In general, thyroid cancers are of 4 types: papillary, follicular, medullary and anaplastic cancer. Anaplastic cancer is quite malignant, and most of the cases diagnosed do not survive more than 6 months.
What are the Findings of Thyroid Cancer?
The patient has cervical lymphadenopathy, hoarseness; pain, difficulty in swallowing (dysphagia) and respiratory distress are seen in the later stages. In patients with familial predisposition, a history of radiation to the neck region, and hoarseness, the probability of a nodule detected in the thyroid being cancer is quite high.
There are four types of thyroid cancer.
1) Papillary thyroid cancer: Papillary cancer is the most common thyroid cancer with the best prognosis. The 30-year mortality rate is 6%. It constitutes 73-80% of thyroid cancers. It is common in the 20-40 age group. It is seen 3-4 times more in women than in men.
2) Follicular thyroid cancer: Follicular thyroid cancer is the second most common. It is worse in character than papillary cancers and constitutes 15-27% of cancers. It is mostly seen in women after the age of 50. Its prognosis is worse than papillary cancers. Follicular cancer, which includes only one of the presence of distant organ metastasis, being over 50 years old, and presence of vascular invasion, is considered low risk.
3) Medullary thyroid cancer: Originating from parafollicular C cells, constituting 10% of thyroid cancers; It is a cancer with a more aggressive course than other cancers.
4) Anaplastic (undifferentiated) thyroid cancer: Anaplastic thyroid cancers are among the cancers with the worst course in the organism. The male/female ratio is 1.5/1. Especially in advanced ages 6-7. occurs in decades. It is rare under the age of 40. In cases, there is usually a large goiter that grows rapidly, hard, and spreads to the surrounding tissues. Lymph node metastases are seen in the early stage. Lung and bone metastases are quite common.
How to Diagnose Thyroid Cancer?
Ultrasonography, Thyroid Scintigraphy, detection of thyroid hormones in blood, Fine Needle Aspiration Biopsy as well as Neck and Lung Computed Tomography or MRI
How Is Thyroid Cancer Treated?
The main treatment for follicular cancer is surgery. The treatment of choice should be total thyroidectomy (removal of the thyroid gland). is. If there is lymph involvement, neck lymph dissection should be added.
Treatment of thyroid diseases is a team work. In this team; endocrine surgeon, endocrinologist, nuclear medicine specialist, radiologist and pathologist. Thanks to these physicians, the disease can be successfully treated with a multi-faceted approach.
Thyroid surgery, on the other hand, requires meticulousness and precision. The reason for this is that the thyroid gland is adjacent to the vocal cords and parathyroid glands. It is preferred because of factors such as the presence of edema and the absence of edema.
Treatment of thyroid cancer begins with surgery, which means removal of the entire thyroid. If less than 95% of the thyroid is removed, the effectiveness of radioactive iodine treatment after the disease decreases and therefore a second operation becomes necessary before the treatment. However, in suspicious cases or very small foci are detected by the pathologist, who is called for surgery, by freezing the tissue during the operation. These are;
- Minimally invasive thyroid surgery. This is the thyroid surgery that will cause the least damage to the tissue.
- The removed nodule is examined in the operating room and operated in accordance with the findings.
- In order to preserve the voice after the surgery, the nerves going to the vocal cords during the surgery are monitored with a special device called neuromonitoring. It is protected by monitoring.
What is Thyroid Cancer Nuclear Medicine Treatment?
Many oncological diseases are diagnosed in Nuclear Medicine, thanks to the ability of the radioactive materials given to the body to be retained in the organs.
Thyroid cancers are more common between the ages of 25-55. The incidence in women is 4 times higher than in men. According to the data of the Public Health Agency of Turkey, the incidence of thyroid cancer in women in recent years is second only to breast cancer. Thyroid cancers usually present as thyroid nodules. Sometimes do it for another reason� It occurs by chance during an examination or examination. Although thyroid cancer is common, it can usually be cured with appropriate treatment and follow-up; The risk of death is almost negligible.
First-line surgical intervention in the treatment of thyroid cancers. Surgical techniques that are safe for the patient and will give good results are applied by specialist surgeons. The second step in the treatment is "Radioactive Iodine Application", popularly known as "Atom Therapy". Targeted treatment with high-dose radioactive drugs is applied, thanks to the ability of tumors to hold special radioactive substances intensely. After the operation, the remaining thyroid cells are targeted.
After the necessary preliminary preparations and examinations are made in order for the thyroid gland to keep the radioactive iodine at a sufficient level, it is administered to the patient at once orally.
The given radioactive iodine is kept in the thyroid cells. It destroys the remaining thyroid cells by irradiating it from the inside.
Patients receiving radioactive iodine treatment should stay in a special lead-lined room for 2-3 days in order to prevent the radiation in their bodies from harming other people (especially pregnant and small children). Patients whose radiation dose drops to a reliable level are discharged. Re-formations that can be seen in very few patients can be detected and treated in the early period thanks to controls.
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