- What is thyroid cancer?
- Thyroid cancer causes
- Types of thyroid cancer
- Thyroid cancer staging
- Thyroid cancer symptoms
- Diagnostics of thyroid cancer
- Thyroid cancer treatment
- Thyroid cancer treatment by stage and type
- Best thyroid cancer treatment centers
- Thyroid cancer prognosis
What is thyroid cancer
Thyroid cancer is a malignant tumor developed in the thyroid gland tissues. It is caused by uncontrolled cells growth and division.
Thyroid cancer statistics
- in 98% of cases, thyroid cancer is curable
- it is diagnosed among people aged 20-65 years
- in 3 cases out 4, thyroid cancer is diagnosed in women
- thyroid cancer takes the 5th place among oncological diseases in women.
Is thyroid cancer curable?
Thyroid cancer is one of the most easily cured oncological diseases. If a malignant thyroid tumor is detected in the early stages, the cure rate is up to 100%. The prognosis is poor only in case of sarcomas or anaplastic cancer, but they are diagnosed in 1-2% of all thyroid cancer cases.
ICD 10 code for thyroid cancer
ICD-10 code (International Classification of Diseases and Related Health Problems of 10th revision) is a globally accepted classification for diseases coding, developed by the World Health Organization (WHO).
According to ICD-10 code, thyroid cancer is a malignant neoplasm of the thyroid gland. Disease code is C73.
Get a consultation with a doctorCauses of thyroid cancer
In most of the cases, thyroid cancer causes are unknown. The development of genetic cells mutations can cause any of cancer forms.
Risk factors for thyroid cancer
There are some thyroid cancer risk factors which increase an appearance of malignant tumor. The most common are:
1. Sex
Doctors detect thyroid cancer by 3 times more often in female than male.
2. Age group
A malignant thyroid tumor may appear at any age. But in most of the cases, doctors detect it in women aged 40-55 and men aged 60-70.
3. Hereditary
A risk for thyroid cancer increases if someone among close relatives has had it: a parent, brother/sister, child.
4. Low-iodine diet
Complete or partial refusal of products containing the iodine. It also increases the thyroid cancer risk.
5. Radiation
Patients treated other cancer types with radiation therapy, may get thyroid cancer.
How to prevent thyroid cancer?
Prevention of thyroid cancer is difficult and even impossible in most of cases. But there are several simple rules which can help decrease a possibility of its development:
- limit fatty and sweet food
- eat more fruit and vegetables
- take potassium iodide medicines (after consultation with a doctor)
- have regular check-ups.
In the case of medullary thyroid cancer which is hereditary, a patient can prevent it by having a gene analysis. If this gene is detected, the thyroid removal may be prescribed.
Types of thyroid cancer
Specialists classify thyroid cancer according to cells type, tumor differentiation, level of cancer spread.
How is thyroid cancer differentiated?
Doctors classify high-, moderately-, and low-differentiated tumors. The lower differentiation is, the faster neoplasm spreads throughout the body and the worse response is to the treatment.
Different types of thyroid cancer
Differentiation | Type | Description |
|---|---|---|
Differentiated thyroid cancer | Papillary thyroid cancer |
|
Follicular thyroid cancer |
| |
Moderately differentiated thyroid cancer | Medullary thyroid cancer |
|
Low-differentiated thyroid cancer | Anaplastic thyroid cancer |
|
Papillary vs. follicular thyroid cancer
Needless to say, cancer diagnosis shocks people. But if a patient has papillary or follicular thyroid cancers, the recovery rate is up to 100%. These tumors are diagnosed in 90% of thyroid cancer cases.
Papillary and follicular thyroid oncological diseases are differentiated. It means that cancer cells are similar with healthy ones. Papillary thyroid cancer grows very slowly but spreads to the cervical lymph nodes. Follicular thyroid cancer does not spread to the lymph nodes but sometimes can do to the lungs or bones.
Thyroid cancer staging
There are 2 most common systems to classify the thyroid cancer — clinical and TNM.
Clinical thyroid cancer staging
The most widely spread classification type is a clinical one. It divides the cancer spread in 4 stages.
Thyroid cancer: stage 1
A tumor is up to 1 cm; it is located within the thyroid gland and does not affect other organs.
Thyroid cancer: stage 2
A neoplasm is up to 4 cm. It can deform the thyroid gland and grow into the cervical lymph nodes from one site. First thyroid cancer signs are swelling of the neck and hoarseness.
Thyroid cancer: stage 3
A malignant tumor spreads beyond the gland, affects the lymph nodes from both sides. In this stage, a patient also notices hoarseness and pain in the lymph nodes area.
Thyroid cancer: stage 4
Secondary tumors appear in the neck, spine, liver, lungs.
TNM thyroid cancer classification
Doctors use TNM to classify tumors according to its diameter and type, localization of metastases. The abbreviation expansion is the following: T-tumor (primary tumor), N-node (metastases are in the regional lymph nodes), M-metastases (remote metastases).
T: a size of neoplasm
- T1 — a tumor is up to 1 cm and located within the thyroid gland
- T2 — a neoplasm is 1-4 cm in size, is located within the thyroid
- T3 — a malignant tumor is more than 4 cm, limited by the organ area
- T4 — cancer process has spread beyond the thyroid gland
- T4a — a tumor metastasis are the neck
- T4b — cancer cells spread to the spine and surrounding large vessels.
N: metastases in the lymph nodes
- N0 — no malignant cells in the lymph nodes
- N1 — thyroid cancer has spread in the regional lymph nodes
- N1a — a tumor spreads in the central cervical lymph nodes
- N1b — a thyroid tumor metastases in the cervical and thoracic lymph nodes
M: metastases in the remote organs
- M0 — no secondary tumors
- M1 — thyroid cancer spreads to the remote organs
Follicular and papillary thyroid cancer staging is based on TNM system. But there is a difference in staging of these thyroid cancer types. For patients with follicular thyroid cancer the age is a key factor. Young people do not die from the follicular thyroid tumor. People aged 55 and less are considered to have follicular thyroid cancer stage 1. If a patient with follicular cancer is older, it means that oncology may progress aggressively, and disease is determined as stage 2 or more.
People aged 55 with papillary or follicular have cancer stage 2 or higher.
However, the age factor is not taken into account for anaplastic and medullary thyroid cancer staging.
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Thyroid cancer symptoms
People often wonder what early warning signs of thyroid cancer are. But the deal is that this pathology rarely manifest itself in stage 1. Usually, signs of thyroid cancer appear in the 2nd stage. They are similar with benign tumors symptoms, so to establish a precise diagnosis is possible only after the complete investigation. You should see a doctor, if you notice:
- swelling or induration in the neck area
- enlarged cervical lymph nodes
- frequent hoarseness
- difficulties with swallowing
- breathlessness
- neck pain.
These signs are featured for papillary, follicular, and medullary thyroid cancers.
However, anaplastic thyroid cancer symptoms differ significantly. The most important one is an appearance of fast growing dense tumor in the front neck area. The growth speed is so high, that changes in tumor size are noticeable within a 1 day.
Thyroid cancer diagnosis
You should present to an endocrinologist to make a thyroid cancer screening. A specialist will study your medical history, palpate the thyroid gland and lymph nodes. After examination, a specialist will develop a diagnostic program.
The following tests are applied to diagnose thyroid cancer:
- Hormonal blood tests for thyroid cancer
- Tumor marker tests
- Ultrasound
- Biopsy of thyroid cancer
- X-ray and CT of the chest
- MRI
- PET-CT scan for thyroid cancer
Doctors make laboratory blood tests to detect thyroid pathologies. Excessive or deficient production of specific hormones can arouse a suspicion of thyroid cancer.
Tumor marker test detects specific substances for thyroid cancer. Among them are thyroglobulin levels and antibodies tests.
A specialist examines the thyroid and lymph nodes using ultrasound. It detects the thyroid gland volume, finds neoplasms, and measures its size.
A thyroid sample tissue is taken under local anesthesia. Doctors perform the biopsy using a medical syringe with a thin needle. Thyroid cancer biopsy is made under control of ultrasound.
It detects secondary malignant thyroid tumors in the lungs.
It is used to find metastases in the brain or spinal cord.
It is the whole body scan for thyroid cancer. PET-CT detects the tiniest (up to 1 mm) metastases in any part of the body.
Thyroid cancer treatment
After the complete diagnostics, doctors choose the most effective thyroid cancer treatment options. Among the main methods are surgery, radiation therapy, drug therapy.
Surgery for thyroid cancer
Thyroid cancer surgery aims at removing a malignant tumor. Depending on the level of cancer spread, doctors conduct:
- lobectomy — removal of the organ lobe
- thyroidectomy — resection of the significant part of the gland or the whole organ.
If a malignant thyroid tumor has spread to the lymph nodes, doctors remove them together with the gland.
The ways of surgical intervention in the case of thyroid cancer are the following:
- Open
- Video-assisted surgery
- Robotic surgery
Doctors carry out surgery through the up to 8 cm incision made on the neck.
Advantage: the open surgery cost is lower than the price of other types.
Disadvantage: after the intervention a visible scar remains.
Doctors perform the manipulations through 2-4 cm incision on the neck. During the intervention, they use an ultrasonic scalpel and a tube with a camera. It transmits the thyroid image on the screen.
Advantage: the procedure leaves almost invisible scar.
Disadvantage: the video-assisted thyroid cancer surgery cost is higher than the open one.
Doctors operate patients using Da Vinci robot. The surgery is carried out through the incision in the axillary cavity.
Advantage: after the surgery no visible scars remain.
Disadvantage: the robotic surgery cost is higher than price for other ones.
Radioactive iodine treatment for thyroid cancer
Doctors conduct the iodine treatment for thyroid cancer after surgical intervention to destroy remained cancer cells and prevent the relapse.
During the procedure, a patient takes a capsule with radioactive iodine. Malignant thyroid cells accumulate this substance and break down. The healthy tissues are affected insignificantly. Due to this, the procedure is safe for a patient.
Side effects of radioactive iodine treatment for thyroid cancer are the following:
- impaired productivity
- tiredness
- weight loss.
Hormonal therapy for thyroid cancer
Doctors prescribe hormonal drugs to:
- compensate for a lack of hormones after thyroid removal
- stop the growth of cancer cells left after surgery
- prevent the relapse.
Chemo treatment for thyroid cancer
Chemotherapy is rarely applied to treat thyroid cancer. Doctors usually prescribe it in combination with radiation treatment if a tumor has spread throughout the body.
Chemotherapy is administered intravenously.
Radiation treatment for thyroid cancer
Specialists carry out radiation treatment for thyroid cancer after a surgery to destroy metastases in the neck or remote organs. The procedure is performed using highly-accurate devices which irradiate only malignant thyroid cells without affecting healthy ones.
The hospitalization is not required to perform radiotherapy for thyroid cancer.
The radiation treatment of thyroid cancer may cause such side effects:
- chronic fatigue
- muscle pain
- skin redness in the neck area
- sore throat when swallowing
- dry mouth
- hoarseness.
Immunotherapy for thyroid cancer
The immunotherapy (targeted therapy) for thyroid cancer is prescribed only after genetic tests. Immunotherapeutic drugs ‘repair’ the immune system and activate the mechanism to resist cancer. The immune system becomes able to detect the malignant cells and destroy them. The following drugs may be prescribed:
- Cabozantinib
- Sorafenib
- Vandetanib.
Thyroid cancer treatment by stage and type
The treatment plan of thyroid cancer depends on its type and spread. The feature of thyroid cancer is that there are no standard schemes for treatment of thyroid cancer stage 1, 2, 3, or 4. The therapeutic methods are chosen individually after complete examination, specifying the stage and type of malignant tumor.
Papillary thyroid cancer treatment
- Surgery
- Radioiodine treatment
- Radiotherapy
- Chemotherapy
- Targeted therapy
If a tumor is within the thyroid gland, doctors perform lobectomy (thyroid cancer stage 1-2). If a tumor has spread throughout the body, thyroidectomy is prescribed (papillary thyroid cancer treatment stage 3).
It is usually prescribed for papillary thyroid cancer treatment stage 3 or 4. In these stages, the neoplasm has spread outside the gland, and there is a probability of the relapse.
Doctors apply this treatment in the advanced stages, when radioiodine is ineffective.
Chemotherapy is also prescribed for papillary thyroid cancer stage 3-4, when metastases are in the remote organs.
Such a therapy is appointed for people with genetic mutations of cells and in case if other methods are ineffective.
Follicular thyroid cancer treatment
- Surgery
- Radioiodine therapy
- Radiotherapy
- Hormonal therapy
- Chemotherapy
- Targeted therapy
If the neoplasm is within the thyroid gland, surgeons carry out lobectomy. If metastases are detected, thyroidectomy is performed. Surgical intervention is applied for follicular cancer treatment of any stage.
Radio-oncologists prescribe this procedure, if thyroid cancer has spread beyond the gland, and there is a possibility of the relapse. Radioiodine therapy is prescribed for the thyroid cancer treatment stage 3-4.
Doctors prescribe radiotherapy if radioiodine therapy is ineffective.
Specialists assign hormonal drugs after complete thyroid gland removal.
Oncologists apply chemo, if a tumor metastasizes and is insensitive to other treatment options.
Doctors prescribe targeted drugs for patients with genetic mutations of cells.
Medullary thyroid cancer treatment
- Surgery
- Hormone therapy
- Radiation therapy
- Chemotherapy
- Targeted therapy
In the case of medullary thyroid cancer, doctors remove the gland and surrounding lymph nodes.
After thyroidectomy, specialists prescribe life-long taking of hormonal drugs.
Radio-oncologists apply radiotherapy to prevent the thyroid cancer relapse and destroy remained malignant cells.
Chemo is prescribed when a tumor has metastasized throughout the body, and another treatment is ineffective.
Targeted drugs are administered to treat patients with thyroid cancer caused by genetic mutations.
Anaplastic thyroid cancer treatment
- Surgery
- Radiotherapy or/and chemotherapy
- Targeted therapy
Surgical intervention is rarely applied because of its low efficiency. But in some cases, doctors may prescribe complete removal of the thyroid gland and surrounding lymph nodes.
They can be used separately or in combination. These therapies destroy malignant cells throughout the body.
If malignant cells have changes in the BRAF gene, such drugs as Dabrafenib and Trametinib are used.
Best thyroid cancer treatment centers
The best hospitals for thyroid cancer treatment are located in Germany, Thailand, and Turkey. The accuracy of diagnostics is 99-100%. Due to the precise establishment of the diagnosis, specialists of the best centers for thyroid treatment conduct the most effective treatment options. 9 out of 10 patients completely recover after thyroid cancer treatment abroad.
Medical Center in Solingen, Germany
Medical Center in Solingen is a multidisciplinary hospital which is in TOP 10 medical centers in Germany according to Focus magazine version.
Specialists working here perform surgery and all types of therapies to treat thyroid cancer. 11 types of radiotherapy are applied at Solingen. That is why you can be sure than radio-oncologists will choose the most effective method.
The efficiency of cancer treatment is approved by German Cancer Society certificate.
Anadolu Medical Center, Turkey
Anadolu Medical Center is a multidisciplinary hospital in Istanbul. It is certified by Organization of European Cancer Institutes for the effective cancer treatment. Only 30 medical facilities in the world have such an accreditation.
Anadolu cooperates with No.1 Hospital in the USA — Johns Hopkins Medical Center. That is why thyroid cancer diagnostics and treatment is performed according to American protocols.
95% of patients recover completely after treatment with iodine therapy at Anadolu.
Bumrungrad International Hospital, Thailand
Bumrungrad International Hospital is one of the most popular medical facilities among foreigners. Annually, over 520,000 international patients choose Bumrungrad for treatment.
Bumrungrad is the 1st center outside the USA which received GHA accreditation. It approves the compliance of the Hospital with international standards in the field of medical tourism.
The thyroid cancer treatment is carried out at the specialized Horizon Center. There are available the latest linear accelerators for radiotherapy, effective drugs for immuno- and chemotherapies.
Bumrungrad Hospital is equipped with IBM Watson supercomputer. It gathers all the medical histories of patients who had cancer accross the world. IBM Watson chooses the most appropriate treatment in each particular case in the short term. It guarantees the highest efficiency and almost excludes the medical error.
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Read also TOP 9 best oncologists in the world
Thyroid cancer prognosis
The life expectancy in the case of thyroid cancer depends on its stage and type. Oncologists measure the thyroid cancer prognosis by 5-year survival. It shows the percentage of people who have lived 5 years without relapse after treatment.
Papillary thyroid cancer prognosis
Papillary cancer is not an aggresive oncological type. It is easily diagnosed and treated in early stages.
Stage | 5-year survival rate |
|---|---|
Stage 1 | 99% |
Stage 2 | 99% |
Stage 3 | 93% |
Stage 4 | 51% |
Follicular thyroid cancer prognosis
Follicular cancer is the 2nd mostly widespread malignant thyroid tumor. It is more aggressive than pappillary thyroid cancer. The survival rate and the speed of disease progression depends on the parient's age. In patients aged over 55, cancer spreads much faster than in younger people.
Stage | 5-year survival rate |
|---|---|
Stage 1 | 99% |
Stage 2 | 99% |
Stage 3 | 71% |
Stage 4 | 50% |
Medullary thyroid cancer prognosis
Medullary thyroid cancer is rarely diagnosed. It is featured by heriditary background. In case of the adequate treatment, medullary thyroid cancer is completely cured in early stages.
Stage | 5-year survival rate |
|---|---|
Stage 1 | 90% |
Stage 2 | 76% |
Stage 3 | 81% |
Stage 4 | 28% |
Anaplastic thyroid cancer prognosis
Anaplastic thyroid cancer is very aggressive. It is usually diagnosed in the 4th stage. 5-year survival rate with anaplastic thyroid cancer is only 7%.
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