Papillary thyroid cancer is the most common type of thyroid cancer, accounting for around 80% of cases.
Papillary thyroid cancer develops from follicular cells ( a type of cell) and usually grows slowly, typically found in one lobe. It is an epithelial malignancy that shows signs of follicular cell differentiation and is usually well-differentiated. Papillary thyroid cancer is highly treatable with a good prognosis and most cases can be cured through treatments such as surgery, chemotherapy, radiation, and radioiodine therapy. While it is generally considered low-risk cancer with a high rate of survival, it is still important to receive prompt medical attention and appropriate treatment.
Symptoms of Papillary thyroid Cancer
Some common symptoms of papillary thyroid cancer include:
- A lump or nodule in the thyroid gland, which is located in the neck
- Swollen lymph nodes in the neck
- Hoarseness or other voice changes
- Difficulty swallowing or breathing
- Pain in the neck or throat.
Diagnosis of Papillary Thyroid cancer
Diagnosis of papillary thyroid cancer typically involves a combination of methods, including physical examination, imaging tests such as high-resolution ultrasound, and biopsy. A physician may begin by performing a careful examination of the neck, feeling for any abnormal masses or nodules on the thyroid gland.
If a nodule is detected, high-resolution ultrasound may be used to determine its size and location, as well as whether it appears to be solid or fluid-filled. Ultrasound can also help to detect any signs that the cancer has spread to nearby lymph nodes.
A biopsy may then be performed to confirm the diagnosis of papillary thyroid cancer.
This can involve a fine-needle aspiration biopsy, in which a small sample of cells is removed from the nodule using a thin needle and examined under a microscope.
Alternatively, a core needle biopsy may be performed, in which a larger sample of tissue is removed for examination.
In some cases, additional tests may be needed to determine the extent of the cancer and whether it has spread to other parts of the body. These may include a chest X-ray, CT or MRI scans, and blood tests to check for abnormal thyroid hormone levels.
Overall, a diagnosis of papillary thyroid cancer involves a careful assessment of the patient’s symptoms and medical history, as well as a series of tests aimed at identifying and characterizing any suspicious nodules or masses on the thyroid gland.
MedicoExperts Tumour board can help to make the right diagnosis of papillary thyroid cancer and recommend further treatment options.
Types of papillary thyroid carcinoma
There are several types of papillary thyroid carcinoma, or PTC, with varying histological and clinical features. The most common type of PTC is classic PTC, which is characterized by tall tumor cells.
Other PTC variants include:
- Follicular variant PTC
- Warthin-like variant PTC
- Diffuse sclerosing variant PTC
- Tall cell variant PTC
- Columnar cell variant PTC
- Solid variant PTC
- Oncocytic variant PTC
Each variant has distinctive histologic features and may have different clinical and prognostic implications.
Risk of papillary thyroid cancer
One of the most well-established risk factors for papillary thyroid cancer is exposure to ionizing radiation, particularly during childhood. This includes exposure from medical procedures, such as radiotherapy treatments for childhood cancers, as well as exposure from environmental sources, such as nuclear accidents.
The risk of developing papillary thyroid cancer from radiation exposure appears to increase with higher levels of exposure and younger age at exposure.
Other risk factors for papillary thyroid cancer may include certain genetic mutations and family history of the disease. For example, mutations in the BRAF and RET genes have been linked to an increased risk of developing the disease.
Similarly, having a first-degree relative who has been diagnosed with papillary thyroid cancer may also increase a person’s risk.
Other possible risk factors for papillary thyroid cancer include being female, having a personal history of goiter or other thyroid conditions,
and certain lifestyle factors such as smoking and obesity.
However, more research is needed to fully understand the role of these factors in the development of papillary thyroid cancer.
Regular screenings and early detection can help identify the disease in its early stages and improve chances of successful treatment.
MedicoExperts Tumour board will rightly monitor the risk of development and proliferation of papillary tumors and take necessary actions to mitigate the risks.
Prevention Strategies for papillary thyroid cancer
There are some strategies that have been suggested to potentially reduce the risk of developing the disease. These strategies include:
- Avoiding radiation exposure: Given that exposure to ionizing radiation is a well-established risk factor for papillary thyroid cancer, it is important to avoid unnecessary exposure to radiation whenever possible. This includes reducing exposure to medical procedures that involve radiation, such as CT scans and X-rays, and minimizing exposure to environmental sources of radiation.
- Maintaining a healthy lifestyle: While there is limited evidence to support a direct link between lifestyle factors and papillary thyroid cancer risk, maintaining a healthy lifestyle may help reduce other risk factors that increase the risk of various types of cancer. This includes eating a balanced diet, maintaining a healthy weight, engaging in regular physical activity, and avoiding tobacco and excessive alcohol consumption.
- Regular thyroid check-ups: Regular check-ups with a healthcare provider can help detect any changes or abnormalities in the thyroid gland early, allowing for prompt diagnosis and treatment if necessary. This is particularly important for individuals with a family history of thyroid cancer or other known risk factors.
Treatment of Papillary thyroid cancer
Treatment of papillary thyroid cancer typically involves a combination of surgical removal of the thyroid gland, or thyroidectomy, and radioactive iodine therapy.
Additional treatments, such as chemotherapy or external beam radiation therapy, may be recommended depending on the stage and severity of the cancer.
The primary treatment for papillary thyroid cancer is surgery, which involves removing the entire thyroid gland along with any nearby lymph nodes that may be affected by the cancer. This is typically done under general anesthesia and may require a hospital stay of a few days.
After surgery, radioactive iodine therapy is often recommended to help destroy any remaining thyroid cells and reduce the risk of recurrence. Radioactive iodine therapy is typically done several weeks after surgery and may require hospitalization for a few days to minimize radiation exposure to others.
Thyroid hormone replacement therapy is usually required after thyroidectomy to replace the missing thyroid hormone and regulate the body’s metabolism. This typically involves taking a daily synthetic thyroid hormone pill.
In cases where the cancer has spread to other parts of the body or cannot be fully removed by surgery and radioactive iodine therapy, additional treatments may be recommended. These may include chemotherapy, external beam radiation therapy, or targeted therapies.
Prognosis of papillary thyroid cancer variants
Treatment for papillary thyroid cancer is highly curable, particularly when caught early and treated promptly. Regular follow-up appointments with a healthcare provider are recommended to monitor for recurrence or spread of the cancer.
The prognosis of papillary thyroid cancer (PTC) variants varies depending on the specific variant. The conventional and follicular variants of PTC generally have an excellent prognosis, with a 10-year survival rate of approximately 93%.
However, certain aggressive variants of PTC, such as the tall cell and solid variants, may have a worse prognosis and higher risk of recurrence.
Role of MedicoExperts tumour board
The MedicoExperts Tumor board is typically made up of a team of healthcare professionals from different specialties, including endocrinologists, oncologists, pathologists, and surgeons, who review and discuss individual cases of PTC to develop a comprehensive, evidence-based treatment plan.
The tumor board’s role is to ensure that each patient receives personalized, optimal care that takes into account the unique characteristics of their cancer, as well as their overall health and well-being.
The tumor board may also play a role in monitoring and managing post-treatment complications and assessing patients’ responses to treatment over time.
Conclusion
Overall, the multidisciplinary MedicoExperts tumor board is an important part of the management of papillary thyroid cancer and can significantly improve patient outcomes by providing access to a range of healthcare professionals and experts.
Treatment options may include surgical removal of the thyroid gland, radioactive iodine therapy, chemotherapy, external beam radiation therapy, and targeted therapies.
Active surveillance may also be recommended in certain cases to avoid over-treatment.
In general, thyroid hormone replacement therapy is required after thyroidectomy to replace the missing thyroid hormone and regulate the body’s metabolism.
Regular follow-up appointments with healthcare providers are recommended to monitor for the recurrence or spread of cancer.
FAQ :
Q1. What is papillary thyroid cancer caused by?
Papillary thyroid cancer can be caused by ionizing radiation exposure, especially during childhood.
Q2. What is the survival rate of papillary thyroid cancer?
The 5-year survival rate of papillary thyroid cancer is 99% if proper treatment is provided at the right time.
