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Thyroid cancer - papillary carcinoma
Papillary carcinoma of the thyroid
Papillary carcinoma of the thyroid is the most common cancer of the thyroid gland. The thyroid gland is located inside the front of the lower neck.
Causes
About 80% of all thyroid cancers diagnosed in the United States are the papillary carcinoma type. It is more common in women than in men. It may occur in childhood, but is most often seen in adults between ages 30 and 50.
The cause of this cancer is unknown. A genetic defect may be involved.
Radiation increases the risk of developing thyroid cancer. Exposure may occur from:
- High-dose external radiation treatments to the neck, especially during childhood, used to treat childhood cancer or some noncancerous childhood conditions
- Radiation exposure from nuclear plant disasters
Radiation given through a vein (through an IV) during medical tests and treatments does not increase the risk of developing thyroid cancer.
Symptoms
Thyroid cancer often begins as a small lump (nodule) in the thyroid gland.
While some small lumps may be cancer, most (90%) thyroid nodules are harmless and are not cancerous.
Most of the time, there are no other symptoms.
Exams and Tests
If you have a lump on your thyroid, your doctor will order blood tests and possibly an ultrasound of the thyroid gland.
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
If the ultrasound shows that the lump is bigger than 1 centimeter, a special procedure called a fine needle aspiration biopsy (FNAB) will be performed. This test helps determine if the lump is cancerous.
Fine needle aspiration
Fine needle aspiration of the thyroid gland is a procedure to remove thyroid cells for examination. The thyroid gland is a butterfly-shaped gland lo...
Thyroid function tests are often normal in people with thyroid cancer.
Thyroid function tests
Thyroid function tests are used to tell whether your thyroid is working normally. The most common thyroid function tests are:Total, or free T4 (the m...
Treatment
There are 3 types of thyroid cancer treatment:
- Surgery
- Radioactive iodine
- Medicine
Surgery is done to remove as much of the cancer as possible. The bigger the lump, the more of the thyroid gland must be removed. Often, the entire gland is taken out.
After the surgery, you may receive radioiodine therapy, which is often taken by mouth. This substance kills any remaining thyroid tissue. It also helps make medical images clearer, so doctors can see if there is any cancer left behind or if it comes back later.
If surgery is not an option, external radiation therapy can be useful.
After surgery or radioiodine therapy, you will need to take medicine called levothyroxine for the rest of your life. This replaces the hormone the thyroid would normally make.
You'll likely need to have a blood test every 6 to 12 months to check thyroid hormone levels. Other follow-up tests that may be done after treatment for thyroid cancer include:
- Ultrasound of the thyroid
-
An imaging test called a
radioactive iodine (I-131) uptake scan
Radioactive iodine (I-131) uptake scan
Radioactive iodine uptake (RAIU) tests thyroid function. It measures how much radioactive iodine is taken up by your thyroid gland in a certain time...
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Support Groups
You can ease the stress of illness by joining a cancer support group . Sharing with others who have common experiences and problems can help you not feel alone.
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society -- www. cancer. orgCancerCare -- www. cancercare. or...
Outlook (Prognosis)
The survival rate for papillary thyroid cancer is excellent. More than 95% of adults with this cancer survive at least 10 years. The prognosis is better for people who are younger than 40 and for those with smaller tumors.
The following factors may decrease the survival rate:
- Older than 45
- Cancer that has spread to distant parts of the body
- Cancer that has spread to soft tissue
- Large tumor
Possible Complications
Complications include:
- Accidental removal of the parathyroid gland, which helps regulate blood calcium levels
- Damage to a nerve that controls the vocal cords
- Spreading of cancer to lymph nodes (rare)
-
Spreading of cancer to other sites (
metastasis
)
Metastasis
Metastasis is the movement or spreading of cancer cells from one organ or tissue to another. Cancer cells usually spread through the blood or the ly...
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When to Contact a Medical Professional
Call your health care provider if you have a lump in your neck.
References
National Cancer Institute: PDQ thyroid cancer treatment. Bethesda, MD: National Cancer Institute. Last modified February 4, 2016. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional . Accessed April 4, 2016.
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Thyroid carcinoma. Version 2.2015. www.nccn.org/professionals/physician_gls/PDF/thyroid.pdf . Accessed April 4, 2016.
Schneider DF, Mazeh H, Lubner SJ, Jaume JC, Chen H. Cancer of the endocrine system. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology . 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 71.
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Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
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Thyroid cancer - CT scan - illustration
This CT scan of the upper chest (thorax) shows a malignant thyroid tumor (cancer). The dark area around the trachea (marked by the white U-shaped tip of the respiratory tube) is an area where normal tissue has been eroded and died (necrosis) as a result of tumor growth.
Thyroid cancer - CT scan
illustration
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Thyroid cancer - CT scan - illustration
This CT scan shows a thyroid cancer tumor in the throat, encircling, narrowing, and displacing the windpipe (trachea).
Thyroid cancer - CT scan
illustration
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Thyroid enlargement - scintiscan - illustration
This image shows enlargement of the thyroid gland and extension down behind the breastbone (retrosternal space). The image, called a scintiscan, was generated using a radioactive isotope.
Thyroid enlargement - scintiscan
illustration
-
Thyroid gland - illustration
The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.
Thyroid gland
illustration
-
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
-
Thyroid cancer - CT scan - illustration
This CT scan of the upper chest (thorax) shows a malignant thyroid tumor (cancer). The dark area around the trachea (marked by the white U-shaped tip of the respiratory tube) is an area where normal tissue has been eroded and died (necrosis) as a result of tumor growth.
Thyroid cancer - CT scan
illustration
-
Thyroid cancer - CT scan - illustration
This CT scan shows a thyroid cancer tumor in the throat, encircling, narrowing, and displacing the windpipe (trachea).
Thyroid cancer - CT scan
illustration
-
Thyroid enlargement - scintiscan - illustration
This image shows enlargement of the thyroid gland and extension down behind the breastbone (retrosternal space). The image, called a scintiscan, was generated using a radioactive isotope.
Thyroid enlargement - scintiscan
illustration
-
Thyroid gland - illustration
The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.
Thyroid gland
illustration
Review Date: 3/16/2016
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
