Papillary Thyroid Cancer: Symptoms and Treatment

Papillary thyroid cancer is the most common type of thyroid cancer, accounting for approximately 80% of all thyroid cancer cases. Despite its prevalence, many individuals remain unaware of its symptoms, causes, and treatment options.

In this complete guide, we will delve into the intricacies of papillary thyroid cancer, discussing its symptoms, diagnosis, treatment options, and long-term prognosis.

What is Papillary Thyroid Cancer?

Papillary thyroid cancer (PTC) is a malignant tumour that arises from the follicular cells of the thyroid gland. It is characterized by its slow growth and is typically diagnosed in individuals aged 30 to 50. Though it may be aggressive, it generally has a favourable prognosis when detected early.

Causes and Risk Factors

While the exact cause of papillary thyroid cancer remains unclear, several risk factors have been identified:

Radiation Exposure: Individuals exposed to radiation, particularly during childhood, have a higher risk of developing PTC. This includes radiation treatments to the head or neck.
Genetic Factors: A family history of thyroid cancer or genetic syndromes such as familial adenomatous polyposis can increase risk.
Gender: Women are more likely to develop papillary thyroid cancer than men.
Iodine Intake: Both excessive and insufficient iodine intake can influence thyroid health, affecting cancer risk.

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Symptoms of Papillary Thyroid Cancer

Papillary thyroid cancer symptoms can be subtle and often overlap with other thyroid conditions, making diagnosis challenging:

Neck Lump: A palpable nodule or lump in the neck is the most common presentation.
Swelling or Pain in the Neck: Discomfort or swelling in the neck region can occur.
Voice Changes: Hoarseness or alterations in voice may arise if the cancer affects the recurrent laryngeal nerve.
Difficulty Swallowing or Breathing: Large nodules can compress the oesophagus or trachea, leading to swallowing or breathing difficulties.
Persistent Cough: A cough that is not associated with a cold or other respiratory issues.

Diagnosis of Papillary Thyroid Cancer

An accurate diagnosis of papillary thyroid cancer is crucial for effective treatment planning. The diagnostic process typically involves:

Physical Examination

A physician may first conduct a physical examination to identify any palpable nodules or lymphadenopathy.

Imaging Tests

Ultrasound: Ultrasound imaging is often the first step to assess the thyroid gland and surrounding tissues.
Radioactive Iodine Scan: Helps to determine the activity of thyroid nodules.
CT Scan or MRI: May be used to evaluate the extent of the disease.

Fine-Needle Aspiration Biopsy (FNAB)

FNAB is a minimally invasive procedure used to extract cells from the thyroid nodule for cytological examination. It is the gold standard for diagnosing papillary thyroid cancer.

Laboratory Tests

Blood tests, including thyroid function tests, can provide additional information about the thyroid's activity but are not definitive for cancer diagnosis.

Treatment Options for Papillary Thyroid Cancer

The treatment of papillary thyroid cancer is multifaceted and depends on the stage and spread of the disease. The primary treatment modalities include:

Surgery

Surgical intervention is the cornerstone of papillary thyroid cancer treatment. The extent of surgery depends on the tumour size and spread:

Lobectomy: Removal of one lobe of the thyroid. It may be considered for small, localized tumours.
Total Thyroidectomy: Removal of the entire thyroid gland, often recommended for larger or more aggressive tumours.
Lymph Node Dissection: If cancer has spread to nearby lymph nodes, they may also be removed.

Radioactive Iodine Therapy

Following surgery, radioactive iodine therapy may be administered to destroy any remaining thyroid tissue or microscopic cancer cells. It is particularly effective due to the thyroid's natural affinity for iodine.

Thyroid Hormone Therapy

Post-surgery, patients often require thyroid hormone replacement therapy to maintain normal hormone levels and suppress TSH (thyroid-stimulating hormone) production, which can stimulate cancer growth.

External Beam Radiation Therapy

In cases where radioactive iodine is ineffective, or if the cancer is inoperable, external beam radiation therapy may be employed.

Targeted Therapy

For advanced cases, targeted therapy drugs that inhibit specific pathways involved in cancer cell growth may be used.

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Prognosis and Survival Rates

The prognosis for papillary thyroid cancer is generally excellent, especially when diagnosed early. The 20-year survival rate exceeds 90%, reflecting the disease's slow-growing nature and responsiveness to treatment.

Papillary Thyroid Cancer and ICD-10

In medical coding, papillary thyroid cancer is classified under the ICD-10 code C73. This code aids in standardizing diagnoses and treatment protocols across healthcare systems.

Living with Papillary Thyroid Cancer

Follow-Up Care

Regular follow-up care is crucial to monitor for any recurrence or complications. This typically involves periodic blood tests and imaging studies.

Coping and Support

Living with a cancer diagnosis can be challenging. Support from healthcare professionals, support groups, and mental health services can be invaluable.

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Frequently Asked Questions

1. What are the symptoms of papillary thyroid cancer?

Symptoms may include a lump in the neck, changes in voice, and difficulty swallowing, often detected during routine examinations.

2. What causes papillary thyroid cancer?

Papillary thyroid cancer is often linked to genetic factors, previous radiation exposure, and certain hereditary syndromes affecting thyroid function.