Treatment of thyroid cancer - a serious approach

The treatment plan for cancer of the thyroid gland will depend on the type and stage of cancer, as well as on whether the doctors believe that it is possible to completely cure. In most cases, the kinds of differentiated thyroid carcinoma (papillary and follicular carcinoma), and in some cases - in medullary thyroid carcinoma, the probability of complete cure is very high.

Treatment Plan

The treatment plan for differentiated thyroid carcinoma usually consists of:

• Surgical removal of the thyroid gland (thyroidectomy)
• Movement radiotherapy, known as the treatment of radioactive iodine, which is intended to destroy any remaining cancer cells following surgery, and prevention of recurrence.

Medullary thyroid cancer Thyroid cancer: it is curable   It spreads quickly differentiated cancers, so when such diagnosis may be required to remove not only the thyroid, but adjacent lymph nodes. Treatment with radioactive iodine in the medullary thyroid cancer Medullary thyroid cancer: identification of disease   ineffective.

The fourth stage of medullary thyroid cancer is usually incurable, although it is possible to slow down the progression of the disease and monitor any associated symptoms.

Treatment of anaplastic thyroid cancer usually impossible, since the time when it is possible to diagnose, it usually has time to spread to other parts of the body, such as the trachea and lungs. To slow down the development of cancer of the type and ease its symptoms can be radiotherapy and chemotherapy.

In some cases, the patient with thyroid cancer can be greatly facilitated by means of a targeted, or targeted therapies. However, it is still undergoing clinical trials and is not used in usual practice. Below is a more complete information about this and other methods of treatment of thyroid cancer.

Thyroidectomy

In most cases, cancer of the thyroid gland must be partial or total removal of the prostate (for this operations are conducted under the names and full tireodektomiya hemithyroidectomy, respectively). In deciding whether to remove the thyroid gland partially or fully affected by a number of factors, including:

• Type of thyroid cancer;
• The size of the tumor;
• Presence or absence of metastasis.

The physician should explain to the patient what he needs an operation and why the patient to make an informed decision on further treatment.

Thyroidectomy is performed under general anesthesia. The surgery usually takes about two hours and then her neck is a small scar - usually not very noticeable.

After surgery, patients usually experience pain in the throat, which can be removed with the help of painkillers. The voice becomes hoarse, but it usually goes away within a few weeks. In rare cases, more or less becomes a permanent hoarseness.

Within a few weeks after thyroidectomy patients feel pain when swallowing food, so it is advisable to stick to a liquid diet until the throat heals. The doctor will make a perfect meal plan.

Most patients leave the hospital 3-5 days after surgery on the thyroid gland. However, during the two or three weeks after discharge is recommended to stay at home and avoid any activity in which the neck muscles tense up. Return to work and normal life is possible only when a doctor determines that the patient is ready for it.

Hormone replacement therapy

After removal of the thyroid gland in the body decreases the level of hormones necessary for the regulation of many body systems. Because of this, the patient will experience symptoms associated with hypothyroidism (decreased thyroid activity):

• Fatigue;
• Weight gain;
• Dry skin.

To compensate for the lack of thyroid hormone, a person until the end of life will have to take hormones.

If the treatment plan to the patient after the surgery to be radioactive iodine therapy, first he will give hormonal pills called triiodothyronine. After the end of treatment with radioactive iodine discharged other hormonal drug - thyroxine Thyroxine - the main thyroid hormone Which in most cases be taken once a day.

Need for regular blood tests to ensure that the patient receives a sufficient amount of hormones, or, if necessary, adjust the dose. Sometimes, a suitable dose of hormone is determined over a relatively long period. During this time, the patient may experience the above symptoms of low thyroid hormone levels Thyroid hormones: mechanism of action and physiological effects . If it receives too high doses of hormones, it can cause the following features:

• Weight loss;
• Hyperactivity;
• Diarrhea.

Once the optimal dose of hormone to be determined, any side effects of hormone replacement therapy should disappear.

The level of calcium

Sometimes during surgery, the surgeon touches the parathyroid glands; they are very close to the thyroid gland and helps regulate blood calcium levels. Their damage leads to lower calcium levels, which causes symptoms such as tingling in the hands, fingers, lips and around the nose.

If you experience any of these symptoms should see a doctor. Usually in such cases it is recommended to take supplements with calcium, parathyroid gland is not to recover and starts to function normally.

Treatment with radioactive iodine

Many patients after thyroidectomy appointed by radioactive iodine therapy to kill any remaining cancer cells in the body.

If a patient is already taking medications for hormone replacement therapy, he should stop taking for 2-4 weeks prior to treatment, because hormonal drugs reduce the effectiveness of radioactive iodine. After discontinuation of hormone may return tired and weak, but they will be when replacement therapy will be resumed.

If the doctor believes that the abolition of hormone replacement therapy would be too problematic, the patient can give a drug called recombinant human thyroid stimulating hormone (rhTSH). Injections of the drug do two days in a row. It is virtually eliminate the appearance of withdrawal symptoms of hormone therapy, but rhTSH is not for everyone.

At the beginning of therapy the patient is given a radioactive iodine in the form of a capsule or liquid. Iodine molecules through the bloodstream to head straight to the neck, and there will be to destroy cancer cells (can only absorb iodine thyroid cells - both healthy and malignant).

The side effects of radioactive iodine therapy are rare, but a small number of patients may appear the pain, swelling and a sense of contraction in the throat, as well as hot flushes. Usually these symptoms disappear within 24 hours.

Some patients have a change of taste and dry mouth. These side effects usually disappear after a few weeks or months, but in some people they remain forever.

Upon receiving the radioactive iodine to the patient should remain in the hospital for five days 3-5, since at this time his body not strong emits radiation. For this reason, the patient should be in a specially equipped private room that was protected from the radiation and medical staff.

Visitors are generally not allowed to enter the chamber. Pregnant women and children visiting banned altogether, as they are most exposed to radiation. Hospital staff and visitors at this time reduce contact with the patient to a minimum.

Physiological fluids, including urine, during this period are also radioactive, so each time you visit the toilet it is necessary to use the sink. It is also strongly recommended to take a shower at least once a day.

Food

If the patient be radioactive iodine therapy for some time before it starts should start a diet, which includes a minimum number of iodine-containing products. In particular, the need to adhere to the following guidelines:

• Avoid all seafood;
• Limit consumption of dairy products;
• Do not take cough medicines and do not use sea salt as well as in fact, and the other contains iodine;
• Do not eat any foods which include coloring E127, known for its high content of iodine.

It is recommended to eat a lot of meat, fresh fruits and vegetables, pasta and rice - there is almost no iodine.

Pregnancy and lactation

Radioactive iodine therapy is contraindicated in pregnant women and women who assume that they can be pregnant. This type of treatment is very harmful to the fetus. Even if there is little likelihood that a pregnancy, it is necessary to inform your doctor. Treatment should be delayed until the end of pregnancy or until when it is well established that the patient is not pregnant.

For at least six months after the end of treatment with radioactive iodine must use reliable contraception. This is due to the existence of a small risk that conceived during this period the child will have birth defects.

The same risk exists for men - they must use reliable contraception for six months after completion of therapy.

Breastfeeding should be stopped at least four weeks (preferably - eight) before treatment with radioactive iodine. Resume feeding only after the permit physician; In most cases this will be possible only in the next pregnancy.

Fertility

Radioactive iodine has no effect on fertility in women, but there is a small risk that it will break the ability to fertilize the men if they require multiple courses of therapy. The doctor helps the patient to assess the risk in each individual case. If the risk is significant, it is worth considering the probability of survival of sperm - it is important for those planning to have children in the future.