Symptoms Treatments And Prognosis For Papillary Thyroid Carcinoma
Papillary thyroid cancer is the most common type of thyroid cancer. You may have even heard your doctor talk about metastatic papillary thyroid cancer . This article will focus on papillary thyroid cancer basics, including papillary thyroid cancer symptoms, treatments, and prognosis. You can read a general overview of thyroid cancer in our Introduction to Thyroid Cancer article.
Visit our Patients’ Guide to Thyroid Cancer for complete information on all types of thyroid cancer, including papillary thyroid cancer.
Papillary thyroid carcinoma is the most common thyroid cancer. About 80% of all thyroid cancers cases are papillary thyroid cancer.1;
Most commonly, papillary thyroid cancers are totally asymptomatic. However, the most common symptom is a mass in the neck. Papillary carcinoma typically arises as a solid, irregular or cystic mass that comes from otherwise normal thyroid tissue. This type of cancer has a high cure rate10-year survival rates for all patients with papillary thyroid cancer estimated at over 90%. Cervical metastasis are present in 50% of small papillary carcinomas and in more than 75% of the larger papillary thyroid carcinomas.
But what do doctors look for;in diagnosing papillary thyroid cancer?
Characteristics of Papillary Thyroid Cancer
Considerable controversy exists when discussing the management of well-differentiated thyroid carcinomas both papillary thyroid cancer and even follicular thyroid cancer.
Tests That May Be Done
Blood tests: Blood tests alone cant tell if a thyroid lump is cancer. But they can help show if the thyroid is working the way it should.
Ultrasound: For this test, a small wand is moved over the skin in front of your neck. It gives off sound waves and picks up the echoes as they bounce off the thyroid gland. The echoes are made into a picture on a computer screen. How a lump looks on ultrasound can sometimes help tell if its cancer, but ultrasound cant tell for sure.
Radioiodine scan: For this test, a low dose of radioactive iodine is swallowed or put into a vein. Over time, the iodine is absorbed by the thyroid gland. A special camera is then used to see the radioactivity. Nodules that have less iodine than the rest of the thyroid can sometimes be cancer.
CT or CAT scan: Its a special kind of x-ray that takes detailed pictures of the thyroid and can show if the cancer has spread.
MRI scan: This test uses radio waves and strong magnets instead of x-rays to take pictures. MRI scans can be used to look for cancer in the thyroid, or cancer that has spread.
PET scan: In this test, you are given a special type of sugar that can be seen inside your body with a camera. If there is cancer, this sugar shows up as hot spots where the cancer is found. This test can be very useful if your thyroid cancer is one that doesnt take up radioactive iodine.
If the diagnosis is not clear after an FNA biopsy, you might need another kind of biopsy to get more cells to test.
When Do Signs And Symptoms First Appear
Typically, cancer signs and symptoms first appear when the cancerous tumor or mass has grown large enough that it begins to push against nearby organs and tissue, blood vessels, and nerves.
This can lead to pain, a change in how the nearby organs function, or both. A brain tumor pressing against the optic nerve will affect vision, for example.
Some cancers are fast moving, such as liver and pancreatic cancers. Prostate cancer, however, is usually slow moving. This is why many older men with prostate cancer forego treatment; theyre more likely to die with prostate cancer than because of it.
Screenings for certain cancers should be part of your normal preventive healthcare. These include cancers of the:
Your age, sex, family history, and your own medical history will dictate when routine screenings should begin and how often they should be done.
If youre concerned about symptoms associated with various cancers, then you shouldnt hesitate to see your doctor. You can connect to a physician in your area using the Healthline FindCare tool.
Cancer May Spread From Where It Began To Other Parts Of The Body
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if thyroid cancer spreads to the lung, the cancer cells in the lung are actually thyroid cancer cells. The disease is metastatic thyroid cancer, not lung cancer.
There Are Different Types Of Thyroid Cancer
Thyroid cancer can be described as either:
- Differentiated thyroid cancer, which includes well-differentiatedtumors, poorly differentiated tumors, and undifferentiated tumors; or
Well-differentiated tumors can be treated and can usually be cured.
Poorly differentiated and undifferentiated tumors are less common. These tumors grow and spread quickly and have a poorer chance of recovery. Patients with anaplastic thyroid cancer should have molecular testing for a mutation in the BRAFgene.
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Staging Papillary Thyroid Cancer
After your diagnosis, your doctor will stage the cancer. Staging is the term used for how doctors categorize the severity of a disease and the treatment needed.
Staging for thyroid cancer is different than for other cancers. There are stages 1 through 4, in order of ascending severity. Staging also takes into consideration a persons age and the subtype of their thyroid cancer. Staging for papillary thyroid cancer is as follows:
How Fast Does Thyroid Cancer Spread
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Types Of Thyroid Cancer
There are 4;main types of thyroid cancer. They are:
- papillary carcinoma this is the most common type, accounting for about 6 out of 10; cases; it usually affects people under the age of 40, particularly women
- follicular carcinoma accounts for around;3 out of 20 cases of thyroid cancer and tends to affect older adults
- medullary thyroid carcinoma accounts for between 5 and 8 out of every 100 diagnosed cases ; unlike the other types of thyroid cancer, medullary thyroid carcinoma;can run in families;
- anaplastic thyroid carcinoma this is the rarest and most aggressive type of thyroid cancer, accounting for less than 1;in 20 thyroid cancers; it usually affects older people over the age of 60;
Papillary and follicular carcinomas are sometimes known as differentiated thyroid cancers, and they’re often treated in the same way.
What Are The Symptoms Of Thyroid Cancer
You or your healthcare provider might feel a lump or growth in your neck called a thyroid nodule. Dont panic if you have a thyroid nodule. Most nodules are benign . Only about three out of 20 thyroid nodules turn out to be cancerous .
Other signs of thyroid cancer include:
- Difficulty breathing or swallowing.
- Swollen lymph nodes in the neck.
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Is Thyroid Cancer Slow Moving
The most common type, papillary thyroid cancer, grows very slowly. They are the same size in someone at age 80 that they were at age 40. Most of these very small thyroid cancers never pose a threat. But when someone has cancer, they or their doctor often want it out, and all surgeries carry some risk.
Anaplastic Thyroid Cancer Overview
Fortunately, anaplastic thyroid cancer is, by far, the least common of all thyroid cancers. It can also be called anaplastic thyroid carcinoma since carcinoma implies a certain type of cancer. Since thyroid cancer is relatively common, it is very likely that you will know somebody that had or has a form of thyroid cancer. However, anaplastic thyroid cancer is a very uncommon type of thyroid cancer. Most patients and even thyroid specialists have had very little to no experience with this type of rare thyroid cancer. Try not to think about anaplastic thyroid cancer as you would other thyroid cancers, since this assumption will likely lead you to decisions that are not necessarily justified or right for you.
Anaplastic thyroid cancer is only able to be cured if it has not spread to any distant sites in your body and it can be completely removed by surgery. Only an expert thyroid cancer surgeon can determine whether an anaplastic thyroid cancer can be completely removed. There is no second chance inanaplastic thyroid cancer surgery
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Thyroid Cancer Types Stages And Treatment Overview
In addition to the material on this page, the;Newly Diagnosed;section has about 30 subsections related to treatment of different types of thyroid cancer.
Thyroid Cancer Basics:;Free 50-page Handbook in
The 2018 Updates to the Staging System for Differentiated Thyroid CancerPapillary, Follicular, Hurthle Cell, and Variants
The following information was obtained from the;National Cancer Institute.
What is cancer of the thyroid?
Cancer of the thyroid is a disease in which cancer cells are found in the tissues of the thyroid gland. The thyroid gland is at the base of the throat. It has two lobes, one on the right side and one on the left. The thyroid gland makes important hormones that help the body function normally.
Cancer of the thyroid is more common in women than in men. Most patients are between 25 and 65 years old. People who have been exposed to large amounts of radiation, or who have had radiation treatment for medical problems in the head and neck have a higher chance of getting thyroid cancer. The cancer may not occur until 20 years or longer after radiation treatment.
A doctor should be seen if there is a lump or swelling in the front of the neck or in other parts of the neck.
Stages of cancer of the thyroid
The following stages are used for papillary cancers of the thyroid:
Papillary and Follicular Thyroid Cancer in Patients Younger than 45 Years of Age:
Stage I Papillary;and Follicular
Medullary Thyroid Cancer
Treatments For Thyroid Cancer
Treatment for thyroid cancer depends on the type of thyroid cancer you have and how far it has spread.
The main treatments are:
- surgery; to remove part or all of the thyroid
- radioactive iodine treatment you swallow a radioactive substance that travels through your blood and kills the cancer cells
- external radiotherapy a machine is used to direct beams of radiation at the cancer cells to kill them
- chemotherapy and targeted therapies medicines used to kill cancer cells
After treatment, you’ll have follow-up appointments to check whether the cancer has come;back.
Read more about;how thyroid cancer is treated.
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Signs That Warrant An Immediate Trip To A Doctor
Some common cancer signs that should result in a visit to the emergency room or to a doctor as soon as possible include:
- coughing up mucus tinged with blood
- blood in stools or urine
- lump in the breast, testicles, under the arm, or anywhere that it didnt exist before
- unexplained but noticeable weight loss
- severe unexplained pain in the head, neck, chest, abdomen, or pelvis
These and other signs and symptoms will be evaluated. Screenings, such as blood and urine tests and imaging tests, will be used if your doctor thinks its appropriate.
These tests are done both to help make a diagnosis as well as rule out various causes of your signs and symptoms.
When seeing a doctor, be prepared to share the following information:
- your personal medical history, including all symptoms you have experienced, as well as when they began
- family history of cancer or other chronic conditions
- list of all medications and supplements you take
How Is Thyroid Cancer Treated
The treatment of thyroid cancer depends on the type of thyroid cancer that is identified. It can involve multiple types of treatment including surgery, radioactive iodine, radiation therapy, chemotherapy/targeted therapy, and/or thyroid suppressive therapy.
Surgery plays a central role in the treatment of thyroid cancer. The goal of surgery is the removal of the tumor. There are several options for surgical procedures to treat thyroid cancer including:
- Total thyroidectomy-the removal of the entire thyroid gland.
- Near-total thyroidectomy-leaving only a small remnant of thyroid tissue with parathyroid glands, which are attached to the thyroid.;
- Lobectomy-the removal of a single lobe of the thyroid gland; in patients with small papillary thyroid cancers, a lobectomy may be appropriate.
If the thyroid gland is not completely removed during the first surgical procedure, the patient is;always;at risk for recurrence in the portion of the thyroid left behind. Additional surgery to remove the remaining portion of the thyroid gland can also be performed.;
Supplemental Thyroid Hormone Therapy
Radioactive Iodine Therapy
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How Long Can You Live With Stage Iv Thyroid Cancer
Thyroid cancer is a highly treatable cancer except for a certain type of cancer . The chances of recovery increase when cancer is diagnosed at its earlier stages. At stage IV, cancer has reached an advanced stage. This means that the tumor has spread to other organs in the neck, lymph nodes or distant organs of the body such as the lungs, liver etc. and hence becomes difficult to treat. How long you can live with this stage depends on your overall health and the type of thyroid cancer you have.
There are four types of thyroid cancer.
Among all these types, papillary thyroid cancer is the most common type of thyroid cancer. It grows slowly and responds well to therapy despite its spread to the lymph nodes.
Follicular and medullary thyroid cancers are the less common types of thyroid cancer. However, they also respond well to cancer treatments.
Anaplastic thyroid cancer is the least common type of thyroid cancer but the fastest to grow among all four types. It doesn’t respond well to treatments.
Other factors that influence your chances of survival with thyroid cancer include
Thyroid Cancer In Lung
I had one side of my thyroid removed and the other side was killed by idione ration back in 1989. On August 7, I fell off the roof and rushed to the ER. The CT scan showed broken bones but also a node in the base of right lung. A PET scan on August 30 confirmed a high uptake in right lung base and also in Hila and subcarinal lymph, followed by bone and brain scan a week later which were clear. A CT scan guided biopsy was performed on September 30 showed a papillary thyroid cancer in right lung. Now I am scheduled for I-131 scan for October 24.I am coughing a bit but I have severe indigestive, not sure if it is related?Oh, for the biopsy, I did that last week, it was a CT scan guided biopsy, did not feel a thing and I was out of the hospital in a couple of hours.
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From What I Have Learned
from what i have learned about cancer if it mestastisizes and spreads to another organ it is still the same type of cancer.. IE thyroid cancer of the lungs so radioactive Iodine should be the treatment unless you have a resitance to radio-iodine cancer type.
talk to your endo and find out what they plan on telling your cancer doctorâ¦ talk to your cancer doctor and find out what they need from your endo and what other info they can give you.
also i recomend looking up http://www.thyca.org/ they will have a nice list of questions there to talk to your doctor about as well as a wonderfull support group.
and yes chemo will make you sick.. it is how sick vs how much they can kill of the cancer that is what matters to the doctors.
also if they are insistant that the nodules are not causing the problems have them get you to a specialist in lungs to figure out what the problem is.
heck i was told a few times by some of the doctors i saw them that just cause i had problem with thyroid they wanted to make sure it was not somehting else just cause people assume all other problems are caused from the first one.
keep talking to the doctors and good luck
How Is The Stage Determined
The staging system most often used for thyroid cancer is the AJCC TNM system, which is based on 3 key pieces of information:
- The extent of the tumor : How large is the cancer? Has it grown into nearby structures?
- The spread to nearby lymph nodes : Has the cancer spread to nearby lymph nodes?
- The spread to distant sites : Has the cancer spread to the distant organs such as the lungs or liver?
The systems described below are the most recent AJCC systems effective January 2018 and applies to differentiated, anaplastic and medullary thyroid cancers.
Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a persons T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage. For more information see Cancer Staging.
The staging system in the table below uses the pathologic stage . It is determined by examining tissue removed during an operation. Sometimes, if surgery is not possible right away or at all, the cancer will be given a clinical stage instead. This is based on the results of a physical exam, biopsy, and imaging tests. The clinical stage will be used to help plan treatment. Sometimes, though, the cancer has spread further than the clinical stage estimates, and might not predict the patients outlook as accurately as a pathologic stage.
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