Follicular thyroid cancer
In the case of a change in voice and the appearance of shortness of breath, doctors suspect the patient of follicular thyroid cancer.This is the second( after papillary cancer) in the prevalence type of malignant neoplasms localized on the thyroid gland.It is diagnosed through a comprehensive examination using ultrasound, biopsy, computed tomography.Treatment of cancer is reduced to resection of damaged areas, as well as the appointment of substitution therapy.Table of Contents: General Information Causes Symptoms of oncological diseases of the thyroid gland Classification Diagnosis Post-operative prophylaxis Prevention
Follicular cancer accounts for about 15% of diagnoses associated with the development of thyroid neoplasms.In the risk group - people who have reached the age of 40, although sometimes oncology is diagnosed in children.And in women this type of cancer is found 3 times more often than in men.
The mechanism of the disease is simple: the thyroid is formed from tissues with follicles and interfollicular cells that synthesize the hormone calcitonin.Under the influence of unfavorable factors, the follicles degenerate, and a malignant focus develops.
Please note! Follicular cancer is considered an aggressive form of oncology.It rarely metastasizes to the lymph nodes, mainly choosing other organs and tissues - the brain, lungs, skin, bones, which significantly worsens the prognosis.
Timely diagnostics performed at the initial stage and subsequent correct treatment provide virtually all patients with 100% five-year survival. There are physicians who are sure that complete excision of the affected tissue guarantees a cure for the disease in most cases.They explain their point of view by the fact that follicular cancer rarely extends to the tissues of surrounding organs.In addition, the likelihood of developing relapse with this form of cancer is extremely low.
The age of the patient is of great importance.The older the person, the harder it is to resist the disease.
Scientists have not yet succeeded in accurately establishing the reasons for the development of follicular cancer.There is an opinion that there is an oncology against the background of the existing goiter.
Concomitant factors increase the risk of its development:
- chronic inflammation of the thyroid gland;
- deficiency of iodine in the body;
- irradiation of the head and neck, including X-rays, which provoke cell mutations;
- low immunity and persistent stresses, which lead to its reduction;
- smoking, alcohol abuse, which contribute to the accumulation of carcinogens in the body;
- hormonal changes in pregnancy, menopause;
- accommodation in areas with a bad environmental situation;
- work on environmentally hazardous production.
Symptoms of oncological disease of thyroid
Despite its aggressiveness, oncology is developing slowly.At the initial stages, when the percentage of cure for the disease is incredibly high, there is no symptomatology. Later, in front of the neck, a dense knot is probed, yet it can be mistaken for a goiter.
As it grows:
- shortness of breath;
- difficulty in swallowing, breathing;
- pain in the thyroid gland;
- breaking the voice;
- increased sweating;
- problems with sleeping;
- rapid fatigue, weakness;
- apathy and depression, mood imbalance;
- loss of appetite and weight;
- pallor of the skin, overheating of the body, or hyperthermia;
- sometimes cramps, chills, tingling.
Important! Metastasis in the peripheral parts of the lung leads to the appearance of a cough with sputum discharge with blood.The penetration of metastases into the bone system results in pain and frequent fractures.The defeat of the liver gives pain in the right hypochondrium, sometimes jaundice, hepatomegaly - an increase in the size of the organ.When metastasizing in the brain, headaches appear.
Growth of lymph nodes, as a rule, with this form of cancer is not observed.
Depending on the degree of development of the disease, is allocated:
- T1 is the stage at which the diameter of the tumor is no more than 2 cm. For more detailed diagnosis, T1a( tumor up to 1 cm) is isolated,T1b( up to 2 cm).This is the first degree in which cells do not decay, and metastases are not observed.At the same time, there is a shortage of iodine, the tumor grows slowly, sometimes over the years.Such a cancer is most often latent and in case of timely detection it is easy to treat .The survival rate of patients reaches almost 100%.
- T2 is the stage at which the growth increases to 2 to 4 cm in diameter.This is the second degree, characterized by the fact that the tumor does not go beyond the thyroid gland and does not metastasize.Survival of patients, as before, remains at the level of 100%.
- T3 is a stage in which the diameter of the node exceeds 4 cm. This is the third degree, which is characterized by the out-going of the thyroid gland and the absence of metastases.Treatment at this stage allows to achieve a 70% survival rate.
- T4 is a stage in which the surrounding organs and tissues are affected.Within this stage, T4a is secreted when metastases are found in the larynx, laryngeal nerve and trachea, and T4b when metastases go into the carotid artery.In fact, this is the fourth degree in which the size of the tumor can vary.In general, they do not even matter because of large-scale metastasis to other organs. The prognosis of treatment depends on the degree of damage to neighboring organs, but the survival rate usually does not exceed 50%.
Sometimes doctors select cell-follicular low-grade thyroid cancer.The frequency of this form of oncology is 4-7%.It is characterized by a rapid progression, in which the patient himself notes an increase in the diameter of the nodes, visible to the naked eye.At this time he experiences problems with breathing and swallowing, watching changes in his voice.
Pathological symptoms are manifested after 2 to 4 months after the onset of the development of the disease.By this time asymmetry of the neck shape is observed, and when pressed on the affected area, the person feels pain.
Due to the high rate of progression of the disease, the prognosis for patients suffering from it worsens.In some cases, after diagnosis, they remain no more than a few months, less often weeks, of life.
If the first signs of the disease are identified, it is necessary to contact the endocrinologist.If he suspects a follicular cancer, he will also send a consultation to an otolaryngologist and an oncologist. Last and assign a diagnosis.
As a rule, it includes:
- Ultrasound of the thyroid gland for identifying nodules that are not felt by probing;
- computed tomography of the thyroid gland, which allows one to layer-by-layer the structure of the organ;
- magnetic resonance imaging of the thyroid gland;
- puncture biopsy of the neoplasm, which confirms its malignancy and is the decisive factor in favor of surgical intervention;
- radioisotope examination - it helps to detect the scale and localization of metastases;
- blood tests for detecting thyroid hormone levels and for oncomarkers;
- Laryngoscopy is a technique for examining the larynx and vocal cords, which involves the introduction of a laryngoscope and is performed under general anesthesia.
If necessary, scintigraphy of the bones of the skeleton, ultrasound of the liver, chest X-ray, MRI of the brain and other procedures that allow to judge the degree of involvement of other organs and tissues in the oncological process.
Treatment of follicular thyroid cancer
The only effective treatment for follicular thyroid cancer is the operation of .However, physicians still can not agree on the opinion of its kind.Some believe that it is better to excise only the tumor area of the thyroid gland, while others insist on complete removal of the organ.Their opinion is supported by the low probability of recurrence of .In any case, the scale of the surgery depends on the degree of development of the tumor.
In the postoperative period, radioactive iodine therapy is prescribed, in which an iodine-131 isotope is used that destroys unhealthy cells.The course of iodine therapy lasts about 6 weeks.
Important! Iodine therapy is also used in case of involvement of lymph nodes and neighboring organs, especially if patients have contraindications to surgery, for example, elderly age, serious somatic pathologies.
When a thyroid gland is removed, the patient is prescribed hormone replacement therapy for life. Once a year he is recommended to do a chest x-ray, visit an oncologist-endocrinologist.
Prognosis after surgery for follicular thyroid cancer
In most cases, the prognosis for follicular thyroid cancer is favorable. If the disease is treated in 1 or 2 stages, the patient will live for at least 5 years with 100% probability.Diagnosis of oncology at the third stage reduces the five-year survival rate to 70%.With the fourth degree of cancer to 5 years from the time of surgery, only one in two patients survive.
To reduce the risk of developing thyroid follicular cancer, it is necessary:
- to give up harmful habits that boil down to smoking and alcohol abuse, taking drugs;
- monitor their diet, as overweight increases the "chances" of getting into a risk group;
- discard products with a high content of stabilizers, dyes, emulsifiers, which manufacturers designate as "E";
- take vitamins from time to time;
- not to sunbathe under direct sunlight, less frequent sunbeds;
- to protect yourself from radiation, choosing for living environmentally friendly areas;
- does not neglect prophylactic examination by specialists.
Follicular thyroid cancer is not a verdict, but a serious disease.In view of the fact that in recent years the number of patients with such a diagnosis has increased, doctors recommend to take a closer look at their health, and when the first signs of an illness appear, contact them for an appointment.In some cases, this can prolong life for several years.
Chumachenko Olga, medical reviewer