Papillary thyroid cancer (which is sometimes also referred to as papillary thyroid carcinoma) - the most common type of thyroid cancer. Approximately 80% of cases of thyroid cancer diagnosed this type of cancer.

Key facts

• Most patients with papillary thyroid cancer is in the age group from 30 to 50 years;
• Papillary thyroid cancer is more common in women than in men. The ratio of the number of cases among both sexes - 3: 1;
• Prognosis is directly related to the size of the tumor. The most favorable is the prognosis of patients with a tumor diameter of less than 1.5 cm;
• In this type of cancer accounts for 85% of all cases of thyroid cancer caused by exposure to radiation;
• More than 50% of papillary thyroid cancer spreads to the lymph nodes in the neck;
• Distant metastases (in the lungs or bone) are rare;
• Cure rates for people with papillary thyroid cancer is very high; patients with small tumors in young patients it reaches 100%.

Symptoms

Papillary thyroid cancer develops slowly and in many patients in the early stages it does not cause any symptoms. Often the first sign of cancer Fifteen signs of cancer that women ignore   this type becomes painless seal on the thyroid gland The thyroid gland - is responsible for your hormones In front of the neck; in many cases it can be detected by touch or visual inspection. This is called a thyroid tumor node. Despite the fact that it does not hurt, the appearance of the site is enough to go to the doctor.

Other symptoms of papillary thyroid cancer may include:

• A sore throat;
• Difficulty swallowing and breathing;
• Hoarse voice.

Although in most cases these symptoms do not indicate a serious disease, if they do not go away within a few weeks, you should consult your doctor.

In the late stages of symptom papillary thyroid cancer can be enlarged lymph nodes in the neck. They may increase for other reasons - for example, due to an infectious disease. However, after the infection goes away, the size of the lymph node returns to normal; If this does not happen for a long time, it is strongly recommended to undergo a medical examination.

Causes

As is the case with other types of cancer, the exact cause of papillary thyroid cancer is unknown. Although there is evidence that malignant tumors of the thyroid gland are formed due to gene mutations, these mutations why begin, is not known.

In general, thyroid cells become cancerous when genetic anomalies cause them to mutate accordingly. As a result, the cells begin to grow rapidly and multiply and, in contrast to healthy cells, they do not die, completing its normal life cycle. Gradually, the cells become so numerous that they form a tumor. Now they can not only reproduce but also attack healthy tissue elsewhere in the body.

It is believed that the development of papillary thyroid cancer genes correspond to the following:

• The gene RET / PTC. Mutations of this gene are found in 10-30% of patients with papillary thyroid cancer, most of which - children and people exposed to radiation;
• The gene BRAF. Mutations in the BRAF gene are found in 30-70% of patients. In contrast, mutations in RET / PTC, BRAF mutations are less common among children and those who are exposed to radiation. Scientists believe that mutations in the BRAF gene cause a more aggressive form of cancer that often metastasize Metastasis - danger everywhere .

The researchers also suggest that the possible relationship between the development of papillary thyroid cancer with changes in gene NTRK1 and MET. However, in order to identify the triggers of these changes and determine whether they cause this type of cancer, more research is needed.

Risk factors

Although the causes of papillary thyroid cancer have been identified, known risk factors that can increase the likelihood of developing the disease. Each of these factors increases the risk of any of the four main types of thyroid cancer:

• Thyroid Cancer (any type) family history;
• Goiter in a personal or family history;
• Exposure to radiation (caused by the therapy, accidents at nuclear power plants or nuclear weapons testing);
• Total body irradiation, which makes prior to bone marrow transplantation;
• A family or personal history of certain genetic syndromes, such as Cowden syndrome (a disorder characterized by benign tumor-like formations on the skin and mucous membranes, known as hamartomas).

Some risk factors are associated exclusively with papillary thyroid cancer. Firstly, it's sexual identity: women developing this type of cancer much more often than men.

Secondly, papillary thyroid cancer Thyroid cancer: it is curable   most often occurs in people aged between 30 and 50 years. In other age groups, the risk of developing this type of cancer is much lower, but this does not mean that such a possibility completely excluded. It should be noted that in patients over 50 years old may develop more aggressive forms of papillary thyroid cancer, although they are rare.

Papillary thyroid cancer is very well to treatment, especially if early diagnosis. Therefore, patients who are at risk of developing this form of cancer (for example, if they hurt someone from relatives of the patient) should undergo regular medical examinations.

Thyroid cancer (TC) has a significant place among cancers. This is due to the rising incidence of thyroid cancer among young adults, the lack of clear guidelines on the treatment of this type of cancer and the frequent relapses of the disease occurring in even after surgery.

How often and why relapse of thyroid cancer after treatment

Recurrences of thyroid cancer after treatment occur frequently, including in the first year after the operation. In connection with this criterion of efficacy of treatment of thyroid cancer is not only the duration of life, but also the frequency of relapses.

Most tend to recur papillary and follicular tumors. Repeated relapses in these types of tumors occur after treatment in a third of cases, with half of the patients develop recurrence within the first year of life. Sometimes relapses occur several years after the treatment. After a recurrence of the disease the patient is removed from the dispensary for life. Often the cause of thyroid cancer recurrence is incomplete removal of the tumor during the first operation.

How to identify a relapse of thyroid cancer

Patients after treatment for thyroid cancer Thyroid cancer: it is curable   should be at the dispensary to relapse was detected in time. If you suspect a relapse of thyroid cancer is performed ultrasonography (US) of the thyroid gland. The second step is performed aspiration biopsy (puncture) detection of the tumor and cytological punctate studied in the laboratory.

You also need to hold a computer or magnetic resonance imaging to identify the prevalence of cancer process. With the same purpose examines the patient otolaryngologist - reveals the possibility of the larynx, vocal cords, and nerves in the area.

Scintigraphy (radioisotope research) of the entire body with iodine 131 reveals nearby and distant metastasis of the tumor. Determined by blood levels of the protein thyroglobulin - it also reveals the recurrence and metastasis of thyroid cancer.

The survey will identify not only the tumor itself, but also its spread to adjacent organs - esophagus, trachea, larynx, vocal cords, major nerves and blood vessels. This will help the doctor determine the tactics of treatment of the patient, including the possibility of surgery.

Basic principles of treatment

Recurrences of thyroid cancer treated carefully selecting individual methods taking into account the patient's age, his general condition, severity of relapse, the timeliness of its detection, the volume of the previous operation, the structural features of the tumor cells.

Relapses of the disease and treated promptly. At the same time during surgery thyroid gland, nearby lymph nodes Lymph nodes - what keeps our immune system , Retrosternal neurovascular bundle carefully examined for the presence of metastases. Operation is not only therapeutic, but also diagnostic character - ablated tissue cancer research is carried out while the patient is on the operating table - the results of histological studies will depend on the volume of transactions.

What operations are conducted with recurrent thyroid cancer

Methods of surgical treatment of thyroid Thyroid medication - what methods are available?   in recent years greatly improved. However, the problem of treatment of relapses now is quite acute. Some oncologists are of the opinion that with recurrent thyroid cancer thyroid gland must be removed completely, followed by systemic therapy with radioactive iodine and lifelong holding of hormone replacement therapy. The risk of repeated recurrence of the disease is greatly reduced, since recurrences and metastases (especially in distant organs) is better to treat the complete absence of thyroid tissue. It reduces the risk of the development against the backdrop of a differentiated cancer with a relatively mild undifferentiated cancers that spread much faster and more difficult to treat.

But there are opponents of such operations that try their best to keep the thyroid gland by removing only the tumor tissue, considering that the concerns of frequent recurrent relapses, including the transition to non-differentiated cancers, much exaggerated. And as replacement therapy can not fully compensate for the absence of the thyroid gland, a part of it should be, as far as possible to maintain.

The treatment of choice is still considered to be the complete removal of the thyroid gland, followed by a course of treatment with radioactive iodine. This can significantly reduce the number of relapses.

Feature thyroid cancer is that some of its shape often recur, so repeated operations on the thyroid gland The thyroid gland - is responsible for your hormones   often it can not be avoided.

Galina Romanenko