Carcinoma of the papillary thyroid: causes, symptoms, stages and features of treatment

Medical statistics show that thyroid diseases at the present time are 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 species. Malignant formation appears from a healthy tissue of the organ, is visualized as a cyst or an uneven tumor of large size. In 80% of all cases the patient manages to completely recover from a carcinoma of this kind.

If to speak about other kinds of a cancer in comparison with them the papillary cancer has property very long to develop. Another feature - the metastases of the papillary thyroid carcinoma often spread to the lymph nodes.

As a rule, the patient finds only one node, in rare cases there are several. Most often suffer from this ailment at the age of 30-55 years, mostly women (but sometimes this diagnosis is also put to men).

Causes

While no one can precisely determine why the cancer of the thyroid gland develops. Physicians suggest that, most likely, the reason lies in the mutation of cells. Why such mutations arise, too, can not be clarified.

The tumor develops after the cells are mutated. They begin to grow, gradually hitting the healthy tissue of the organ.

As scientists suggest, the papillary carcinoma of the thyroid gland develops because of:

• Insufficient iodine in the body;
• Environment;
• Ionizing radiation;
• Disorders in the hormonal background;
• Congenital pathology;
• Bad habits (smoking, alcohol abuse);
• Frequent viral and bacterial infections of the respiratory tract.

Symptoms

This form of cancer develops slowly, therefore at 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, it leads to painful sensations in the neck. A person can find for himself a foreign compaction.

At later stages of the carcinoma, the papillary thyroid causes such symptoms:

• An increase in cervical lymph nodes (in most cases, on the one hand, where there is a malignant tumor);
• Pain in the neck;
• Foreign body sensation when swallowing;
• Sometimes the voice becomes hoarse;
• Difficulty breathing;
• When the neck is squeezed (especially when the person is lying on his side) there is considerable discomfort.

Stages of

Do somehow classify papillary thyroid cancer? Stages, the signs of which are the basis for diagnosing:

1. Age to 45 years:

• I stage: the size of any education. Sometimes cancer cells spread to nearby tissues, lymph nodes. Metastases do not spread to other organs. The person does not feel any signs of the disease, but sometimes there is a slight hoarseness, slight pain in the neck.
• II stage: stronger growth of cancer cells. Metastases affect both lymph nodes and organs that are located close to the thyroid (lungs, bones). Symptoms are quite pronounced, they can not be overlooked.

2. Age after age 45:

• I stage: the tumor is not more than 2 cm, no other organs affect the papillary thyroid cancer. Symptoms of the stage: a person does not feel any particular changes, or signs are weakly expressed.
• II stage: the tumor does not go beyond the borders of the thyroid, but the size reaches 4 cm.
• III stage: size is more than 4 cm, cancer cells affect nearby organs.

General picture

The appearance of a node or compaction is the first, with which the cancer of the thyroid gland begins. Carcinoma of the papillary thyroid is characterized by single formations, in rare cases, multiple. If the node is deep, and its size is insignificant, then the person can not find it independently. Malignant tumors up to 1 cm can not be determined even by an endocrinologist. Only after ultrasonography such small formations are found or after the cancer cells began to spread to the lymph nodes, and those, in turn, increased.

With a small amount of nodes, the disease is called "hidden papillary carcinoma." Such formations are not very dangerous, even at the stage of metastasis. The tumor freely moves in the thyroid gland, it can shift during swallowing. But when cancer cells spread to surrounding tissues, malignant formation becomes immobile.

Metastases rarely spread to other organs (except lymph nodes). This happens only in advanced stages of the disease. Metastases have a property for a long time not to make itself felt. In most cases, papillary cancer affects the lymph nodes, less likely to spread to another portion of the thyroid gland.

Cell Features

The main characteristic of malignant education:

• Size - from a few millimeters to several centimeters;
• In rare cases, mitoses are observed;
• Centered in education may be calcium deposition or scar change;
• Tumor not encapsulated;
• Cells do not have hormonal activity.

Examination

Initially, the doctor palpates the neck in the thyroid gland. The cervical lymph nodes are probed. If the doctor discovers something, the patient is sent to the ultrasound, with which it will be possible to determine the presence of the formations, their size and structure.

Cytological picture of papillary carcinoma of the thyroid gland is the main task of examination. To do this, a fine needle aspiration biopsy is used, which is performed strictly under the supervision of ultrasound.

To understand whether there are metastases in other organs, the patient is not sent an X-ray.

Important!

Cytological papillary carcinoma of the thyroid gland is an incorrect definition, which does not contain any sense. There are the terms "cytological study" (determination of the structure of cells for the purpose of revealing pathology) and "papillary carcinoma."

Treatment

How to help a patient with a diagnosis of "papillary thyroid carcinoma"? Treatment consists in surgical intervention. With this disease, thyroidectomy is used. There are two possible options for the operation:

• Partial thyroidectomy;
• Total thyroidectomy.

To completely destroy cancer cells, they resort to radioactive iodine therapy, which is performed after the operation.

Partial thyreectomy

Surgical intervention of this type is indicated in patients with a small size of malignant formation, which is in one of the lobules of the organ. It is important that cancer cells no longer spread anywhere. 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 hypothyroidism, because the hormone synthesizes the unaffected portion of the thyroid gland. Sometimes hormone replacement therapy is required.

Total thyroidectomy

The procedure involves the complete removal of the thyroid gland. Both limbs of the organ are excised, as well as the isthmus that connects them. Sometimes there is a need to remove the cervical lymph nodes. This occurs when they are greatly enlarged, and metastases are found in them. The duration of the procedure is approximately 4 hours.

After this kind of surgery, 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 performed. It is aimed at destroying the remnants 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 itself after a partial thyrotectomy.

Even if cancer cells spread to the lungs, then with the help of radioactive iodine therapy they can be successfully disposed of.

Postoperative period

Thyroidectomy is a complex surgical intervention, but recovery after it is quite fast. Most patients who have to undergo such surgery do not feel much discomfort after the procedure. A person can return to the usual way of life immediately after discharge from the hospital.

Some people think that after the procedure it will not be possible to fully eat, drink water. But this is not so. The cut does not affect the swallowing of either solid or liquid food.

Possible complications

In rare cases, the operation ends with complications:

1. Damage to the recurrent nerve, which is responsible for voice.
2. Hoarseness of the voice or a slight change in it. Sometimes the voice changes forever.
3. Damage to the parathyroid glands. They are located behind the thyroid, so they can be affected during surgery. But this happens very rarely in inexperienced surgeons. Damage threatens the violation of the exchange of phosphorus and calcium. As a result, all this leads to hypoparathyroidism.

Forecast

What can a papillary thyroid carcinoma be for a person? The forecast is favorable in most cases. Even if the cancer cells have spread to the lymph nodes, the patient can live for a long time. Statistics show that after an operation the 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, not so terrible papillary carcinoma of the thyroid gland. Survival is high enough even in cases when the tumor has spread beyond the thyroid gland.

Further examination

After a full course of treatment a person must regularly visit an endocrinologist. This is necessary in order to monitor the overall health. Sometimes the cancer returns, so every year you will have to undergo a complete examination:

• Blood test (determine the effectiveness of substitution therapy, as well as the presence of malignant formations, the 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 you can completely get rid of it. The main method of treatment is surgery, after which it is necessary to resort to therapy with radioactive iodine.