at highest risk?
Clinical data have suggested that the development of papillary thyroid cancer is related to various factors, such as:
- A diet low in iodine: papillary thyroid cancers are more common in regions characterized by iodine-deficient diets.
- Radiation exposure
- Patients over the age of 45-years
Firstly, a doctor will likely preform a physical exam (noting swollen lymph nodes and lumps in the neck that are perceptible by touch) and review patient medical history. Based upon the physical examination the patient's self-reported symptoms, the doctor may recommend the following tests:
- Calcitonin blood test to check for medullary cancer
- Thyroid biopsy
- Thyroid scan
- Ultrasound of the thyroid
When to seek urgent medical care?
Call your health care provider if symptoms of thyroid cancer develop.
Patients with papillary thyroid cancer have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radioactive iodine, and chemotherapy. In case surgery is not viable, radiation therapy can also be administered.
- Surgery: Surgery is the main treatment for papillary thyroid cancer. Usually, surgery of removing the tumor and all or part of the remaining thyroid gland is recommended.
- Radiation therapy: It includes radioactive Iodine (Radioiodine) therapy and external beam radiation therapy. Radioactive iodine (RAI) known as I-131 can be taken into the body to destroy the thyroid gland and any other thyroid cells including cancer cells. During external beam radiation therapy, the doctors use high-energy rays to destroy cancer cells or slow their rate of growth.
- Chemotherapy: Chemotherapy is seldom helpful for most types of papillary thyroid cancer.
- Thyroid hormone therapy: This treatment is to take daily pills of thyroid hormone. The aim is to help maintain the body's normal metabolism (by replacing missing thyroid hormone) and prevent some thyroid cancers from returning.
Where to find medical care for papillary thyroid cancer?
Prevention of papillary thyroid cancer
There are no primary preventive measures available for papillary thyroid cancer, although the following may aid in risk reduction:
- Consuming an adequate amount of iodine
- Avoiding radiation exposure
- Alert doctors of family history
What to expect (Outlook/Prognosis)?
The prognosis of papillary thyroid cancer depends on the following:
- The stage of the cancer: the size of the tumor, whether the cancer has spread outside the thyroid gland
- Whether or not the tumor can be removed by surgery
- Patient's age
- Size of the tumor
- Injury to the voice box and hoarseness after thryoid surgery
- Low calcium levels from accidental removal of the parathyroid glands during surgery
- Spread of the cancer to the lungs, bones, or other parts of the body