Medical statistics suggest that thyroid disease is currently one of the most common. They are diagnosed in every third person, especially in old age. The most dangerous disease is cancer (carcinoma) of the thyroid gland. This diagnosis scares everyone who hears such words. But in reality, everything is not as scary as it seems. Modern medicine is so developed that it allows you to identify the disease at an early stage and successfully get rid of it. Consider in detail one of the types of cancer, which is called "papillary thyroid carcinoma."
Features of the disease
Papillary cancer is more common than other types. A malignant tumor emerges from a healthy organ tissue, visualized as a cyst or large non-uniform tumor. In 80% of all cases, the patient manages to completely recover from this type of carcinoma.
If we talk about other types of cancer, then in comparison with them, papillary cancer tends to develop for a very long time. Another feature - metastases of papillary thyroid carcinoma often spread to the lymph nodes.
As a rule, only 1 node is found in a patient, in rare cases there are several of them. Often suffer from this disease at the age of 30–55 years, mostly women (but sometimes men are also given this diagnosis).
Causes
So far, no one can determine exactly why thyroid cancer develops. Doctors suggest that, most likely, the reason lies in the mutation of cells. Why such mutations occur, it is also not possible to find out.
A tumor develops after the cells have mutated. They begin to grow, gradually affecting healthy organ tissue.
As scientists suggest, papillary thyroid carcinoma develops due to:
- insufficient amount of iodine in the body;
- the environment;
- ionizing radiation;
- disorders in the hormonal background;
- congenital pathology;
- bad habits (smoking, alcohol abuse);
- frequent viral and bacterial infections of the respiratory tract.
Signs
This form of cancer develops slowly, so in the initial stages it is determined by chance, and not from any symptoms. A person does not have discomfort, nothing hurts, he lives a full life. When the neoplasm begins to increase, then this leads to painful sensations in the neck. A person can feel for himself a foreign seal.
In the later stages of carcinoma, papillary thyroid gland causes the following symptoms:
- an increase in cervical lymph nodes (in most cases, on the one hand, where there is a malignant tumor);
- neck pain;
- foreign body sensation when swallowing;
- sometimes the voice becomes hoarse;
- difficulty breathing;
- when squeezing the neck (especially when a person is lying on his side), significant discomfort is felt.
Stages
Is papillary thyroid cancer classified somehow? Stage, the signs of which are the basis for the diagnosis:
1. Age to 45 years:
- I stage: any education size. Sometimes cancer cells spread to nearby tissues, lymph nodes. Metastases do not expand to other organs. A person does not feel any signs of the disease, but sometimes there is a slight hoarseness, slight pain in the neck.
- Stage II: stronger growth of cancer cells. Metastases affect both the lymph nodes and organs that are located close to the thyroid gland (lungs, bones). The signs are quite pronounced, they cannot be overlooked.
2. Age after 45 years:
- Stage I: the tumor is no more than 2 cm, no other organs affect papillary thyroid cancer. Symptoms of the stage: a person does not feel any special changes, or signs are poorly expressed.
- Stage II: the tumor does not extend beyond the borders of the thyroid gland, but the size reaches 4 cm.
- Stage III: the size is more than 4 cm, cancer cells infect nearby organs.
Overall picture
The appearance of a node or seal is the first thing that begins with thyroid cancer. Papillary thyroid carcinoma is characterized by single formations, in rare cases, multiple. If the knot is deep and its size is insignificant, then a person cannot grope it on his own. Malignant tumors up to 1 cm cannot be determined even by an endocrinologist. Only after ultrasound find such small formations or after the cancer cells began to spread to the lymph nodes, and those, in turn, increased.
With a small size of the nodes, the disease is called "hidden papillary carcinoma." Such formations are not very dangerous, even at the stage of metastasis. The tumor moves freely in the thyroid gland, can move during swallowing. But when cancer cells spread to surrounding tissues, the malignant formation becomes immobile.
Metastases very rarely spread to other organs (except for the lymph nodes). This happens only in advanced stages of the disease. Metastases tend to not make themselves felt for a long time. In most cases, papillary cancer affects the lymph nodes, less often spreads to another part of the thyroid gland.
Cell Features
The main characteristic of malignancy:
- size - from a few millimeters to several centimeters;
- in rare cases, mitoses are observed;
- centered in the formation may be calcium deposition or scarring;
- the tumor is not encapsulated;
- cells have no hormonal activity.
Survey
Initially, the doctor palpates the neck in the thyroid gland. The cervical lymph nodes are also felt. If the doctor finds something, then the patient is sent for an ultrasound scan, with which it will be possible to determine the presence of formations, their size and structure.
The cytological picture of papillary thyroid carcinoma is the main task of the examination. For this, a fine-needle aspiration biopsy is used, which is carried out strictly under the supervision of ultrasound.
To understand if there are metastases in other organs, the patient is not sent an x-ray.
Important!
Cytological papillary thyroid carcinoma is a misnomer that does not make sense. There are the concepts of “cytological examination” (determining the structure of cells in order to identify pathology) and “papillary carcinoma”.
Treatment
How to help a patient with a diagnosis of papillary thyroid carcinoma? Treatment consists in surgery. With this disease, thyroidectomy is used. There are two possible operations:
- partial thyroidectomy;
- total thyroidectomy.
For the complete destruction of cancer cells, they resort to radioactive iodine therapy, which is carried out after the operation.
Partial thyroidectomy
Surgery of this type is indicated for patients with a small size of a malignant tumor, which is located in one of the lobes of the organ. It is important that cancer cells do not spread anywhere else. As a rule, in such cases, the node does not exceed 1 cm in diameter. The duration of the procedure is no more than 2 hours.
The patient is not threatened with the development of hypothyroidism, because the hormone synthesizes the unaffected lobe of the thyroid gland. Sometimes hormone replacement therapy is required.
Total thyroidectomy
The procedure involves the complete removal of the thyroid gland. Both lobes of the organ, as well as the isthmus that connects them, are excised. Sometimes it becomes necessary to remove the cervical lymph nodes. This happens in those cases when they are greatly enlarged, and metastases are found in them. The duration of the procedure is approximately 4 hours.
After this kind of operation, the patient will have to take hormone-containing drugs for life. After all, the body does not have thyroid tissue.
Radioactive iodine therapy
Such therapy is used when an operation has already been done. It aims to destroy the remains of cancer cells. Metastases that went beyond the body, went to the lymph nodes, are very dangerous. With the help of radioactive iodine, it is possible to kill such cells. Often they remain in the thyroid gland after a partial thyroidectomy.
Even if the cancer cells have spread to the lungs, then with the help of radioactive iodine therapy they can be successfully eliminated.
Postoperative period
Thyroidectomy is a complex surgical intervention, but recovery from it is quite fast. Most patients who have to undergo such an operation do not feel much discomfort after the procedure. A person can return to their usual lifestyle immediately after discharge from the hospital.
It seems to some that after the procedure there will be no opportunity to fully eat, drink water. But this is not so. The incision does not affect the swallowing of either solid or liquid food.
Possible complications
In rare cases, the operation ends with complications:
- Damage to the recurrent nerve, which is responsible for the voice.
- Hoarseness or slight change. Sometimes the voice changes forever.
- Damage to the parathyroid glands. They are located behind the thyroid gland, so they can be affected during surgery. But this happens very rarely in inexperienced surgeons. Damage threatens to disrupt the exchange of phosphorus and calcium. As a result, all this leads to hypoparathyroidism.
Forecast
What can a human papillary thyroid carcinoma turn into? The prognosis in most cases is favorable. Even if the cancer cells have spread to the lymph nodes, the patient can live for a long time. Statistics show that after surgery, a person lives:
- more than 20 years in 70% of cases;
- more than 10 years in 85% of cases;
- more than 5 years in 95% of cases.
As you can see, papillary carcinoma of the thyroid gland is not so terrible. Survival is quite high even in cases where the tumor has spread beyond the thyroid gland.
Further examination
After a full course of treatment, a person should regularly visit an endocrinologist. This is necessary in order to monitor the general state of health. Sometimes the cancer returns, so every year you have to undergo a full examination:
- blood test (the effectiveness of replacement therapy is determined, as well as the presence of malignant tumors, remaining metastases);
- Ultrasound of the thyroid gland and lymph nodes;
- body scan with iodine.
Papillary thyroid cancer is a dangerous disease, but in most cases it can be completely eliminated. The main method of treatment is surgery, after which it is necessary to resort to radioactive iodine therapy.