Life expectancy for papillary thyroid cancer. Papillary thyroid cancer - symptoms, treatment and prognosis for patients

Carcinoma is a type of malignant tumor in the body formed by epithelial cells. A malignant process can develop in any organ, and the neoplasm itself comes in different forms. Papillary carcinoma of the thyroid gland is considered quite common; in this organ, this type of cancer accounts for 80% of cases.

The papillary form has the most favorable prognosis for complete recovery. The process manifests itself mainly in the form of a single cystic neoplasm; in more rare cases, it may have several growth centers. The peculiarity of papillary thyroid carcinoma is that it grows slowly, has a fairly low degree of metastasis and responds well to treatment.

Most often, the pathology is detected in people aged 40-55 years, but cases of the disease are also common in adolescents.

Causes of tumor appearance and development

Modern medicine, unfortunately, does not yet provide an unambiguous conclusion about what can lead to the development of papillary thyroid carcinoma. Doctors have identified only a number of the most dangerous factors that can provoke disruption in the vital activity of organ cells:

hereditary predisposition to cell mutation;
iodine deficiency in the human body;
living in environmentally unfavorable conditions;
alcohol addiction.

Attention! Constant stress and poor nutrition, unsaturated with the necessary complex of microelements and vitamins, also contribute to problems in the body at the cellular level.

Clinical picture and pathological features

The development of papillary carcinoma is indicated by the appearance of a nodule or lump in the area of the thyroid gland that is painless to the touch. The tumor has a dense structure and if its size is more than 1 cm, then it is easily determined by palpation. If the neoplasm is only a few millimeters in size, then it may not be palpable. It is also difficult to identify deep-lying tumor nodes by palpation, since they are covered by healthy gland tissue. In most cases, small neoplasms (up to 1 cm in size) and those that are deeply localized manifest themselves only after metastases have spread to nearby lymph nodes.

The difficulty of identifying papillary carcinoma at an early stage is also based on the fact that the tumor nodes are very mobile, they are easily displaced and do not interfere with swallowing or during conversation. Tumor resistance begins to appear after it has grown into adjacent tissue. Metastases remain encapsulated for quite a long time. The first to be affected by metastases are usually the lymph nodes or, slightly less frequently, another part of the gland; in extremely rare cases, the lungs, bones, and mammary glands.

Apart from compactions, this type of carcinoma has no other characteristic signs. There are only a few manifestations that may be characteristic of other organ pathologies, but most often their presence depends on the location of the tumor and the stage of the process. If the seal puts pressure on the larynx, the following may appear:

hoarseness of voice;
some difficulty swallowing;
feeling of a lump stuck in the throat;
cough (not related to a cold or allergy);
dyspnea;
pain in the affected area (for this type of carcinoma, as in the case of bladder localization, pain appears at the last stage of the process);
swelling of the neck veins is possible (with a large tumor).

Cytological picture of pathology

A distinctive feature is the cytological appearance of papillary carcinoma. Tumor cells are characterized by the following features:

the size can be from 1 mm to several centimeters in diameter;
as a rule, neoplasms do not have a shell, but consist of branches with a vascularized connective tissue base;
the branches of the neoplasm are covered by two types of epithelium (cylindrical, cubic);
the nucleus is filled with a specific substance - chromatin;
often the neoplasm contains bodies of basophilic and calcified mass;
hormonally inactive;
mitotic division occurs rarely;
the cells of such a tumor absorb radioactive iodine (in this they differ from papillary carcinoma).

Methods for diagnosing the disease

The pathological neoplasm is initially identified by an endocrinologist by palpation of the affected area (this is possible if the tumor is larger than 1 cm); small nodes can only be noticed during an ultrasound.

The final diagnosis is made only after receiving the results of a hormonal analysis of venous blood and histological examination of a particle of tumor tissue obtained by fine-needle aspiration biopsy.

What types of treatment are provided?

Almost all cases of papillary thyroid carcinoma require surgery. In the first stages, surgical excision of the tumor with part of the adjacent healthy tissue or partial removal of the organ is possible. However, most often the entire gland must be removed, as well as nearby lymph nodes (if they are affected by metastases). The entire organ must be removed even if multiple foci of pathology are detected in it.

The second stage of treatment is procedures using radioactive iodine. This type of therapy is necessary to eliminate microscopic foci of malignant tumors, metastases in the lymphatic system and tissue particles of the gland affected by the tumor.

After the described two stages of basic treatment, patients are assigned a rehabilitation program. It necessarily includes hormone replacement therapy, based on the administration of thyroxine (this is a synthetic analogue of the biologically active part of the thyroid gland).

Attention! Hormone replacement therapy with a thyroxine analogue is indicated for patients throughout their lives.

After treatment of papillary thyroid carcinoma (as well as after urothelial carcinoma g2 or in case of malignant processes of another localization), special nutrition is prescribed, aimed at strengthening the body.

Life after illness: prognosis, survival

Papillary thyroid carcinoma has a favorable prognosis; the malignant tumor grows very slowly, so patients live with the pathology for quite a long time, maintaining their ability to work. This type of malignant process has a very low degree of metastasis, and even if the metastasis spreads to nearby lymph nodes, the disease is highly treatable. It is also characteristic that when metastases grow into bone tissue or lungs, the prognosis is also very often favorable, since effective therapy allows one to achieve stable remission or complete cure.

The average survival rate after treatment for papillary thyroid carcinoma is:

in 96% of cases – more than 5 years;
in 86% of cases – 10 years or more.

In many ways, the effectiveness of treatment and further recovery are influenced by several important factors:

general condition of the body;
patient's age;
maintaining a healthy lifestyle (in particular, quitting smoking);
strict adherence to the doctor’s recommendations regarding annual examinations.

Annual preventive examinations are indicated for absolutely all patients who have undergone cancer in order to prevent relapse of the disease. The examination assumes:

Patients who have had thyroid cancer are recommended to have an enhanced diet, the purpose of which is to saturate the body with useful substances and minerals. First of all, the emphasis should be on green vegetables (cabbage, broccoli, lettuce, green peas). The diet should contain natural products of orange, yellow and red colors (carrots, pumpkin, apricot), green tea.

Among the variety of cancerous tumors found in the body, thyroid cancer (carcinoma) does not occupy a leading position in terms of frequency of occurrence. However, its appearance has recently become more frequent, especially among young citizens. Statistically, older people remain the leaders in the development of the disease, and with every ten years the incidence rate rises by ten percent.

Tumors of a benign nature are observed more in women; men are more likely to degenerate nodes into malignant ones. A small proportion of thyroid carcinomas are inherited.

Signs of carcinoma

More often, a malignant tumor degenerates from a benign one. At first, the disease does not manifest itself in any way, then the goiter changes its structure, becoming more dense and lumpy. The size of the tumor begins to increase.

If a rapidly developing node without the formation of symptoms is detected, it is assumed to be malignant, despite the fact that single nodes are more often benign.

A malignant nodule usually develops on the underside of one of the thyroid lobes. Sometimes it is found in the area of the isthmus of the gland, then it spreads to both lobes. In the first stages, the tumor is visually smooth, with a denser structure than healthy thyroid tissue. As it progresses, the neoplasm becomes rough, with blurred boundaries, and gradually begins to occupy the entire lobe of the thyroid gland. The three-dimensional volume of the tumor also changes: growth goes deeper into the gland, causing compression of neighboring tissues, the trachea and the recurrent nerve, to become more and more noticeable. The voice becomes hoarse, shortness of breath begins during physical exertion, and other breathing difficulties begin. Problems with swallowing (dysphagia) begin, the vascular-venous pattern is clearly visible on the surface of the skin in the area of the gland, the tumor takes over more and more tissues, the neck muscles.

The lymph nodes on the part of the neck where the tumor is located begin to increase in size, which indicates the degeneration of normal lymphoid tissue into malignant one. This symptom is the main one when diagnosing cancer in children. Compression of the recurrent nerve affects the vocal cord of the affected side, causing paresis in it. Sometimes this does not affect the disturbance of voice timbre, but the glottis still detects a disturbance if it is examined by laryngoscopy.

Types of cancer: follicular

An additional nuisance when identifying follicular cancer from other types of malignant thyroid tumors is the inability to detect it during a biopsy. If the follicular nature of the tumor is detected, the patient is subject to mandatory surgery to remove the affected lobe of the gland. Follicular carcinoma of the thyroid gland can be distinguished from follicular adenoma by examining the capsule of the node: with carcinoma, a tumor grows into it.

Types of cancer: medullary

Medullary thyroid carcinoma is not so common (only about 6% of all thyroid carcinomas). It is mainly treated surgically. There are two forms of this type of neoplasm:

sporadic. The most common form (4 cases out of 5), is not inherited.
family. It has a hereditary predisposition and is transmitted together with pheochromocytoma (tumor in the adrenal glands) and parathyroid carcinoma or parathyroid adenoma (tumors in the parathyroid glands).

These forms of tumors can be distinguished using a genetic study of the 10th chromosome. This chromosome is the location of the RET proto-oncogene, which is responsible for the synthesis of tyrosine kinase.

The presence of a mutation in the RET proto-oncogene is the basis for examining close relatives of the patient.

An increased level of the hormone calcitonin and a node detected during an ultrasound examination indicate medullary carcinoma and immediate surgical intervention.

The immediate treatment (radioactive iodine treatment is not used in this case) is due to the aggressive nature of this type of cancer. In addition to surgical removal of the gland, tyrosine kinase inhibitors are used.

Types of cancer: papillary

Papillary thyroid carcinoma is the most common cancer of all thyroid carcinomas (about 80% of cases). The least dangerous, develops slowly, occurs even in newborns.

Tumors do not have capsules; their size can vary from a few mm to 4 cm or more. Papillary carcinoma has the appearance of a fern leaf, with a branching stem, the center of which can deposit calcium compounds. In the papillary variant of papillary carcinoma, both the tumor and metastases do not have hormonal activity, and, therefore, cannot capture the radioactive isotope of iodine-131. The follicular variant of papillary carcinoma exhibits hormonal activity and is therefore treated with radioiodine therapy. In both variants, spread occurs through the lymphatic vessels, and metastases often penetrate the lymph nodes on the corresponding side.

The disease often manifests itself in the form of a single node, less often - multiple nodes. Palpation fails to detect thyroid carcinoma smaller than 10 mm. Even such small tumors can metastasize to the lymph nodes on the corresponding side of the neck. However, the indolent nature of cancer makes it possible to establish a favorable prognosis even for such small tumors.

Usually the tumor moves when it moves with the skin. If, nevertheless, it grows into neighboring tissues and organs, it becomes motionless both during swallowing and during attempts to displace.

Metastases can develop over several years, with only 6 out of ten patients having metastases to the cervical lymph nodes.

It is possible to avoid the appearance of metastases when removing the thyroid gland with benign nodes. In addition to metastases involving the lymph nodes, cases of metastasis to another lobe of the thyroid gland have been described. And cases of cancer cells spreading to the lungs, bones, etc. are very rare. If this happens, then papillary carcinoma with encapsulated follicular metastases occurs. During diagnosis, cancer is recognized only by bone fractures or pain using radiography. There are no signs of disease from the thyroid gland (euthyroid nature).

Death after surgery for papillary cancer is very rare. If such cases occur, the cancer returns to the remaining part of the thyroid gland. It is almost always possible to remove metastases even from bones with iodine-131.

If it is impossible to detect a node by palpation, and metastases to the lymph nodes are obvious, the result of a histological examination of the lymph node resolves the issue. Until this point, the origin of the metastases remains a mystery: lymphogranulomatosis, tuberculosis of the lymph nodes or papillary thyroid carcinoma.

Although the absence of metastases to the lymph nodes (or single metastases) makes it possible to preserve part of the thyroid gland, the practice of surgeons is more radical.

Their fears are understandable: after all, the percentage of metastasis through the lymphatic vessels to the neighboring lobe is quite high and it is not advisable to subject the body to a second operation. Therefore, total thyroidectomy is often used. Sometimes after surgery, the neck area at the site of the former thyroid gland and local lymph nodes is exposed to X-rays, although papillary carcinoma is not very sensitive to these rays.

Types of cancer: anaplastic

Anaplastic carcinoma is diagnosed in elderly patients. Very rare. Refers to tumors of an undifferentiated nature, since cancer cells do not have common functionality with thyroid cells. Therefore, the use of radioiodine therapy is useless. It is detected when there are already both metastases in the lymph nodes and distant ones. Due to the late timing of patients’ treatment, when difficulties with swallowing, breathing, and a hoarse voice appear, patients are advised not only surgery, but also subsequent radiation and chemotherapy for recovery.

Types of cancer: Hurthle cell

This form is similar to follicular cancer, the peculiarity is greater metastasis.

Thyroid cancer is a malignant tumor that develops from the cells of this organ. The disease is considered relatively rare. It accounts for 1% of all malignant tumors and less than 0.5% of deaths. But after the accident at the Chernobyl nuclear power plant, more and more people are noticing alarming signs of the disease.
The peak incidence is between 45 and 60 years of age, but a malignant thyroid tumor can appear at any age. This form of cancer is also sometimes found in children and adolescents. Moreover, at an early age the tumor behaves more aggressively than in adults.

Women are 2-3 times more likely to become victims of thyroid cancer. But in old age (over 65) men are at greater risk of getting sick than their peers.

The disease most often occurs in regions that have been exposed to radiation and where there is an insufficient amount of iodine in nature. This form of cancer is most common among Caucasians. Residents of Asian, African and South American countries are less likely to suffer from thyroid problems.

Thyroid cancer is a non-aggressive tumor. This tumor may not increase in size for years and not metastasize to other organs. But this is not a reason to ignore a serious illness. Modern diagnostic methods make it possible to detect cancer in the early stages and begin treatment on time. This approach allows you to completely defeat the disease and provide a person with a healthy, full life.

Causes of thyroid cancer

The causes that cause thyroid cancer are not fully established. But doctors name many factors, which can increase the risk of developing the disease tenfold.

Radioactive exposure. Studies conducted in areas affected by the Chernobyl accident have proven that after the explosion, the number of cases of thyroid cancer increased 15 times. Also dangerous are radioactive rains that fall after nuclear weapons tests.
Radiation therapy to the head and neck area. Long-term exposure to X-rays can cause tumors to appear decades later. Cells of the human body become prone to mutations, active growth and division. These processes ensure the appearance of papillary and follicular forms of tumors.
Age over 40 years. Although malignant tumors can appear in children, the risk increases greatly with age. During the aging process, thyroid cells are more likely to experience gene failures.
Family predisposition. Scientists have identified a special gene that is inherited and is responsible for the development of thyroid cancer. If it is present in a person, then the probability of a tumor appearing is almost 100%. When doctors discover such a gene, they may suggest preventive surgery to remove the thyroid gland.
Occupational hazards. Work with ionizing radiation among medical personnel, workers in hot shops, or activities associated with heavy metals is considered dangerous.
Stressful situations. Severe stress, after which a person cannot recover for a long time and depression undermines the immune system. But it is immune cells that are responsible for destroying cancer.
Bad habits. Tobacco smoke contains carcinogens, and alcohol weakens the body's natural defenses against abnormal cells.

The occurrence of thyroid cancer may be caused by: chronic diseases:

Medullary cancer is detected in people over 40-50 years of age. It affects men and women equally. The tendency to such tumors is inherited. But medullary cancer can also appear in a person whose ancestors never suffered from such a disease. This is called the sporadic form.

Medullary thyroid cancer is often accompanied by other disorders of the endocrine glands - multiple endocrine neoplasia. The cells of this tumor do not absorb iodine, unlike other forms of cancer. Therefore, radioactive iodine therapy does not help in this case.

Only surgery can help get rid of medullary cancer. The thyroid gland and cervical lymph nodes will need to be completely removed. Patients over 50 years of age have a poor prognosis.

Anaplastic thyroid cancer

This is the rarest form of the disease, in which atypical cells develop in the gland. They have lost all their functions and can only actively share. The proportion of aplastic tumors is less than 3%.

The tumor appears in people over 65 years of age, and in women more often than in men. The disease is characterized by rapid growth and spread of metastases. Difficult to treat. It has the worst prognosis of all forms of thyroid cancer.

Diagnosis of thyroid cancer

Devices are used to examine the condition of the thyroid gland. Ultrasound. This inexpensive and painless procedure allows you to determine whether the gland is enlarged, whether there are nodules and tumors in it, to find out their size and exact location. But, unfortunately, ultrasound cannot determine whether a nodule is a cancerous tumor. Doctors are most concerned about nodes that poorly reflect the ultrasound wave, have unclear and uneven edges, a heterogeneous structure, and in which blood circulation is well developed.

Fine-needle aspiration puncture biopsy (FNA) helps determine what cells the tumor consists of. Under ultrasound guidance, a thin needle is inserted into the tumor. With its help, the doctor takes a sample of cells for research. This is a very accurate and low-traumatic method.

If the result of a fine-needle biopsy is doubtful, then an open biopsy of the suspicious node is performed. This is a small operation during which the doctor excises a small area of the tumor and does a quick examination of it.

Blood tests

A person needs to donate blood from a vein. In the laboratory, using an enzyme immunoassay, they determine whether there are tumor markers in it. These are special protein-based chemicals. Elevated levels may indicate a certain form of thyroid cancer.

Calcitonin . An elevated level indicates that a person has medullary thyroid cancer. In people who have already undergone treatment, high concentrations indicate distant metastases. But it is necessary to remember that the amount of the hormone increases during pregnancy, taking hormonal contraceptives, calcium supplements and diseases of the pancreas. The following indicators are considered normal: women - 0.07-12.97 pg/ml, men - 0.68-30.26 pg/ml.
Thyroglobulin. This is a protein secreted by thyroid cells. The normal level of its content in the blood is 1.4-74.0 ng/ml. An increased level may indicate papillary and follicular thyroid cancer and the presence of metastases.
BRAF gene. Its level makes it possible to determine the prognosis of the course of the disease in papillary thyroid cancer. Normally it shouldn't be there.
EGFR. This test detects epidermal growth factor. It is done after the tumor is removed. An increased amount of it in the blood indicates that there is a high probability that the tumor will reappear.
Antithyroid antibodies in blood serum. High levels of these proteins indicate that a person has an autoimmune thyroid disease (the immune system mistakenly attacks the organ). This often happens with papillary thyroid cancer.
Proto-oncogene mutationsRET . Identification of changes in genes confirms medullary cancer. Such a study is carried out not only on the sick person, but also on his family members.

In each specific case, the doctor may order several tests to confirm suspicions about a tumor. But it must be remembered that tumor markers do not provide completely reliable information about the disease. There is always a percentage of people who have elevated levels of these substances, but do not have a tumor. There are also patients in whom a tumor is detected, but tumor markers are normal. Therefore, only a biopsy can give the most accurate result.

In order to find out how impaired the function of the thyroid gland is, hormone levels are determined:

Thyroid-stimulating hormone (TSH). This is a hormone secreted by the pituitary gland that stimulates the development of thyroid cells. It is important to measure its level after cancer treatment. The concentration should not exceed 0.1 mIU/l, otherwise the disease will return.
Thyroxine (T4). The level of this hormone shows how active the thyroid gland is.
Triiodothyronine (T3). Biologically active hormone. Its concentration indicates how the gland works.
Parathyroid hormone (PTG). A substance produced by the parathyroid glands. Its high concentration indicates metastases in medullary cancer.

Stages of cancer

In any oncological disease, there are 4 stages of tumor development. When a doctor determines the stage of cancer, he takes into account: the size of the tumor, its prevalence, the presence of metastases in nearby and distant organs.

Metastasis is a secondary tumor, a new focus of growth. It is formed after cancer cells are carried through the blood or lymph into other organs.

Stage I. A tumor up to 2 cm in size is located in one lobe (half) of the thyroid gland. It does not deform the gland capsule and does not form metastases.
Stage II. A single large tumor that deforms the gland. Many small tumors belong to this stage. Tumors do not grow into the capsule. There may be metastases on the side of the neck where the cancer is located.
Stage III. The tumor grows into the capsule of the thyroid gland. It compresses the trachea and surrounding tissues and fuses with them. Metastases appear in the cervical lymph nodes on both sides of the gland.
Stage IV. The tumor grows deeply into the surrounding tissues, the thyroid gland becomes immobile and greatly increases in size. Metastases are detected in nearby and distant organs.

How do you know that metastases have appeared?

Metastases in thyroid cancer appear most often in lymph nodes neck. In this case, the lymph nodes become enlarged and inflamed. They become dense, less mobile and merge with the skin. This complication does not worsen the prognosis of the disease. In papillary and follicular cancer, metastases are well treated with radioactive iodine.

Metastases to the brain manifested by headaches that are not relieved by analgin. Possible loss of coordination and blurred vision, seizures similar to epileptic ones.

Metastases in bones cause pain and fractures. More often than others, the ribs, bones of the skull, pelvis and spine are affected, and less often the limbs. On X-ray, metastases appear as voids or dark growths.

Liver metastases can cause jaundice, heaviness in the right hypochondrium and digestive disorders. The person cannot tolerate fatty foods or meat. In severe cases, internal bleeding may occur in the form of bloody stools and coffee-ground vomiting.

Metastases to the lungs cause dry cough, difficulty breathing, blood in sputum. There is a feeling of tightness and pain in the chest, severe fatigue.

Metastases to the adrenal glands practically do not show themselves in any way. With severe damage to these glands, the level of sex hormones decreases. Acute adrenal insufficiency may occur. It causes a sharp drop in blood pressure and a blood clotting disorder.

To determine the stage of thyroid cancer and detect metastases, ultrasound, radiography and magnetic resonance imaging, positron emission tomography are used.

Surgery for thyroid cancer

The indication for surgery is suspicion of cancer. If the biopsy confirms that there are cancer cells in the thyroid nodule, then it definitely needs to be removed.

If the tumor is very small, the doctor will suggest removing half of the thyroid gland with the isthmus. This operation is called hemithyroidectomy. The remaining share takes over the production of hormones.

But most doctors believe that the best option is to completely remove the thyroid gland - a thyroidectomy. Only in this case can you be sure that no tumor, even the smallest one, will be missed and cancer will not recur. After all, a second operation on the thyroid gland can cause complications, for example, paresis of the vocal cords.

If the tumor has grown into the surrounding tissue and lymph nodes, they are also removed. This operation is called thyroidectomy and lymph node dissection. The surgeon excises the gland itself, the affected lymph nodes and fatty tissue in this area of the neck.

Operation stages

Patient preparation. The operation is scheduled for a specific date. At this point, the person should not have acute infectious diseases or exacerbation of chronic ones. Before the operation, an ultrasound of the thyroid gland is performed. You will also need to take tests: a clinical and biochemical blood test, a general urine test, a blood group, and a “coagulogram”.
Consultations with a therapist, surgeon and anesthesiologist. Doctors will determine the scope of the operation and answer all your questions.
The patient is given general anesthesia. He is in medicated sleep and does not feel pain. Thyroid operations are not performed under local anesthesia.
Carrying out the operation. The procedure lasts about an hour, and if it is necessary to remove lymph nodes, then 2-3 hours. The surgeon removes the gland, restores blood circulation to healthy organs and applies stitches.
Postoperative period. The patient is transferred to the ward. The first day you are not allowed to get out of bed - you need strict bed rest. On the first day, a drainage is installed to drain fluid from the surgical site. This is a thin silicone tube through which the ichor comes out. The next day it is removed and bandaged. The person is discharged from the department 2-3 days after the operation.

It is very important that the operation is performed by an endocrinologist surgeon who specializes in the treatment of glands. In this case, you can be confident in the successful outcome of the operation and the absence of recurrent tumors and complications.

After surgery, patients are prescribed radionuclide therapy with iodine-131 to ensure the destruction of all malignant cells. Radiation therapy with X-rays is of little help in this case.

After thyroid surgery

Many people are interested in how life changes after removal of thyroid cancer and whether disability occurs. Many studies have shown that almost all patients tolerate surgery well and continue to lead a normal life and work. Women after treatment can become pregnant and give birth to a healthy child.

During the first weeks after surgery, a person may experience neck pain and swelling. These phenomena happen to everyone and go away on their own after 1-2 months. It is enough to properly handle the seams. For the first 3-4 days, while the patient is in the hospital, he is bandaged by a nurse in the dressing room. Before discharge, the doctor tells you in detail how to treat the wound yourself, what medications to take and when to come back to continue treatment.

After tumor removal the following is prescribed:

Administration of radioactive iodine to destroy possible metastases. Treatment begins 4-5 weeks after surgery.
Thyroid hormones, which are normally produced in the thyroid gland. You may have to take them for life.
L-Thyroxine (Levothyroxine) to reduce the production of thyroid-stimulating hormone by the pituitary gland. This hormone stimulates thyroid cells that may have remained after surgery, which means it increases the risk of tumor regrowth. The doctor prescribes the dose of this drug individually, based on the level of titeotropic hormone.
Mineral supplements with vitamin D and calcium. They are necessary for rapid recovery and proper functioning of organs.

Medical supervision after thyroid surgery

Communication with doctors does not end after surgery to remove the tumor. People are registered at the oncology clinic.

In 3 weeks After the operation, the doctor evaluates its results and prescribes levothyroxine (TSH suppressive therapy).
After 6 weeks A whole body scan is performed with iodine-131. This is necessary to detect residual thyroid cells in the neck or other organs. If such metastases are detected, radioactive iodine is prescribed, which quickly destroys the remaining cancer cells.

In 6 months After the operation, you must come to the clinic for a re-examination. The doctor feels the neck and does an ultrasound.

Every 6 months It is necessary to visit a doctor for a routine examination. The doctor may set a different schedule, depending on the level of hormones and tumor markers.

After 1 year and after 3 years After surgery, all patients undergo a body scan.
Regularly monitor the level of thyroglobulin hormone and antibodies to thyroglobulin. It increases if metastases appear in the body. In this case, the doctor prescribes additional examination and treatment.

Postoperative complications

There is a small percentage of postoperative complications. If the operation was performed in a specialized endocrinology department, then the probability is 1-2%, and if in general, then it increases to 5-10%.
Nonspecific complications, which can occur after any operation. This is bleeding, severe swelling or suppuration of the wound. Doctors can easily treat them with antibiotics. In addition, the probability of their occurrence is less than 1%. These complications arise on the first day after surgery. Therefore, if this did not happen in the hospital, then the danger has passed.

Specific complications occur only after surgery on the thyroid gland. This is damage to the nerves that control the vocal cords and disruption of the parathyroid glands.

The laryngeal recurrent nerves pass very close to the thyroid gland. To avoid damaging them, doctors use high-precision electric instruments. But in some cases, injury cannot be avoided. Hoarseness or loss of voice, coughing occurs. Often this phenomenon is temporary, but sometimes the consequences can last a lifetime.

Hypoparathyroidism occurs when the parathyroid glands malfunction. This condition is associated with a lack of calcium in the body. It manifests itself in muscle pain and muscle cramps in the limbs and face, burning and tingling in the lips and fingertips. To correct the situation you need to take calcium supplements.

Nutrition after thyroid surgery

After surgery to remove a thyroid tumor, you do not need to follow a strict diet. The menu should be varied and satisfy all the needs of the body. Remember, there are many foods that inhibit the growth of tumor cells. Scientists have named the healthiest food for tumor prevention. These are vegetables: different varieties of cabbage, turnips, radishes, radishes. Legumes: soybeans, peas, beans, lentils. And plants of the umbrella family: carrots, parsley, celery, parsnips.

If you include these and other “right” foods in your diet, you can prevent a relapse (recurrence) of the disease.

Squirrels– building material for body cells and the basis of immunity. It is best to get proteins from fish and seafood, cottage cheese, eggs, legumes and soybeans, buckwheat and oatmeal. You can eat lean meats several times a week.

Carbohydrates is a source of energy. After surgery, it is better to limit the amount of sugar and confectionery products. It is better to get carbohydrates from honey, fruits, fresh juices, marshmallows, marmalade, jam. Complex carbohydrates - pectins and fiber are found in vegetables, grain bread, and cereals.

Fats– a necessary component for hormones and cell membranes. Vegetable oils: olive and rapeseed can be a source of the necessary unsaturated fatty acids. It is better to avoid lard, margarine and other animal fats.

The diet should contain a wide variety of vitamins. Most of them are antioxidants and help fight tumors. It is better to get vitamins from fresh fruits and greens. But if this is not possible, then you need to take a vitamin-mineral complex.

Traditional methods of treating thyroid cancer

Traditional methods of treating thyroid cancer are used in two cases.

Tinctures and decoctions are drunk before and after surgery, as an addition to the treatment prescribed by the oncologist. During surgical treatment and chemotherapy, you should not take concentrated infusions that contain plant poisons.
In the event that official medicine is unable to help a person. For example, surgery cannot be performed. The patient may not survive it due to advanced age, diseases of the cardiovascular or respiratory systems, or because the tumor has grown into vital organs. Then traditional methods help improve the condition and reduce the tumor.

Treatment with herbs is more gentle than with drugs, but takes longer. Therefore, you need to take herbal medicines from 6 months to 5 years. Every six months they take a break for 2 weeks. You should not stop treatment if you notice improvement. Only a full course will ensure health and prevent the disease from returning.

Treatment with traditional methods before surgery

Cleansing the body
To prepare the body for surgery, it is necessary to do a cleansing. Enemas with apple cider vinegar are well suited for this: a tablespoon of vinegar per 2 glasses of water. The first week of enemas is done daily, the second week - every other day, the third - every 2 days, the fourth - once a week. During this period, you need to drink more water and eat plant foods. Drink one tablespoon of flaxseed oil 3 times a day before meals.

Three-ingredient recipe
Wash and dry 1.8 kg lemons, remove the seeds and grind together with the peel in a meat grinder. Prepare a glass of aloe juice. Do not water the plant for a week, then pick it, wash and dry the leaves. Grind and squeeze the juice through cheesecloth. Mix with lemons and add half a glass of honey. Mix the components thoroughly. Store the product in the refrigerator, take 1 tsp. 3 times a day before meals. The course of treatment is 1 month.

Traditional medicine traditionally uses plants that contain a lot of iodine and other useful substances to treat thyroid cancer: common cocklebur, chickweed, common chickweed, tenacious bedstraw, and lesser duckweed. They are used in the form of decoctions prepared in a water bath.

Traditional treatment after surgery

Nut tincture
At the beginning of July, collect 30 walnuts. They need to be chopped together with the green peel. Pour 0.5 liters of vodka and add a glass of honey. Mix the product in a glass container and place in a dark place. Leave for 15-20 days at room temperature. Drink 1 tablespoon of the tincture in the morning on an empty stomach. During one course of treatment you need to drink all the medicine.

Black poplar buds
This remedy helps reduce the production of thyroid-stimulating hormone. 2 tbsp. pour a glass of boiling water over the kidneys, cover and leave for 2 hours. Strain the infusion. Take 1 tbsp. 3-4 times a day before meals.

Plant poisons
Hemlock and celandine contain toxic substances. These substances destroy malignant cells that may remain in the body after surgery. Do not forget that these tinctures should not be taken during radiation therapy or radioactive iodine treatment.

Hemlock tincture You can make it yourself or buy it ready-made at the pharmacy. Scheme for taking the tincture: on the first day, drink 3 drops 3 times a day, on the second day, 6 drops 3 times a day, and on the third day, 9 drops 3 times a day. Gradually increase the dose to 75 drops per day. This treatment lasts 3 months. Then the dose is gradually reduced to 3 drops per day.

Tincture of celandine you'll have to cook it yourself. To do this, the roots of the plant are collected during flowering in May. The roots are dug up, washed and dried on a towel. Grind in a meat grinder and squeeze out the juice through cheesecloth. The resulting liquid is half diluted with vodka. The product must be infused for 2 weeks in a dark place. Take 1 teaspoon 3 times a day.

Treatment of thyroid cancer without surgery

In the event that surgery is contraindicated and only supportive treatment is carried out, it is possible to help a person cope with cancer and improve their general condition.

Djungarian aconite root

You can buy a tincture of this plant or prepare it yourself. To do this, pour 20 grams of root into 200 ml of high-quality vodka. Infuse in a glass container in a dark place.

Take the medicine according to the schedule. The first day, 1 drop 3 times a day before meals. The second day, two drops, the third, three. So by the tenth day the single dose increases to 10 drops or 30 drops throughout the day. From day 11, the dose is reduced by 1 drop. Thus, the course takes 20 days. After this, take a break for 2 weeks and repeat the treatment. You need to take 3 courses in a row.

Remember that the plant contains poisons and strong bioactive substances. Do not exceed the dose! In order to cleanse the body of toxins during treatment, it is recommended to drink an oncological herbal mixture, which can be bought in pharmacies.

What determines the prognosis for thyroid cancer?

The prognosis for thyroid cancer is much more optimistic than for other malignant tumors. For example, in people under 45 years of age with a tumor size of up to 3 cm, there is a complete guarantee of recovery. Older patients with advanced forms of cancer have a less favorable prognosis.

But much depends on the shape of the cancer and the stage of the cancer.

In people with papillary cancer The five-year survival rate is 95-100%. This means that after treatment all patients remained alive for at least 5 years.
In people with follicular cancer Stage IV five-year survival rate is 55%. But in less advanced cases this figure also reaches 100%.
In people with medullary cancer Stage IV, the five-year survival rate is lower - 30%, but in stages I and II, doctors guarantee recovery for 98% of patients.
At aplastic cancer, the prognosis is worse. Most patients live 6-12 months after diagnosis.

This is due to the rapid growth of such a tumor and the formation of metastases. In addition, such cancer cells are not sensitive to treatment with iodine-131.

But no matter what diagnosis the doctors make, remember that human possibilities are limitless. If you combine your desire to live, the forces of nature and the help of a doctor, then you will cope with even the most severe illness.

Thyroid cancer is called carcinoma. Unlike cancers of other organs, thyroid cancer has a favorable prognosis and can be cured in the vast majority of patients.
is divided into several types. Almost all types of cancer develop as nodules, or lumps. Of all thyroid nodules, about 5 percent are cancerous. They are life-threatening, but certain important conditions determine their successful treatment.

Factors for successful treatment of thyroid carcinoma

Early diagnosis. This is an important component of success. If there is a 1 cm node or more, you need to undergo a biopsy. A biopsy is also prescribed for smaller sizes - at the discretion of the doctor.
Complete removal of the thyroid gland.
Radioactive iodine therapy as the most effective method in the combined treatment of carcinoma.
All malignant thyroid tumors can be completely cured.

Principles of diagnosis and treatment of carcinoma

The basis of diagnosis is fine-needle testing.
If cancer is detected after a biopsy, surgery to remove the thyroid gland is inevitable.
The use of combined treatment: surgery plus treatment with radioactive iodine.
Careful observation over many years and decades.

It must be taken into account that the removal of the thyroid gland should be carried out in a specialized center, and not in a clinic without sufficient experience in the field of endocrine surgery.

Types of carcinomas

Papillary carcinoma

Papillary carcinoma occurs in 80% of malignant neoplasms and is the least life-threatening. Papillary carcinoma grows extremely slowly, rarely metastasizes, and has the most favorable prognosis. With a competent approach and adequate treatment, healing is most likely. Papillary carcinoma is hereditary, so it is necessary to examine all relatives to exclude a cancer process.
Treatment for papillary carcinoma involves complete removal of the thyroid gland and all affected lymph nodes, radioactive iodine therapy with a full body scan after therapy, and then hormone replacement therapy. Annual examinations should be carried out - ultrasound and blood tests for thyroglobulin levels, in some cases - scanning with iodine isotopes.

Follicular carcinoma

Follicular carcinoma accounts for 15 percent of all cancers of the gland and is the second most common cancer. It also grows slowly, but has a tendency to metastasize, so the prognosis is not so favorable. The treatment regimen is the same.

Hurthle cell carcinoma

The rarest type of thyroid cancer occurs at only 3 percent and has a greater tendency to metastasize. Similar to follicular in its properties and treatment tactics.

Medullary carcinoma

It is characterized by almost complete insensitivity to radiation and chemotherapy. The main method of treatment is early surgery, in which case the prognosis is favorable. The treatment regimen includes removal of the thyroid gland, affected lymph nodes and lymph nodes along the trachea. After the operation, the level of calcitonin in the blood is determined again. If the values are still elevated, a search for other foci of carcinoma is carried out.

Anaplastic carcinoma

It is rare and one of the most malignant human neoplasms. Anaplastic carcinoma occurs in older people after 70 years of age, beginning acutely with the appearance of a fast-growing dense tumor in the neck. This causes difficulty swallowing, breathing problems, weakening of the voice and hoarseness. Treatment consists of surgery followed by radiation and chemotherapy.

Squamous cell carcinoma of the thyroid gland

This is the rarest form of gland tumors; it is rare and occurs mainly in people over 50 years of age. Characterized by rapid growth and high aggressiveness. A dense tumor appears on the patient’s neck, rapidly increasing in size. It is detected in the later stages, when it has grown into neighboring organs. Treatment also consists of surgery and radiation or chemotherapy. The prognosis depends on the extent of the cancer process and the amount of therapy performed.

Lymphomas of the thyroid gland

This disease is associated with damage to the organs of the lymphatic system by a malignant process. The diagnosis is made after a biopsy and examination of enlarged lymph nodes in the neck and chest cavity. Treatment consists of chemotherapy or a combination of chemotherapy and radiation therapy. Surgery is usually not required; it is only possible to remove one of the affected lymph nodes during the examination to confirm the diagnosis.

One of the most common oncological diseases of the thyroid gland is carcinoma. It occurs most often in older women and is treatable in most cases. A tumor can arise as an independent neoplasm in healthy tissues, as well as from degenerated cells of benign tumors. To detect papillary thyroid carcinoma, you must pay close attention to the appearance of any suspicious signs and sensations in the area where it is located, and immediately consult a doctor for removal.

Papillary carcinoma, as a rule, forms in the form of a single node; very rarely, the formation of several nodes is observed. Usually one of the lobes of the thyroid gland is affected. Tumors range in size from a few millimeters to 5 cm.

A small neoplasm can be mobile (moves freely during palpation, moves when swallowing). But as it grows, when it grows into neighboring tissues of the gland, mobility disappears. Cancer cells of this type usually spread only to the nearest lymph nodes (95% of tumors) and extremely rarely spread to other organs (larynx, trachea, lungs, and bones). The low “aggressiveness” of this type of tumor allows doctors in most cases to cope with the disease and completely cure patients.

A feature of papillary thyroid cancer is that the tumor is hormonally inactive, that is, it does not produce hormones and does not cause signs of their excess in the body.

A neoplasm of this type develops very slowly, at the initial stage it resembles a cyst or benign tumor. Under a microscope, the formed papillary node looks like a capsule with uneven edges, from which papillae extend, capable of growing into neighboring thyroid tissues. There are calcium deposits inside the tumor.

Forms of the disease

The disease can occur in various forms:

Typical, in which the tumor grows slowly and characteristic symptoms gradually appear.
Hidden when the tumor is small in size and located deep in the thyroid gland. However, it is impossible to detect it by palpation or external manifestations.
Follicular-papillary, in which the tumor contains not only papillary, but also follicular cells.
Oncocytic – papillary carcinoma of the thyroid gland, which is characterized by distant metastasis. This form occurs in only 5% of patients.
Solid – occurring in a person exposed to radioactive radiation. The tumor spreads faster than usual throughout the thyroid gland, affecting blood vessels and nearby lymph nodes.
Diffuse sclerotic. Most often found in children aged 7-14 years. The tumor is formed from fibrous tissue cells. It contains many cysts covered with papillae. Cancer cells usually penetrate into the cervical lymph nodes, less often into the lung tissue. The disease in this form is the most dangerous.
Clear cell, which is characterized by the spread of metastases to the kidneys (this occurs only in 0.3% of cases).

Papillary carcinoma occurs 3 times more often in women than in men. It is usually found in people aged 30-50 years.

Symptoms of papillary carcinoma

It is almost impossible to detect a papillary tumor, which is small in size, by its external manifestations. The lump cannot be felt, there is no pain in the neck or any other unpleasant sensations. There are no signs of hormonal disorders.

Nonspecific symptoms and signs

As the tumor gradually grows, the first signs of the disease appear: a sore throat, a feeling of a lump in it, difficulty swallowing and breathing, hoarseness, dry skin, swelling of the neck. Impaired functioning of the thyroid gland leads to hypothyroidism (lack of thyroid hormones). Its symptoms are weakness, low blood pressure, low pulse, and dizziness.

After the cancer spreads to the nearest lymph nodes, signs appear indicating the occurrence of edema in them: sore throat, discomfort in the chest and armpits. In the last stages of the disease, symptoms of damage to other organs appear. Signs characteristic of severe intoxication of the body also appear: sudden weight loss, the appearance of a sallow skin tone. The patient is plagued by severe pain, which can only be suppressed with the help of narcotic drugs.

All these symptoms are considered nonspecific, characteristic not only of papillary thyroid cancer, but also of some of its other diseases.

Specific symptoms

Specific signs indicating the formation of a papillary tumor are the presence of painless nodes with papillary processes, spread of the tumor to the lymph nodes, its slow growth and the absence of signs of hyperthyroidism.

Stages of papillary cancer

There are 4 stages of development of papillary carcinoma, taking into account the gradual change in its size and the degree of spread of cancer cells. Characterizing the signs of the disease in stages 1 and 2, experts distinguish 2 age categories of patients: younger than 45 years and older than 45 years. This allows them to more accurately predict the consequences of the disease and survival rate.

Stage of carcinoma development	Patient's age	Carcinoma size	Metastases in lymph nodes	Metastases in other organs
	Under 45 years old		None	None
	More than 45 years	No more than 2 cm, the tumor does not extend beyond the boundaries of the capsule	None	None
	Under 45 years old		None	None
	More than 45 years	From 2 to 4 cm	None	None
	Under 45 years old			None
	More than 45 years	From 2 to 4 cm		None
		More than 4 cm, the tumor is mobile	Lymph nodes are affected and enlarged. Compression of nearby organs and tissues occurs. Shortness of breath, sore throat, difficulty swallowing	Possible
		More than 4 cm, but the tumor is motionless, as it grows through the capsule shell and affects a large area of the gland, disrupting the symmetry of the lobes, and penetrates other organs	Lymph nodes are significantly enlarged as a result of damage by metastases and impaired lymph outflow	The tumor grows into the spine, blood vessels, larynx and distant organs (lungs, kidneys)

Causes

Thyroid carcinoma occurs due to the fact that, under the influence of certain unfavorable factors, mutation of the cells of this organ occurs.

The causes of mutations can be:

Exposure to radioactive radiation on the body. Thyroid tumors occur in people who have been in an area of high radiation. The formation of carcinoma can also be a consequence of radiation therapy performed for cancer of other organs.
Malignant degeneration of benign tumor cells (goiter).
Changes in hormonal levels, which occur in women much more often during their lives than in men. Fluctuations in the levels of various hormones occur during each menstrual cycle. Puberty, pregnancy, childbirth, menopause - all these are important physiological periods associated with significant fluctuations in the production of hormones both in the thyroid gland itself and in other endocrine organs.
Metastasis of cancer tumors formed in other parts of the body (breasts, intestines).
Inflammatory processes in the thyroid gland, leading to disruption of its functioning.
Weakening of the body's immune resistance to the proliferation of cancer cells, as well as the presence of autoimmune thyroid diseases.
Iodine deficiency, which occurs due to poor diet or lack of this element in drinking water or soil in the area.

Predisposition to the disease may be hereditary. Pollution of the natural environment, as well as the habit of smoking and frequent drinking of alcohol, contribute to the development of carcinoma.

Video: How thyroid cancer is diagnosed. The importance of prevention

Diagnosis and treatment

The presence of cancerous nodes in the thyroid gland is detected using ultrasound. Their number, shape, location and size are assessed, which allows us to make an assumption about the stage of the disease. In case of doubt about the nature of a tumor larger than 1 cm, a fine-needle biopsy and histological examination of tissues are performed.

X-rays, MRIs, and CT scans are used to detect metastases. The basis of treatment is surgical removal of the papillary thyroid tumor, followed by radiation and chemotherapy, as well as therapy using radioactive iodine.

Surgical methods of treatment

Partial or complete removal of the thyroid gland is performed. The technique is selected according to the size of the tumor and the degree of its spread.

Partial excision (thyroidectomy). It is performed when the tumor size is less than 1 cm and there is no metastasis to the lymph nodes or other organs, while a single compaction is found in only one of the lobes of the thyroid gland. The tumor itself is cut out, and part of the surrounding healthy tissue is captured. Most often, a lack of thyroid hormones does not occur after such an operation, since they are produced in the 2nd lobe. The need for hormonal therapy is rare.

Total thyroidectomy. Both lobes and the isthmus of the thyroid gland are removed, as well as cervical lymph nodes affected by metastases. After surgery, the patient must take L-thyroxine (a drug that is a synthetic analogue of thyroid hormones) for life. The dose of the drug is selected gradually, based on the results of blood tests. In case of hypothyroidism, the dose of the medicine is increased, in case of hyperthyroidism it is decreased.

Thyroidectomy is a fairly simple operation, after which the patient’s health is quickly restored. A complication may be a change in voice timbre due to damage to the vocal nerve. It is extremely rare that damage to the parathyroid glands occurs, which leads to disruption of phosphorus-calcium metabolism.

Radioiodine therapy

It is performed more often after surgery or cancer recurrence. Taking radioactive iodine-131 preparations in the form of solutions or capsules leads to the destruction of tumor cells. Therapy is carried out for 2-3 months. Stop taking any hormonal medications in advance. The patient does not experience any discomfort associated with taking iodine preparations. Only the thyroid gland itself is affected. It does not apply to other organs.

Radiation therapy and chemotherapy

They are used only for stage 4 carcinoma, when extensive spread of metastases occurs.

Prognosis for cure

The prognosis for cure for papillary thyroid carcinoma is favorable. After tumor removal, patients can live from 5 to 20 years, depending on what stage of cancer was treated. The five-year survival rate of patients with stage 1-2 carcinoma is almost 100%. For stage 3 disease it is 93%. After treatment of patients with stage 4 disease, survival for 5 years is observed in 50-70% of patients.

After treatment, the patient must periodically undergo preventive examinations: check the level of thyroid hormones in the blood, do an ultrasound, and a radioactive iodine study (scintigraphy).