Thyroid cancer: types, symptoms, treatment methods

Formations (so-called nodes) in the thyroid gland are often benign in nature, however, they require regular monitoring. It is important to carry out additional studies in a timely manner (including a biopsy of suspicious nodes) in order to diagnose cancer in a timely manner. process and begin appropriate treatment.

Thyroid cancer is considered a relatively rare disease, 3 times more often diagnosed in women. May occur at a young age and in children.

Symptoms of thyroid cancer

The most common symptoms are:

• Swelling, palpable formation in the anterior surface of the neck.
• Neck pain.
• Persistent, progressive hoarseness.
• Dry cough, sore throat.
• Difficulty swallowing.
• Enlarged cervical lymph nodes.
• Symptoms associated with organ damage during the development of distant metastases (pain in various locations, organ dysfunction).

Classification of thyroid cancer.

• Papillary thyroid cancer (75-80%). It is characterized by slow growth, metastases are extremely rare, and the treatment prognosis is favorable.
• Follicular cancer (15-25%). It is more common in regions with iodine deficiency. It is also characterized by a relatively favorable prognosis.
• Anaplastic or undifferentiated cancer is diagnosed least often (1-9.8%). It is more common over the age of 65 years, in 70% of cases in women. Characterized by rapid growth of the primary tumor, a tendency to metastasize, and an aggressive course.
• Medullary thyroid cancer, a neuroendocrine tumor formed from parafollicular cells that produce calcitonin (1-2%). In 25% of cases it develops as part of the multiple endocrine neoplasia syndrome type 2 (MEN 2). The disease can be cured in the early stages; if the disease recurs and metastases are present, the prognosis is questionable.

Diagnostics

1. Ultrasound.

   The simplest and most effective diagnostic method, including in the early stages, is an ultrasound scan of the thyroid gland. To standardize the approach to diagnosing patients with thyroid nodules, the TI-RADS system is used. It is an acronym for Thyroid image reporting and data system.

   A standardized scale is used:

   • TI-RADS 1 – gland meets the norm.
   • TI-RADS 2 – changes are benign.
   • TI-RADS 3 – changes are probably benign.
   • TI-RADS 4 - suspicion of malignant changes. This group is further divided into subtypes depending on the magnitude of the risk of malignancy.
   • TI-RADS 5 – probability of malignancy exceeds 80%.
   • TI-RADS 6 – a previous biopsy proved the malignant origin of the formation.

   As a rule, the appropriate type is determined by a specialist: often the wording can be found on the results of ultrasound given to the patient. Starting from level 2 on the scale, it makes sense to enlist the support of a specialist in order to track any changes and begin further examination in a timely manner.

2. CT and MRI.

   In the presence of a widespread thyroid mass, an MRI of the soft tissues of the neck with contrast is recommended. If the presence of distant metastases is suspected, a computed tomography scan of the chest, abdominal cavities, and small pelvis with contrast enhancement, in some cases PET-CT, and MRI of the brain are performed.

3. Fine needle aspiration biopsy (FNA) with cytological examination.

   Mandatory research to establish an oncological diagnosis. FNA is recommended when TI-RADS 4-5 formations are detected. It is advisable to consider FNA for newly identified nodes larger than 10 mm or for intensive growth of previously identified nodes.

4. Laboratory research.

   Depending on the type and stage of the disease, in addition to standard general and biochemical blood tests, the following may be recommended for testing: thyroid-stimulating hormone, thyroglobulin, antibodies to thyroglobulin, calcitonin.

5. Scintigraphy with 99mTc-pertechnetate and 123I-sodium iodide.

   Specific studies are not routinely performed, are carried out only in specialized centers, are prescribed by oncologists who specialize in thyroid cancer in the context of diagnostically difficult cases, relapses after radioiodine therapy, to determine indications for radioiodine therapy or resistance to it, or during radioiodine therapy.

   The chances of effective therapy directly depend on timely detection. If the formation is localized exclusively in the gland, the likelihood of cure after surgical treatment is quite high. However, in the presence of distant metastases, the prognosis becomes less optimistic.

   The risk group includes patients with a family history (presence of close relatives diagnosed with medullary thyroid cancer or MEN2 syndrome); in this case, consultation with a medical geneticist and regular monitoring are recommended oncologist and endocrinologist.

Treatment

The type of treatment depends on the type and stage of the disease. The treatment strategy is determined at the oncology consultation.

Various types of treatment are used:

• Surgical method.

  It is the main treatment method for localized thyroid cancer (without distant metastases). The extent of surgical treatment depends on the size of the formation.

• Radioiodine therapy.

  The method is used for follicular and papillary (differentiated) cancer. Depending on the stage it may be an addition to surgery (for prophylactic purposes), and is also an independent method of treatment with an inoperable process with the presence of distant metastases. Involves oral administration radioactive iodine (I131) in a specialized hospital.

• Targeted therapy.

  Oral antitumor therapy. Used to treat inoperable differentiated thyroid cancer with the development of resistance to radioiodine therapy, as well as for the treatment of medullary thyroid cancer.

• Chemotherapy and chemoradiotherapy.

  Used to treat anaplastic thyroid cancer.

Timely diagnosis is the key to health

Self-diagnosis practically does not work in this case. A visit to an endocrinologist and an ultrasound examination will allow you to suspect thyroid pathology at an early stage. stages and understand whether further examination is required, and in case of a verified disease, you can get a consultation with an oncologist information about the possibilities of specialized examination and treatment.

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