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What Are The Symptoms Of Follicular Thyroid Cancer

What Is The Likelihood Of Thyroid Cancer Recurrence

Thyroid Cancer: Adenoma, Papillary, Follicular, Medullary, Anaplastic for USMLE Step 1

The recurrence rate of thyroid cancer depends upon whether the cancer remains localized within the thyroid gland or whether it has spread or metastasized to local structures in the neck or to distant sites in the body.

In general, the recurrence risk of a cancer that has not spread is very low. For example, Italian researchers found that among patients with papillary cancer of the thyroid gland, those with a low risk of disease had a recurrence rate of about 1.4% at eight years.

Researchers from the Mayo Clinic followed patients for up to 15 years and concluded that low risk patients had a recurrence rate of 3%-5%. However, they noted that more recently, thyroid cancer was being diagnosed much earlier and with the appropriate surgery, cure was much more likely and survival rate after surgery was very high.

The Second Most Common Type Of Thyroid Cancer

Follicular thyroid cancer is the second most common type of thyroid cancer . This article will focus on the symptoms, diagnosis, and treatments for follicular thyroid cancer. You can read our Introduction to Thyroid Cancer article for an overview of the various types of thyroid cancer.Learn more about thyroid cancer in our Patients’ Guide to Thyroid Cancer. It covers diagnosis and treatments for all types of thryoid cancer, including follicular thyroid cancer.

About 15% of all thyroid cancer cases are follicular thyroid cancer.1 Follicular carcinoma is considered more malignant than papillary carcinoma.

But what are some common follicular thyroid cancer symptoms, and how is follicular thyroid cancer diagnosed? Follicular thyroid cancer occurs in a slightly older age group than papillary thyroid cancer and is also less common in children. In contrast to papillary cancer, it occurs only rarely after radiation therapy.

Mortality is related to the degree of vascular invasion. Age is a very important factor in terms of prognosis. Patients older than 40 years old have a more aggressive disease and typically the tumor does not concentrate iodine as well as in younger patients. Vascular invasion is characteristic for follicular carcinoma and therefore distant metastasis is more common.

With follicular thyroid cancer, lung, bone, brain, liver, bladder, and skin are potential sites of distant spread. Lymph node involvement is far less common than in papillary carcinoma.

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.

Thyroid biopsy

If the diagnosis is not clear after an FNA biopsy, you might need another kind of biopsy to get more cells to test.

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How Is Pediatric Follicular Thyroid Cancer Diagnosed

The core evaluation of follicular thyroid carcinoma includes an initial comprehensive visit with a member of the Thyroid team as well as a blood draw to evaluate the function of the thyroid gland, an ultrasound of the thyroid and neck, and a fine needle aspiration biopsy of the thyroid mass.

  • Ultrasound is a non-invasive test that uses sound waves to develop pictures of the thyroid gland.
  • Fine needle aspiration involves a very small needle that is used to remove a sample of thyroid tissue that will then be analyzed by an expert pathologist who will assess for the presence of any cancer.

Based on the results of these and possible additional studies, a treatment plan will be recommended.

When Should I Call My Doctor If I Suspect Hurthle Cell Carcinoma Or Any Thyroid Cancer

Follicular Thyroid Cancer  Thyroflex

Contact your doctor if you have any symptoms of HCC or other thyroid cancer, especially:

  • A painful lump in your throat
  • Difficulty breathing, speaking, or swallowing
  • Persistent fatigue
  • Unexplained or unintentional weight loss

If you have been treated for HCC, make sure you follow any schedule of testing or appointments your healthcare provider recommends. You should also contact them if you have any difficulties or symptoms that worry you.

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Outlook For Thyroid Cancer

Around 9 in every 10 people are alive 5 years after a diagnosis of thyroid cancer. Many of these are cured and will have a normal lifespan.

But the outlook varies depending on the type of thyroid cancer and how early it was diagnosed. At present the outlook is:

  • more than 9 in 10 people with papillary carcinoma live at least 5 years after diagnosis
  • more than 9 in 10 people with follicular carcinoma live at least 5 years after diagnosis
  • more than 7 in 10 men, and around 9 in 10 women with medullary thyroid carcinoma live at least 5 years after diagnosis
  • around 1 in 10 people with anaplastic thyroid carcinoma live at least 5 years after diagnosis

Up to 1 in 4 people treated for thyroid cancer are later diagnosed with cancer in another part of the body, such as the lungs or bones, but cancer can often be treated again if this happens.

Page last reviewed: 28 August 2019 Next review due: 28 August 2022

What Is The Prognosis Of Thyroid Cancer

Overall, the prognosis of differentiated thyroid cancer is excellent, especially for patients younger than 45 years of age and those with small cancers. Patients with papillary thyroid cancer who have a primary tumor that is limited to the thyroid gland have an excellent outlook. Ten year survival for such patients is 100% and death from thyroid cancer anytime thereafter is extremely rare. For patients older than 45 years of age, or those with larger or more aggressive tumors, the prognosis remains very good, but the risk of cancer recurrence is higher. The prognosis may not be quite as good in patients whose cancer is more advanced and cannot be completely removed with surgery or destroyed with radioactive iodine treatment. Nonetheless, these patients often are able to live a long time and feel well, despite the fact that they continue to live with cancer. It is important to talk to your doctor about your individual profile of cancer and expected prognosis. It will be necessary to have lifelong monitoring, even after successful treatment.

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What Kind Of Support Is Available For Those With Thyroid Cancer

Patients, families, and friends are all affected by a diagnosis of cancer is made. Support is available not only for the patient but for all those who are close to the patient. Hospitals, clinics, and health care professionals’ offices often have specially trained staff to help patients and families address their physical, emotional, and spiritual needs.

It is important for the patient and family to understand the disease, the treatment options, the expected outcomes, and the journey that will occur with cancer. Family members will benefit from being present for provider visits during the diagnosis and treatment, as well as with follow-up appointments. This allows all to be involved in advocating for the patient, since there is so much information to understand and absorb it can be overwhelming.

There are many community resources available as well. The American Cancer Society is a good place to begin. They have local offices and may be contacted online.

Articles On Thyroid Cancer

Follicular Thyroid Cancer Treament

Your thyroid is shaped like a small butterfly, and is usually found inside the lower front of your neck. Itâs a gland that controls your metabolism. It also releases hormones that direct many functions in your body, including how you use energy, how you produce heat, and how you consume oxygen.

Thyroid cancer develops when cells change or mutate. The abnormal cells begin multiplying in your thyroid and, once there are enough of them, they form a tumor.

If itâs caught early, thyroid cancer is one of the most treatable forms of cancer.

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Complications Of Thyroid Cancer

Thyroid cancer that comes back

Despite treatment, thyroid cancer can return, even if youve had your thyroid removed. This could happen if microscopic cancer cells spread beyond the thyroid before its removed.

Thyroid cancer may recur in:

  • Lymph nodes in the neck
  • Small pieces of thyroid tissue left behind during surgery
  • Other areas of the body

Thyroid cancer that recurs can be treated. Your doctor may recommend periodic blood tests or thyroid scans to check for signs of a thyroid cancer recurrence.

Recurrence Of Thyroid Cancer

Although thyroid cancer recurrence is not common, there are many treatment options available if it happens. If a cancer recurrence is detected in the neck lymph nodes, the best course of action is usually an operation to remove the affected node or additional treatment with RAI ablation. In order to determine the best treatment for recurrent thyroid cancer, it is critical to work with an experienced team of thyroid specialists.

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What Are Follicular Thyroid Cancer And Hurthle Cell Carcinoma

Follicular thyroid cancer makes up about 10% of all cases of thyroid cancer.

Follicular thyroid cancer does not often spread to the lymph nodes, but it can spread to other organs, like the liver, lungs, bones, and brain.

Hurthle cell carcinoma is a form of follicular thyroid cancer, and accounts for 3% of all thyroid cancer cases. It is more likely to spread to lymph nodes than follicular thyroid cancer.

New Findings On Familial Thyroid Cancers

Thyroid Cancer Symptoms: Thyroid Cancer Symptoms and Early ...

For those of us that have been diagnosed with any type of cancer, we often worry about our family members, and for me, especially my babies. Wonderful new research out of Penn State University has revealed a mutation in the DUOX2 gene may be at least partly responsible for many non-medullary thyroid cancers. This gene is responsible for producing hydrogen peroxide within the thyroid, which is a needed compound in the production of thyroid hormones. When the mutation is present in this gene, the production of hydrogen peroxide does not turn off at the right time, which can cause further genetic damage to the thyroid which as we have learned is a precursor to cancer. What a blessing it could be to discover a genetic marker that could enable early identification of many thyroid cancers!

As always, much love, many prayers, and abundant blessings to all of the warriors out there!!

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Follicular Thyroid Cancer Treatment

Depending on your personal health history, the extent of your follicular thyroid cancer and other factors, your oncologist may recommend one or more of the following treatment options:

  • Thyroidectomy – the usual treatment for people with thyroid cancer is the surgical removal of the thyroid gland. After you have your thyroid gland removed, you will need to take thyroid medication for the rest of your life to replace the hormones that the thyroid usually secretes.
  • Chemotherapy – this treatment involves the use of medications to destroy cancer cells. Chemotherapy drugs can be delivered orally or an intravenous, or IV, liquid . You may need to undergo chemotherapy after surgery so that your doctor can destroy any cancerous cells that couldnt be removed surgically.
  • Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any cancerous cells that couldnt be removed surgically.

Treatment Of Local Recurrence And Metastatic Disease

Surgical resection with tumor-free margins is the mainstay of therapy for local recurrence along with removal of any remaining thyroid tissue. Macroscopic lymph node metastases in the central neck are treated with a central neck dissection, which entails removal of all fibrofatty and nodal tissue between the common carotid arteries from the hyoid bone superiorly to the innominate artery inferiorly. Macroscopic lymph node metastases in the lateral neck are treated by a modified neck dissection, which involves removal of all nodal and fibrofatty tissue from levels IIV in the neck. This includes the upper, mid, and lower cervical, the posterior cervical, and the supraclavicular lymph nodes. Macroscopic metastases that are isolated to the lung, bone, or brain that can be resected result in improved survival .

Surgery also has a role in patients with metastases involving the vertebral bodies or long bones to prevent fractures and for palliation of neurologic sequelae. Bone metastases are most often osteolytic and most commonly occur in the vertebral bodies followed by the pelvis, femur, skull, and ribs. Patients with vertebral body metastases and neurologic symptoms from vertebral collapse or tumor compression are candidates for spine stabilization with tumor resection or percutaneous vertebroplasty . Surgery may also be indicated for severe pain refractory to medical therapy and for metastases that do not concentrate radioiodine.

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What Questions Should I Ask My Doctor

If you have thyroid cancer, you may want to ask your healthcare provider:

  • Why did I get thyroid cancer?
  • What type of thyroid cancer do I have?
  • Has the cancer spread outside of the thyroid gland?
  • What is the best treatment for this type of thyroid cancer?
  • What are the treatment risks and side effects?
  • Will I need thyroid replacement hormone therapy?
  • Is my family at risk for developing this type of thyroid cancer? If so, should we get genetic tests?
  • Can I get thyroid cancer again?
  • Am I at risk for other types of cancer?
  • What type of follow-up care do I need after treatment?
  • Should I look out for signs of complications?

A note from Cleveland Clinic

Receiving a cancer diagnosis is unsettling, regardless of the type. Fortunately, most thyroid cancers respond extremely well to treatment. Your healthcare provider can discuss the best treatment option for the type of thyroid cancer you have. After treatment, you may need to take synthetic thyroid hormones for life. These hormones support vital body functions. They usually dont cause any significant side effects, but youll have regular checkups to monitor your health.

Last reviewed by a Cleveland Clinic medical professional on 08/13/2020.

References

Are There Different Kinds Of Thyroid Cancer

Thyroid Cancer Surgery, Especially for Papillary and Follicular Thyroid Cancer

There are 4 main types of thyroid cancer. They are listed below. Your doctor can tell you more about the kind you have.

  • Papillary thyroid cancer is the most common kind of thyroid cancer. It may also be called differentiated thyroid cancer. This kind tends to grow very slowly and is most often in only one lobe of the thyroid gland. Even though they grow slowly, papillary cancers often spread to the lymph nodes in the neck.
  • Follicular cancer is the next most common type. Its more common in countries where people dont get enough iodine in their diet. These cancers do not tend to spread to lymph nodes, but they can spread to other parts of the body, like the lungs or bones.
  • Medullary cancer is a rare type of thyroid cancer. It starts in a group of thyroid cells called C-cells. C-cells make calcitonin, a hormone that helps control the amount of calcium in the blood.
  • Anaplastic cancer is a rare type of thyroid cancer. It often spreads quickly into the neck and to other parts of the body, and is very hard to treat.

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What Is The Latest Research On Thyroid Cancer

Research continues regarding the best treatment for the different types of thyroid cancers. New drugs are being developed that specifically target the thyroid cancer cells by attacking specific genes or proteins.

MTC research and treatments include developing anti-cancer antibodies and attaching them to radioactive iodine to be injected into the body so that the combination molecule is taken up by the thyroid gland and then specifically attaches to and destroys cancer cells.

Clinical trials continue to enroll patients with many diseases, including thyroid cancer. If appropriate, your health care professional may be a resource in finding a clinical trial that may be beneficial. Clinical trials that are enrolling patients can be found at the U.S. National Cancer Institute web site .

Who Might Have Thyroid Cancer

Women are three times more likely than men to get thyroid cancer. The disease is commonly diagnosed in women in their 40s and 50s, and men in their 60s and 70s. Even children can develop the disease. Risk factors include:

  • Exposure to radioactive fallout from nuclear weapons or a power plant accident.

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Signs Of Thyroid Cancer Include A Swelling Or Lump In The Neck

Thyroid cancer may not cause early signs or symptoms. It is sometimes found during a routine physical exam. Signs or symptoms may occur as the tumor gets bigger. Other conditions may cause the same signs or symptoms. Check with your doctor if you have any of the following:

  • A lump in the neck.
  • Trouble breathing.

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