The most common type of thyroid cancer is papillary, accounting for 80% to 85% of cases. There are many body functions regulated by hormones produced by the thyroid gland, a butterfly-shaped organ in the front of the neck. Although papillary thyroid cancer tends to grow slowly and has a good prognosis, it can spread to the lymph nodes and sometimes to other organs.
Causes
There is no exact cause of papillary thyroid cancer, but some factors may increase the risk:
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Radiation exposure, especially during childhood, from radiation therapy for other cancers or from nuclear accidents.
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Mutations in certain genes, such as RET and BRAF, affect thyroid growth and function.
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A family history of papillary thyroid cancer or other thyroid diseases, such as familial adenomatous polyposis (FAP), Cowden disease, or Carney syndrome.
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As women are three times more likely than men to develop papillary thyroid cancer.
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Being between 20 and 60 years old, which is the most common age range for papillary thyroid cancer.
Symptoms
In its early stages, papillary thyroid cancer may not cause any symptoms, and it may be detected with a routine physical exam or thyroid ultrasound. However, some possible symptoms include:
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A lump or nodule in the neck that may or may not be painful.
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As a result of the tumor pressing on the throat or windpipe, you may have difficulty swallowing or breathing.
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Hoarseness or changes in the voice caused by tumors or surgery causing damage to the vocal cords.
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Swelling or pain in the neck caused by enlarged lymph nodes or thyroid inflammation.
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Thyroid hormones can cause weight loss, fatigue, and changes in appetite.
Diagnosis
A doctor may perform the following tests and procedures to diagnose papillary thyroid cancer:
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Examine your neck and thyroid gland for lumps, swelling, or tenderness.
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Tests of thyroid hormones and thyroid-stimulating hormone (TSH), which indicate how well the thyroid gland is functioning.
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It is used to create images of the thyroid gland and surrounding tissues, and to identify nodules and abnormal growths.
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An FNA biopsy removes a small sample of tissue from the nodule or lymph node and examines it under a microscope for cancer cells.
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The DNA of the biopsy sample will be analyzed for genetic mutations associated with papillary thyroid cancer, such as RET and BRAF.
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A computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, or positron emission tomography (PET) scan can be used to determine the extent and spread of the cancer.
Treatment
A thyroidectomy and sometimes a lymph node dissection are the most common treatments for papillary thyroid cancer. The extent of the surgery depends on the size, location, and stage of the cancer, as well as the patient's age, health, and preferences. In order to compensate for the loss of the thyroid gland, the patient may need to take thyroid hormone replacement pills forever after the surgery.
It is also possible that the patient will receive radioactive iodine treatment (RAI), which involves taking a pill or a liquid containing radioactive iodine, which destroys any remaining cancer cells or normal thyroid tissues after it is absorbed by the thyroid cells. A few weeks after surgery, RAI therapy is usually administered, and the patient may need to stay isolated for a few days to avoid radiation exposure to others.
Papillary thyroid cancer may also be treated with:
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This treatment uses high-energy rays to kill cancer cells or shrink tumors, especially if the cancer has spread to other organs or bones or cannot be surgically removed.
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The use of drugs that target specific molecules or pathways involved in the growth and survival of cancer cells, such as RET inhibitors or BRAF inhibitors, for patients with genetic mutations.
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For patients with advanced or recurrent papillary thyroid cancer who haven't responded to other treatments, chemotherapy uses drugs to kill or stop cancer cells from dividing.
Prevention
In order to lower the risk of papillary thyroid cancer, some steps can be taken:
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Exposure to unnecessary or excessive radiation, especially in childhood, such as from radiation-using medical tests or procedures, or living near nuclear power plants or nuclear accident sites.
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Consuming iodine-rich foods, such as seafood, dairy products, eggs, and iodized salt, is essential for thyroid gland function.
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Regularly checking for thyroid nodules and abnormalities, especially if there is a family history of papillary thyroid cancer.
