Thyroid Cancer: Prognosis and Treatments

Thyroid Cancer: Prognosis and Treatments

What is thyroid cancer?

Thyroid cancer is a malignant tumor that originates in the cells of the thyroid. A malignant tumor means that it can invade surrounding tissues and destroy them. It can also spread (metastasize) to other parts of the body.

The thyroid is part of the endocrine system. It is a small gland located in the front of the neck, under the larynx (organ of speech) and near the trachea. It is formed of two lobes, right and left, located on each side of the trachea. The lobes are connected by a thin piece of tissue called isthmus.

The thyroid is mainly composed of follicular cells and C cells. Follicular cells produce thyroid hormones. These help break down food into energy. They also help regulate certain body functions such as body temperature, heart rate and breathing. C-cells, also called parafollicular cells, produce calcitonin, a hormone that helps regulate calcium levels in the blood.

Thyroid cells sometimes undergo changes that make their growth pattern or behavior abnormal. These changes can lead to non-cancerous or benign conditions, such as hypothyroidism, hyperthyroidism, thyroid nodules, thyroiditis and goiter.

In some cases, the modified cells of the thyroid can become cancerous. The most common types of thyroid cancer are papillary carcinoma and follicular carcinoma. They are usually classified together and given the name of differentiated thyroid cancer. It accounts for more than 90% of thyroid cancers.

There are also less common types and rare types of thyroid cancer. These include low-grade carcinoma, anaplastic carcinoma, medullary carcinoma, non-Hodgkin's lymphoma, and soft tissue sarcoma.

thyroid cancer

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Prognosis for thyroid cancer

If you have thyroid cancer, you can ask questions about your prognosis. The prognosis is the act by which the doctor evaluates the cancer commenting on the cancer and he reacts to the treatment. Prognosis and survival depend on many factors. This is a treatment of the cancer, one-to-dog-opinion of your medical treatment, under-the-day-of-the-tumor-and-one-time-treatment-treatment-review-treatment-review-statistic-control -review-data-audition-to-review prognosis.

Prognostic factor is an aspect of cancer or the patient that the doctor takes into consideration when dealing with a prognosis. A predictor influences the way cancer responds to a certain treatment. Prognostic factors and predictive factors are often discussed. Both play a role in the choice of the treatment plan and in the prognosis.

The following are prognostic factors and predictors of thyroid cancer.

Type of tumor

The type of tumor is the most important prognostic factor for thyroid cancer. Papillary carcinoma, which tends to respond well to treatment, is associated with the best outcome and prognosis. Follicular carcinoma and medullary carcinoma produce good prognosis, but these are less favorable than papillary carcinoma. The prognosis of anaplastic carcinoma is very dark.

Age

Age is an important prognostic factor for differentiated thyroid cancer (papillary carcinoma and follicular carcinoma). The prognosis of people under 40 is more favorable.

Stadium

The earlier the stage of diagnosis, the better the prognosis. Tumors that are larger than 4 cm in size or have passed through the thyroid and invaded adjacent tissues and structures have a less favorable prognosis. Thyroid cancer that has spread to other parts of the body (distant metastases) is also less favorable.

Multiple endocrine neoplasia type 2B (NEM2B)

The prognosis for people with medullary carcinoma associated with NEM2B, a hereditary condition, is generally poor. This type of cancer is often advanced at the time of diagnosis.

thyroid cancer

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Treatments for thyroid cancer

If you have thyroid cancer, your healthcare team will develop a treatment plan specifically for you. This plan will be based on your health status and information specific to cancer. When your healthcare team decides what treatments to offer for thyroid cancer, it takes the following into consideration:

the type of thyroid cancer

the stadium

the risk category

your age

your personal preferences

You may be offered one or more of the following treatments for thyroid cancer.

Surgery

Surgery is the first treatment of most thyroid cancers. Depending on the type, stage, risk category and location of the cancer, one or more of the following types of surgery could be performed.

During a lobectomy, one side of the thyroid, called the lobe, is removed. This surgery can be performed to treat a low-risk thyroid carcinoma (papillary carcinoma or follicular carcinoma) or anaplastic carcinoma with a small tumor confined to the thyroid.

During a total thyroidectomy, all the thyroid is removed. This is the type of surgery most commonly performed to treat thyroid cancer.

Cervical lymph node dissection consists of removing the lymph nodes from the neck. Other tissues surrounding the thyroid can also be removed. Cervical lymph node dissection is usually performed when the cancer has spread to a lymph node in the neck. It is practiced at the same time as total thyroidectomy.

When performing a monobloc resection, remove the tumor and surrounding tissues, structures, and lymph nodes from the lump (block). This technique may be used when anaplastic carcinoma has spread to the outside of the thyroid gland, tissues, and neck structures.

In rare cases, surgery is used to remove metastases when thyroid cancer has spread (metastasized) to distant organs such as the lungs, bones, brain or liver.

Palliative surgery aims to relieve symptoms. It can be used to remove a large tumor. It can also be used to remove as much of a cancer as possible (tumor reduction). For example, the surgeon could remove a cancerous tumor that obstructs a respiratory tract or exerts pressure on the spinal cord.

A tracheostomy is a surgical procedure that involves opening an opening (called a stoma) in the neck leading to the trachea for air to reach the lungs. This surgery is necessary when breathing is difficult because a tumor puts pressure on the trachea or obstructs it.

Hormone

Levothyroxine-based hormone therapy (Synthroid, Eltroxin) is the standard treatment after total thyroidectomy. This medicine is used to replace thyroxine, a hormone that is normally produced by the thyroid. It is also used to slow the growth of any thyroid differentiated cancer cell that may remain and to help reduce the risk of recurrence.

Radiotherapy

Radiation therapy is a common treatment for many thyroid cancers. It is most commonly used after surgery to destroy all cancer cells and all normal thyroid tissue that may remain in the body, as well as to treat cancer that has spread to the lymph nodes or other parts of the body. from the body. Radiation therapy can be used as a palliative treatment when thyroid cancer cannot be removed by surgery (it is said to be unresectable) or spread to other parts of the body and that it causes symptoms.

Radioactive iodine therapy is the most common type of radiation therapy used for thyroid cancer. It is often used to treat differentiated thyroid cancers that are bulky or have spread outside the thyroid. It is also used to treat most undifferentiated carcinomas.

External radiotherapy can be used to treat thyroid cancers that do not absorb iodine, such as anaplastic and medullary carcinomas.

Targeted treatment

Targeted therapy can be used to treat advanced or metastatic differentiated thyroid cancer when radioactive iodine therapy has not worked or is no longer effective. Targeted treatment is also used in cases of spinal cord carcinoma that recurs (recurrence) after other treatments.

Targeted drugs used to treat thyroid cancer include the following agents:

sorafenib (Nexavar), for differentiated thyroid cancer

lenvatinib (Lenvima) for differentiated thyroid cancer

vandetanib (Caprelsa), for medullary carcinoma

Chemotherapy

Chemotherapy is not very often used to treat thyroid cancer. It can be administered for:

help relieve or control symptoms of advanced or metastatic thyroid cancer (referred to as palliative chemotherapy)

to treat anaplastic carcinoma, sometimes as part of a chemoradiotherapy

Chemotherapeutic agents used to treat thyroid cancer may be used alone or in combination. These include:

doxorubicin (Adriamycin)

cisplatin (Platinol AQ)

paclitaxel (Taxol)

docetaxel (Taxotere)

If you cannot or do not want to receive cancer treatment

You may want to consider care that is designed to make you feel better rather than treat the cancer itself, perhaps because cancer treatments no longer work, and are no longer likely to improve your cancer. condition or that their side effects are difficult to tolerate. Other reasons may explain why you cannot or do not want to receive cancer treatment.

Discuss with members of your care team. They can help you choose care and treatment for advanced cancer.

Followed

Post-treatment follow-up is an important component of caring for people with cancer. You will need regular follow-up visits, usually for at least 10 years after the end of treatment. These visits will allow the care team to monitor your progress and find out how you are recovering from the treatment.

Clinical tests

A few clinical trials of thyroid cancer are underway in Canada and accept participants. Clinical trials aim to find new ways to prevent, detect and treat cancer. Learn more about clinical trials

Questions to ask about treatment

In order to make the right decisions for you, ask questions about treatment to your healthyol team.

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