thyroid cancer
Information on thyroid cancer
What is thyroid cancer?
Thyroid cancer is a malignant degeneration of glandular cells in the thyroid. A distinction is made between differentiated carcinomas, medullary carcinomas and undifferentiated thyroid tumors. The distinction has a significant impact on the treatment and chances of recovery. Thyroid surgery and radioiodine therapy play an important role in the treatment of thyroid carcinoma.
Frequency of thyroid cancer
According to estimates by the Robert Koch Institute, 7,300 people in Germany develop thyroid cancer each year. This makes this type of tumor one of the rarer ones. However, there is a strong regional difference in its occurrence. In recent years, the number of discovered thyroid tumors has actually increased, which is attributed to improvements in diagnostic options.
Causes of thyroid tumors
In general, thyroid cancer usually occurs spontaneously. Previous radiation of the neck region is known to be a risk factor. Thyroid tumors, like most carcinomas, are classified according to the "TNM classification", which is particularly important for surgical purposes. The tumors are classified according to
T - size of the primary tumor
N - involvement of the surrounding lymph nodes
M - distant metastases.
Above all, the extent to which the tumor spreads to nearby lymph nodes is an important prognostic factor for the patient's chances of recovery and future risk of recurrence. Lymph node metastases seem to have less of an impact on long-term survival. The type of tumor is the more decisive factor here.
Thyroid cancer also has familial tumor forms. For example, around 30% of those suffering from medullary carcinoma have a hereditary predisposition. Other hereditary diseases such as MEN 2 syndrome can also cause thyroid cancer.
Symptoms of thyroid cancer:
- Fatigue, exhaustion
- Feeling of pressure in the neck area
- Difficulty swallowing
- Enlarged lymph nodes in the neck region
- Hoarseness
- Rapid enlargement of the thyroid gland
Diagnosis: How is thyroid cancer diagnosed?
The diagnosis of thyroid diseases and thus also of thyroid carcinoma is made by means of
anamnesis (detailed, targeted patient interview),
clinical examination (palpation of the gland, symmetry, mobility, etc.),
laboratory tests (clarifies thyroid function, TSH, sometimes with free thyroid hormone T3 and T4, thyroid antibodies),
imaging (ultrasound, thyroid scintigraphy),
fine needle aspiration (tissue sampling) and additionally
vocal cord function (test of the innervation of the vocal cord, as the supplying nerve runs directly through the thyroid and can be damaged by strong growth or a possible upcoming operation).
Treatment: How is thyroid cancer treated?
Infographic Thyroid cancer treatment and chances of recoveryThe therapy strategy used for thyroid carcinoma depends heavily on the tumor stage and type.
Thyroid surgery
The basic principle of surgical treatment is, as with other tumors, the complete resection of the malignant tissue with the affected lymph nodes. Depending on the size of the tumor, a partial resection of the thyroid may be sufficient, but with larger cancerous tumors, complete removal of the thyroid (thyroidectomy) cannot be avoided.
Radioiodine therapy
If the tumor is in an advanced stage, adjuvant radioiodine therapy is essential. After surgical removal, the patient is treated with radioactive iodine. Since iodine is only stored in the thyroid in the human body, the tumor cells can be attacked very precisely with this method without causing too much collateral damage.
Radiation therapy and chemotherapy
Depending on the stage of the tumor, the associated lymph nodes are also removed during the operation. There is also the option of additional radiation (more likely in advanced stages or with aggressive tumors such as anaplastic thyroid carcinoma). Chemotherapy or certain drugs that affect thyroid hormone production can be used for advanced, inoperable thyroid cancer.
Prognosis and chances of recovery for thyroid cancer
For most thyroid tumors, there is a good chance of recovery if detected early. After the thyroid has been removed, the body no longer produces its own thyroid hormones. However, these can now be easily controlled with medication. Regular blood tests are strongly recommended. Follow-up care should initially be carried out closely and will have increasingly longer intervals as the disease progresses.
