Wednesday, January 4, 2012

Thyroid Cancer - The Four Types

By Owen Jones


Thyroid cancer (cancer of the thyroid gland) comes in four variations: papillary, follicular, medullary and anaplastic. Papillary and medullary are slow-growing and sometimes return, but respond well to treatment in patients under middle age.

Medullary also responds well to treatment, if it has not already spread. Anaplastic grows rapidly and reacts badly to therapy. The extent of these types of cancer is not consistent throughout the world, but is roughly: 78% for papillary; 17% for follicular; 4% for medullary and 1% for anaplastic.

Normally, the first symptom of difficulty is the growth of a nodule or nodules in the neck near the thyroid gland. However, merely 5% of these are malignant. Sometimes an early warning sign is discomfort or even pain; sometimes, the lymph nodes swell, the voice changes or there is hypo- or hyper- thyroidism.

Discovery usually takes place after a nodule is discovered during a (general) physical examination. The patient is then referred to an endocrinologist or a thyroidologist, who will arrange an ultrasound test or a biopsy. Using a thin needle enough cells can be gathered to do an accurate test on the precise condition of the thyroid and whether the nodules are cancerous.

Papillary thyroid cancer more frequently occurs in women and frequently in the 30-40 year old age group and is frequently characterized by bulging eyes. If the growth is less than 1cm in size a partial thyroidectomy or hemithyroidectomy would almost certainly be recommended.

Above 1cm and a full thyroidectomy is preferred. Some surgeons would rather a full thyroidectomy anyway because the cancer cannot come back then.

Follicular thyroid cancer is more widespread in women more than 50 years of age. Therapy is most frequently full thyroidectomy as the threat of recurrence of this aggressive kind is quite big for partial surgery.

Medullary thyroid cancer (MTC) starts in the cells that produce the hormone calcitonin. Increased degrees of calcitonin in the blood are a realistic indication of MTC, although these elevated levels of calcitonin are probably not harmful in themselves.

Changes in the DNA involved in cell growth and development are responsible for nearly all cases of hereditary or familial medullary thyroid carcinoma. Hereditary medullary thyroid cancer is inherited as a 50/50 probability from every affected parent. DNA analysis makes it possible to identify children who carry the mutant gene.

Surgical removal of the thyroid in children who carry the mutant gene is effective if the entire thyroid gland is removed at an early age, before there is a spread of the tumor. Hereditary MTC accounts for around 25% of all cases of MTC. The other 75% of cases are known as sporadic MTC and normally happen in older patients.

Frequently the disease is well advanced in these cases as there has been no screening as in hereditary MTC. The first sign is frequently diarhoea. The likelihood of surviving MTC seem to be linked to the rate at which the patient?s post operative calcitonin levels double.

Anaplastic thyroid cancer is extremely aggressive and likelihood of survival are virtually nil. It is resilient to all known cancer treatments and invades nearby tissue rapidly.




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