Thyroid cancer (thyroid cancer, thyroid cancer, thyroid cancer). How to recognize thyroid cancer Thyroid cancer printed work

Thyroid cancer is diagnosed in women and men over the age of 40. It is quite rare and accounts for only 1% of the total number of cancers.

Reasons for origin

Among the predisposing factors that have a direct impact on the occurrence of the pathological process, experts include:

Consequences of the Chernobyl accident;

Chronic inflammatory processes in the thyroid gland;

Long-term use of radiation therapy in the neck and head;

Professional activities related to ionizing radiation, heavy metals or performing professional duties in hot shops;

Smoking;

Constant stress, which reduces the body's immune response.

Hereditary predisposition

Long-term clinical studies have revealed that the human body contains a gene responsible for the development of thyroid pathology. It is inherited and the likelihood of developing cancer increases significantly in families where cases of low-quality thyroid tumors have already been identified. Hereditary forms of cancer occur in 20-30% of patients who seek help.

Classification of the international TNM system

Modern specialists use this classification to determine the stage of development of the pathological process:

T0 - at the time of surgery there are no signs of a tumor in the gland;

T1 - the diameter of the tumor does not exceed 2 cm and it does not grow into the capsule of the thyroid gland;

T2 - the size of the neoplasm is more than 2, but less than 4 cm and does not grow into the capsule of the thyroid gland;

T4 - when the diameter of the neoplasm is more than 4 cm, the tumor does not grow into the wall of the capsule, or when the size is less than 4 cm, areas of growth into the capsule of the thyroid gland are noted;

T4A - regardless of the diameter, specialists identify areas of invasion of affected tissue into the capsule, subcutaneous tissue, larynx, recurrent laryngeal nerve, trachea or esophagus;

T4B is a tumor with invasion of the retrosternal vessels, as well as the carotid artery or prevertebral fascia.

Based on the presence of thyroid metastases in the regional lymph nodes, they are classified as:

Nx - it is impossible to differentiate the presence in the cervical lymph nodes;

N0 - absent in the study of regional lymph nodes;

N1 - identified during research in regional nodes.

Based on the presence of distant metastases, they are classified as:

Mх - it is impossible to assess their presence;

M0 - the study revealed their absence;

M1 - as a result of the examination, the presence of distant metastases was established.

Diagnostics

For the most complete diagnosis, specialists use high-precision equipment and modern research methods. These include:

Ultrasound of the thyroid gland, which reveals the heterogeneous structure of the organ and the presence of nodules;

Fine needle or open biopsy. With its help, specialists obtain material for histological examination;

Laboratory blood testing to evaluate its biochemical composition;

A blood test aimed at determining hormonal levels;

A blood test to conduct a study to determine tumor markers.

Treatment methods

After the examination, the specialist prescribes a comprehensive treatment aimed at adjusting hormonal levels, slowing down the growth of the tumor or its surgical elimination. The choice directly depends on the stage of development of the disease, the activity of the pathological process, the presence of metastases, as well as the general condition of the patient.

The most common and effective methods include surgical removal of an organ or part of it, as well as the use of chemotherapy, radiation therapy and hormonal drugs to maintain the body.

Surgery using Gamma Knife

This modern method of performing operations is characterized by minimal tissue trauma and good results. This technique is based on removing the affected part of the thyroid gland without damaging healthy tissue, which characterizes this method of surgical intervention as minimally invasive and gentle.

Chemotherapy

It is based on the ability of thyroid tissue to absorb iodine. After degeneration, the cells of a low-quality tumor still actively absorb and accumulate iodine. The use of cytotoxic drugs allows for a targeted effect on the affected cells and does not harm healthy tissues. Individual selection of dosage allows you to reduce the negative effects of chemotherapy on the body and get the maximum effect from the treatment.

Radiation therapy

It is based on a violation of the DNA structure of the degenerated cell, which leads to its destruction. Experts have also proven that radiation therapy not only helps to reduce the manifestation of the disease and alleviate the patient’s condition, but also prevents further division of pathological tissue.

Based on the examination results, the doctor makes a choice either in favor of external irradiation or gives preference to radioiodine therapy. The first method is used in the presence of metastases, as well as aggressive forms of the disease. And the second is used to treat the initial stages of thyroid cancer and as part of complex therapy.

Hormone therapy

Individual selection of the dosage of medications helps maintain hormone balance and ensures a normal lifestyle for patients suffering from thyroid cancer. The main objective of the method is to maintain an optimal level of thyroid-stimulating hormone (TSH), which helps prevent the development of concomitant diseases, complications after treatment and various abnormalities in the functioning of internal organs.

Radiosurgery

Allows you to suppress the development of metastases localized in the brain and spinal cord using modern treatment methods, called CyberKnife. The technique belongs to the category of minimally invasive and is characterized by lasting results and high efficiency.

Rehabilitation

The opportunity to spend the rehabilitation period in a modern clinic equipped with high-precision equipment and qualified personnel significantly speeds up the body’s recovery process. Specialists will help you overcome the unpleasant consequences of treatment, and will also select medications for further use. Diet, moderate physical activity and procedures will strengthen the body’s immune system, normalize hormonal levels, and a psychologist will help cope with the emotional side of the problem.

The incidence of thyroid cancer, according to various authors, varies widely from 1 to 23% of all diseases of this organ. It is more often observed in women - 3.5:1 (9:1) at the age of 40-60 years. Improved diagnostics and greater familiarity of doctors with the clinical picture of the disease have led to a significant increase in the number of observations published in recent years.

Etiology and pathogenesis are not clear. It has been established that in 80-90% of cases, cancer develops against the background of an existing goiter. In goiter-endemic areas, the incidence of thyroid cancer is 10 times higher. Chr. contributes to the development of the disease. inflammatory processes in the gland, the presence of nodular and mixed goiter, TSH stimulation of hyperplastic processes in the gland, X-ray irradiation of the neck area and the use of a therapeutic dose of 131I in childhood and young age, as well as hormonal imbalance in the body (women - pregnancy, lactation, menopause).

There are thyroid cancers primary when the tumor has its starting point in the gland itself, and secondary when a tumor grows into a gland from a neighboring organ.

Depending on the morphological structure, thyroid cancers are divided into differentiated and undifferentiated.

To the first group include papillary, alveolar, follicular cancers and various combinations thereof. These tumors have a relatively favorable course. They occur in relatively young people. Emerging metastases usually develop in the cervical regional lymph nodes.

Differentiated tumors (except papillary) can be treated with radioactive iodine. The function of the gland is often increased. Long-term results are favorable in most patients.

To undifferentiated cancers include solid, squamous, round cell tumors, etc. These tumors are 2 times less common than differentiated ones and have a rapid unfavorable course. Distant metastases occur early in the lung, less often in the bones and liver. Radioactive iodine has no therapeutic effect. Even with combination therapy, outcomes are poor.

Often there are crayfish with a mixed structure, with a predominance of certain cellular elements.

The stages of thyroid cancer are divided according to the TNM system:

T 1 N 0 M 0- the tumor node is located in one lobe of the thyroid gland, does not extend beyond the capsule, there are no metastases to the regional lymph nodes.

To stage T 2 N 0-1 M 0 included tumors that occupy the entire lobe of the gland, have infiltrating growth, grow into the capsule and, as a rule, give regional metastases. In the T3N2M0 stage, the tumor spreads to the entire gland, grows into the capsule and surrounding tissues, and compresses the trachea and recurrent nerves. It is immobile, there are metastases to regional and paratracheal lymph nodes.

IN T 4 N 1-2 M 1 stage, the tumor can be small in size, but give distant metastases (lung, bones, liver). More often, a large tumor grows into the most important organs of the neck: trachea, esophagus, neurovascular bundle, etc.

Clinical picture There are differences between differentiated and undifferentiated thyroid cancer. In patients with differentiated cancer, an almost constant, and sometimes the only complaint is an indication of availability of education on the neck. Most patients experience progressive growth of a previously long-existing goiter. Sometimes develop signs of compression of the neck organs: difficulty swallowing, shortness of breath due to compression of the trachea, attacks of suffocation and excruciating shooting pains in the back of the head, chin, shoulder. The trachea may become so compressed that the patient dies during one of these attacks of suffocation. As the tumor grows into the deep tissues, the recurrent (complete loss of voice) and sympathetic nerves ( Horner's sign- retraction of the eye, drooping of the upper eyelid and constriction of the pupil). General symptoms are also observed: weakness, weight loss, loss of appetite. Most patients in this group are characterized by a long course of the disease. Their cancer develops against the background of nodular goiter. During an objective examination, it is possible to detect larger or smaller single or multiple nodes in both lobes and a total change in the entire gland. Characteristic features are the adherence of the tumor to the surrounding tissues, limitation of its mobility, dense consistency and lumpy surface. Along with very dense areas, soft elastic nodes can often be found. Availability regional metastases- a reliable sign of cancer. Often in these patients it is determined anemia, accelerated ESR, increased or normal gland function.

At undifferentiated cancer the tumor usually occupies the entire gland, the consistency is very dense, the surface is lumpy, and the mobility of the gland is sharply limited. Distant metastases in other organs are detected early. Often these patients experience anemia and accelerated ROE. Gland function is normal or reduced.

In children Thyroid cancer has a relatively favorable slow course. They often have highly differentiated tumors - papillary cancer. At the same time, regional cervical lymph nodes are widely involved in the tumor process. The latter can even come to the fore when the tumor is in the gland and is small.

A distinctive feature of thyroid cancer in patients at a young age is a predisposition to metastases through the lymphatic tract. In older patients, tumors acquire the ability to invade surrounding organs of the neck. The prognosis for thyroid cancer in children is relatively favorable.

In elderly patients, thyroid cancer is more common than in children. Characterized by the severity of general symptoms and rapid progression of the disease. High-grade forms of cancer are common.

The diagnosis of thyroid cancer is established mainly on the basis of an analysis of the clinical course of the disease, data from a manual examination of the neck, a study of the histological structure of the tumor or secondary formations, gammatopographic data, among which the study of the nature of the distribution of I 131 in the gland is of particular importance, as well as x-ray examination of the larynx and initial trachea department.

Differential diagnosis should be carried out with hr. thyroiditis, nodular goiter. In cancer, a tumor develops in one of the lobes. There is no uniform, diffuse enlargement of the gland, as with Hashimoto's thyroiditis. Cancer can grow into surrounding tissues and give regional metastases, which is not observed with autoimmune thyroiditis. The use of prednisolone for cancer, unlike autoimmune thyroiditis, is not effective. Unlike a nodular goiter, a cancerous nodule is very dense, lumpy, quickly grows or invades surrounding tissue. In addition, tuberculosis and syphilitic lesions of the gland should be taken into account. Metastases of thyroid cancer to the lymph nodes should be differentiated from TVS of the cervical lymph glands and lymphogranulomatosis.

Treatment of thyroid cancer must be comprehensive. It includes radical surgery as the main method of treatment, radiation, hormonal therapy and cytostatic chemotherapy. The scope of the operation must be individual. For stage 1-2 thyroid cancer, when the infiltration does not spread beyond the capsule and is localized in one lobe, you can limit yourself to removing the latter, the isthmus and suspicious areas of the other lobe.

Extension of the operation with removal of the neck muscles, excision of the jugular vein (if it is involved in the tumor process) and all regional lymph nodes along with subcutaneous fat and thyroidectomy is indicated for stage 3-4 thyroid cancer.

Radiation therapy- a valuable additional treatment method. X-ray and telegamma therapy 60 Co has become widespread. It is advisable to carry out radiotherapy (in a total dose of 2000-3000 rad per course) after surgery, especially in cases where there is no confidence in the ablasticity of the intervention performed. Follicular cancer usually responds to treatment with radioactive iodine. The absolute indication for the use of radioactive iodine is the presence of metastases that can concentrate I 131 if the thyroid gland is removed. Radioiodine therapy is especially indicated for sensitivity to I 131 metastases in the neck or paratracheal space, when radical surgery has failed. Relative indications include incurable tumors, cancer recurrences and cases of refusal of surgery. I 131 is also given to prevent tumor recurrence after radical surgery.

Inhibition of thyroid tumor growth under the influence of thyroidin has been established. This is explained by the inhibition of TSH secretion, as well as the possible inhibitory effect of the hormone on the tumor (up to 2-3 g per day).

It is especially advisable to prescribe hormones after surgery and subsequent massive doses of radiotherapy. When prescribing drugs, it is important to support the body on the verge of developing signs of mild thyrotoxicosis.

In the complex treatment of thyroid cancer when the process has spread and there are distant metastases, chemotherapy is advisable, with regional infusion into the superior thyroid artery having a greater advantage.

Literature:

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2. A.T. Lidsky Symptomatic diagnosis of surgical diseases. M.: Medicine, 1973.- 228 p. Page 38.

3. Private surgery (a guide for doctors) ed. prof. A.A. Vishnevsky and prof. V.S. Levita. Volume 1. M., 1962.- 782 p. Page 484-486.

4. Encyclopedia of a family doctor (in two books). Book 2. K.: Health, 1993.- 670 p. Page 115-117.

5. Robert Hagglin Differential diagnosis of internal diseases. M.: Miklos, 1993.- 794 p. Page 478.

6. Great medical encyclopedia. Volume 27. M.: Soviet Encyclopedia, 1986.- 576 p. Page 527-529.

7. V.V. Potemkin Endocrinology.- M.: Medicine, 1987.- 432 p. pp. 168-174.

8. L.V. Ivanova, A.I. Strashinin. Radiation therapy of inoperable thyroid cancer. - M.: Medicine, 1977. - 28 p. Page 8-10.

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Thyroid cancer is a malignant tumor that develops from the cells of this organ. The disease is considered relatively rare. It accounts for 1% of all malignant tumors and less than 0.5% of deaths. But after the accident at the Chernobyl nuclear power plant, more and more people are noticing alarming signs of the disease.

The peak incidence is between 45 and 60 years of age, but a malignant tumor of the thyroid gland can appear at any age. This form of cancer is also sometimes found in children and adolescents. Moreover, at an early age the tumor behaves more aggressively than in adults.

Women are 2-3 times more likely to become victims of thyroid cancer. But in old age (over 65) men are at greater risk of getting sick than their peers.

The disease most often occurs in regions that have been exposed to radiation and where there is an insufficient amount of iodine in nature. This form of cancer is most common among Caucasians. Residents of Asian, African and South American countries are less likely to suffer from thyroid problems.

Thyroid cancer is a non-aggressive tumor. This tumor may not increase in size for years and not metastasize to other organs. But this is not a reason to ignore a serious illness. Modern diagnostic methods make it possible to detect cancer in the early stages and begin treatment on time. This approach allows you to completely defeat the disease and provide a person with a healthy, full life.

Causes of thyroid cancer

The causes that cause thyroid cancer are not fully established. But doctors name many factors, which can increase the risk of developing the disease tenfold.

1. Radioactive exposure. Studies conducted in areas affected by the Chernobyl accident have proven that after the explosion, the number of cases of thyroid cancer increased 15 times. Also dangerous are radioactive rains that fall after nuclear weapons tests.
2. Radiation therapy to the head and neck area. Long-term exposure to X-rays can cause tumors to appear decades later. Cells of the human body become prone to mutations, active growth and division. These processes ensure the appearance of papillary and follicular forms of tumors.
3. Age over 40 years. Although malignant tumors can appear in children, the risk increases greatly with age. During the aging process, thyroid cells are more likely to experience gene failures.
4. Family predisposition. Scientists have identified a special gene that is inherited and is responsible for the development of thyroid cancer. If it is present in a person, then the probability of a tumor appearing is almost 100%. When doctors discover such a gene, they may suggest preventive surgery to remove the thyroid gland.
5. Occupational hazards. Work with ionizing radiation among medical personnel, workers in hot shops, or activities associated with heavy metals is considered dangerous.
6. Stressful situations. Severe stress, after which a person cannot recover for a long time, and depression undermine the immune system. But it is immune cells that are responsible for destroying cancer.
7. Bad habits. Tobacco smoke contains carcinogens, and alcohol weakens the body's natural defenses against abnormal cells.

The following chronic diseases can contribute to the appearance of thyroid cancer:

1. Diseases of the female genital organs. Chronic diseases of the uterus and ovaries, especially if they are accompanied by hormonal disorders.
2. Tumors of the mammary glands. Benign and malignant neoplasms in the breast in women (especially hormone-dependent).
3. Rectal polyps and colon cancer.
4. Multiple endocrine neoplasia.
5. Multinodular goiter.
6. Benign tumors and nodules of the thyroid gland.

Symptoms and signs of thyroid cancer

The thyroid gland is similar in structure to a butterfly. It lies on the front surface of the neck under the thyroid cartilage and is covered with skin. Thanks to this location, it is clearly visible and can be felt. This makes the examination much easier.

Let's figure out what symptoms should lead you to believe that some changes are happening to the thyroid gland and you need to consult an endocrinologist.

The first sign is the appearance of a small nodule on the thyroid gland. It is noticeable under the skin and looks like a small elevation on one side. At the initial stages, the nodule may be elastic and painless, its mobility is limited. It does not grow into the skin, but rolls under it. Over time, the node becomes denser and increases in size.

Do not panic if you find such a lump on your neck. Many people have nodules, and only 5% of them are cancerous tumors. But if such a lump appears in a child, then the doctor must be immediately informed about it, since there should be no lumps on the thyroid gland until the age of 20.

Another early symptom of thyroid cancer is an enlarged lymph node in the neck. Sometimes this is the only sign of illness.

In the later stages, when the tumor becomes larger, other symptoms appear:

• pain in the neck, which may radiate to the ear;
• difficulty swallowing;
• feeling of a lump in the throat;
• hoarseness of voice;
• cough that is not associated with a cold or allergy;
• shortness of breath and difficulty breathing;
• swelling of the neck veins.

These symptoms are caused by the fact that the tumor has reached a large size and began to compress the surrounding organs: the esophagus, trachea. Metastases in the vocal cords and the recurrent laryngeal nerve, which runs next to the gland, are the cause of voice changes.

Types of thyroid cancer

The thyroid gland is a unique organ. It produces many hormones that regulate metabolic processes in the human body. A variety of cells become the basis for different forms of thyroid cancer.

Papillary thyroid cancer

Such cancerous tumors have many protrusions on their surface that resemble papillae. Because of this, the new growth becomes similar to a fern leaf. Papillary cancer is a highly differentiated tumor. This means that its cells at first glance look like normal thyroid cells.
Papillary cancer is the most common form of the disease - 80% of all cases. This tumor is the most “peaceful” and is characterized by slow growth. It is not prone to metastasize and responds well to treatment.

If you examine the thyroid gland of healthy people under a microscope, then in 10% you can find tiny papillary tumors that do not grow and do not manifest themselves in any way. But in some cases they reach quite large sizes, then treatment is required.

Papillary tumors occur 3 times more often in women than in men. They appear at the age of 30-50 years.
99% of people who undergo therapy live longer than 25 years. Therefore, papillary thyroid cancer is considered to have a favorable prognosis.

Follicular thyroid cancer

In this case, the tumor looks like round vesicles - follicles. Its share in thyroid cancer is 10-15%. It appears more often in older people, especially women.

In one third of cases, the tumor does not grow into blood vessels and surrounding tissues and does not metastasize, which is why it is called minimally invasive. But the remaining 70% of follicular tumors are more aggressive. Cancer spreads not only to blood vessels and lymph nodes, but also to distant organs: bones and lungs. but such metastases respond well to treatment with radioactive iodine.

The prognosis for the course of the disease is favorable, especially in patients under 50 years of age. In older people, the disease can be complicated by numerous metastases.

Medullary thyroid cancer

This is a fairly rare form of cancer. It arises in 5-8% of cases from paraphyllicular cells that produce the hormone calcitonin. It regulates phosphorus and calcium levels, as well as bone growth.

Medullary tumor is more dangerous than previous forms. It can grow through the capsule into the trachea and muscles. The disease is accompanied by hot flashes, a feeling of heat, redness of the face and diarrhea.

Medullary cancer is detected in people over 40-50 years of age. It affects men and women equally. The tendency to such tumors is inherited. But medullary cancer can also appear in a person whose ancestors never suffered from such a disease. This is called the sporadic form.

Medullary thyroid cancer is often accompanied by other disorders of the endocrine glands - multiple endocrine neoplasia. The cells of this tumor do not absorb iodine, unlike other forms of cancer. Therefore, radioactive iodine therapy does not help in this case.

Only surgery can help get rid of medullary cancer. The thyroid gland and cervical lymph nodes will need to be completely removed. Patients over 50 years of age have a poor prognosis.

Anaplastic thyroid cancer

This is the rarest form of the disease, in which atypical cells develop in the gland. They have lost all their functions and can only actively share. The proportion of aplastic tumors is less than 3%.

The tumor appears in people over 65 years of age, and in women more often than in men. The disease is characterized by rapid growth and spread of metastases. Difficult to treat. It has the worst prognosis of all forms of thyroid cancer.

Diagnosis of thyroid cancer

Devices are used to examine the condition of the thyroid gland. Ultrasound. This inexpensive and painless procedure allows you to determine whether the gland is enlarged, whether there are nodules and tumors in it, to find out their size and exact location. But, unfortunately, ultrasound cannot determine whether a nodule is a cancerous tumor. Doctors are most concerned about nodes that poorly reflect the ultrasound wave, have unclear and uneven edges, a heterogeneous structure, and in which blood circulation is well developed.

Fine-needle aspiration puncture biopsy (FNA) helps determine what cells the tumor consists of. Under ultrasound guidance, a thin needle is inserted into the tumor. With its help, the doctor takes a sample of cells for research. This is a very accurate and low-traumatic method.

If the result of a fine-needle biopsy is doubtful, then an open biopsy of the suspicious node is performed. This is a small operation during which the doctor excises a small area of ​​the tumor and does a quick examination of it.

Blood tests

A person needs to donate blood from a vein. In the laboratory, using an enzyme immunoassay, they determine whether there are tumor markers in it. These are special protein-based chemicals. Elevated levels may indicate a certain form of thyroid cancer.

• Calcitonin . An elevated level indicates that a person has medullary thyroid cancer. In people who have already undergone treatment, high concentrations indicate distant metastases. But it is necessary to remember that the amount of the hormone increases during pregnancy, taking hormonal contraceptives, calcium supplements and diseases of the pancreas. The following indicators are considered normal: women - 0.07-12.97 pg/ml, men - 0.68-30.26 pg/ml.
• Thyroglobulin. This is a protein secreted by thyroid cells. The normal level of its content in the blood is 1.4-74.0 ng/ml. An increased level may indicate papillary and follicular thyroid cancer and the presence of metastases.
• BRAF gene. Its level makes it possible to determine the prognosis of the course of the disease in papillary thyroid cancer. Normally it shouldn't be there.
• EGFR. This test detects epidermal growth factor. It is done after the tumor is removed. An increased amount of it in the blood indicates that there is a high probability that the tumor will reappear.
• Antithyroid antibodies in blood serum. High levels of these proteins indicate that a person has an autoimmune thyroid disease (the immune system mistakenly attacks the organ). This often happens with papillary thyroid cancer.
• Proto-oncogene mutationsRET . Identification of changes in genes confirms medullary cancer. Such a study is carried out not only on the sick person, but also on his family members.

In each specific case, the doctor may order several tests to confirm suspicions about the tumor. But it must be remembered that tumor markers do not provide completely reliable information about the disease. There is always a percentage of people who have elevated levels of these substances, but do not have a tumor. There are also patients in whom a tumor is detected, but tumor markers are normal. Therefore, only a biopsy can give the most accurate result.

In order to find out how impaired the function of the thyroid gland is, hormone levels are determined:

• Thyroid-stimulating hormone (TSH). This is a hormone secreted by the pituitary gland that stimulates the development of thyroid cells. It is important to measure its level after cancer treatment. The concentration should not exceed 0.1 mIU/l, otherwise the disease will return.
• Thyroxine (T4). The level of this hormone shows how active the thyroid gland is.
• Triiodothyronine (T3). Biologically active hormone. Its concentration indicates how the gland works.
• Parathyroid hormone (PTG). A substance produced by the parathyroid glands. Its high concentration indicates metastases in medullary cancer.

Stages of cancer

In any oncological disease, there are 4 stages of tumor development. When a doctor determines the stage of cancer, he takes into account: the size of the tumor, its prevalence, the presence of metastases in nearby and distant organs.

Metastasis is a secondary tumor, a new focus of growth. It is formed after cancer cells are carried through the blood or lymph into other organs.

Stage I. A tumor up to 2 cm in size is located in one lobe (half) of the thyroid gland. It does not deform the gland capsule and does not form metastases.
Stage II. A single large tumor that deforms the gland. Many small tumors belong to this stage. Tumors do not grow into the capsule. There may be metastases on the side of the neck where the cancer is located.
Stage III. The tumor grows into the capsule of the thyroid gland. It compresses the trachea and surrounding tissues and fuses with them. Metastases appear in the cervical lymph nodes on both sides of the gland.
Stage IV. The tumor grows deeply into the surrounding tissues, the thyroid gland becomes immobile and greatly increases in size. Metastases are detected in nearby and distant organs.

How do you know that metastases have appeared?

Metastases in thyroid cancer appear most often in lymph nodes neck. In this case, the lymph nodes become enlarged and inflamed. They become dense, less mobile and merge with the skin. This complication does not worsen the prognosis of the disease. In papillary and follicular cancer, metastases are well treated with radioactive iodine.

Metastases to the brain manifested by headaches that are not relieved by analgin. Possible loss of coordination and blurred vision, seizures similar to epileptic ones.

Metastases in bones cause pain and fractures. More often than others, the ribs, bones of the skull, pelvis and spine are affected, and less often the limbs. On X-ray, metastases appear as voids or dark growths.

Liver metastases can cause jaundice, heaviness in the right hypochondrium and digestive disorders. The person cannot tolerate fatty foods or meat. In severe cases, internal bleeding may occur in the form of bloody stools and coffee-ground vomiting.

Metastases to the lungs cause dry cough, difficulty breathing, blood in sputum. There is a feeling of tightness and pain in the chest, severe fatigue.

Metastases to the adrenal glands practically do not show themselves in any way. With severe damage to these glands, the level of sex hormones decreases. Acute adrenal insufficiency may occur. It causes a sharp drop in blood pressure and a blood clotting disorder.

To determine the stage of thyroid cancer and detect metastases, ultrasound, radiography and magnetic resonance imaging, positron emission tomography are used.

Surgery for thyroid cancer

The indication for surgery is suspicion of cancer. If the biopsy confirms that there are cancer cells in the thyroid nodule, then it definitely needs to be removed.

If the tumor is very small, the doctor will suggest removing half of the thyroid gland with the isthmus. This operation is called hemithyroidectomy. The remaining share takes over the production of hormones.

But most doctors believe that the best option is to completely remove the thyroid gland - a thyroidectomy. Only in this case can you be sure that no tumor, even the smallest one, will be missed and cancer will not recur. After all, a second operation on the thyroid gland can cause complications, for example, paresis of the vocal cords.

If the tumor has grown into the surrounding tissue and lymph nodes, they are also removed. This operation is called thyroidectomy and lymph node dissection. The surgeon excises the gland itself, the affected lymph nodes and fatty tissue in this area of ​​the neck.

Operation stages

1. Patient preparation. The operation is scheduled for a specific date. At this point, the person should not have acute infectious diseases or exacerbation of chronic ones. Before the operation, an ultrasound of the thyroid gland is performed. You will also need to take tests: a clinical and biochemical blood test, a general urine test, a blood group, and a “coagulogram”.
2. Consultations with a therapist, surgeon and anesthesiologist. Doctors will determine the scope of the operation and answer all your questions.
3. The patient is given general anesthesia. He is in medicated sleep and does not feel pain. Thyroid operations are not performed under local anesthesia.
4. Carrying out the operation. The procedure lasts about an hour, and if it is necessary to remove lymph nodes, then 2-3 hours. The surgeon removes the gland, restores blood circulation to healthy organs and applies stitches.
5. Postoperative period. The patient is transferred to the ward. The first day you are not allowed to get out of bed - you need strict bed rest. On the first day, a drainage is installed to drain fluid from the operation site. This is a thin silicone tube through which the ichor comes out. The next day it is removed and bandaged. The person is discharged from the department 2-3 days after the operation.

It is very important that the operation is performed by an endocrinologist surgeon who specializes in the treatment of glands. In this case, you can be confident in the successful outcome of the operation and the absence of recurrent tumors and complications.

After surgery, patients are prescribed radionuclide therapy with iodine-131 to ensure the destruction of all malignant cells. Radiation therapy with X-rays is of little help in this case.

After thyroid surgery

Many people are interested in how life changes after removal of thyroid cancer and whether disability occurs. Many studies have shown that almost all patients tolerate surgery well and continue to lead a normal life and work. Women after treatment can become pregnant and give birth to a healthy child.

During the first weeks after surgery, a person may experience neck pain and swelling. These phenomena happen to everyone and go away on their own after 1-2 months. It is enough to properly handle the seams. For the first 3-4 days, while the patient is in the hospital, he is bandaged by a nurse in the dressing room. Before discharge, the doctor tells you in detail how to treat the wound yourself, what medications to take and when to come back to continue treatment.

After tumor removal the following is prescribed:

• Administration of radioactive iodine to destroy possible metastases. Treatment begins 4-5 weeks after surgery.
• Thyroid hormones, which are normally produced in the thyroid gland. You may have to take them for life.
• L-Thyroxine (Levothyroxine) to reduce the production of thyroid-stimulating hormone by the pituitary gland. This hormone stimulates thyroid cells that may have remained after surgery, which means it increases the risk of tumor regrowth. The doctor prescribes the dose of this drug individually, based on the level of titeotropic hormone.
• Mineral supplements with vitamin D and calcium. They are necessary for rapid recovery and proper functioning of organs.

Medical supervision after thyroid surgery

Communication with doctors does not end after surgery to remove a tumor is performed. People are registered at the oncology clinic.

In 3 weeks After the operation, the doctor evaluates its results and prescribes levothyroxine (TSH suppressive therapy).
After 6 weeks A whole body scan is performed with iodine-131. This is necessary to detect residual thyroid cells in the neck or other organs. If such metastases are detected, radioactive iodine is prescribed, which quickly destroys the remaining cancer cells.

After 6 months After the operation, you must come to the clinic for a re-examination. The doctor feels the neck and does an ultrasound.

Every 6 months It is necessary to visit a doctor for a routine examination. The doctor may set a different schedule, depending on the level of hormones and tumor markers.

After 1 year and after 3 years After surgery, all patients undergo a body scan.
Regularly monitor the level of thyroglobulin hormone and antibodies to thyroglobulin. It increases if metastases appear in the body. In this case, the doctor prescribes additional examination and treatment.

Postoperative complications

There is a small percentage of postoperative complications. If the operation was performed in a specialized endocrinology department, then the probability is 1-2%, and if in general, then it increases to 5-10%.
Nonspecific complications, which can occur after any operation. This is bleeding, severe swelling or suppuration of the wound. Doctors can easily treat them with antibiotics. In addition, the probability of their occurrence is less than 1%. These complications arise on the first day after surgery. Therefore, if this did not happen in the hospital, then the danger has passed.

Specific complications occur only after surgery on the thyroid gland. This is damage to the nerves that control the vocal cords and disruption of the parathyroid glands.

The laryngeal recurrent nerves pass very close to the thyroid gland. To avoid damaging them, doctors use high-precision electric instruments. But in some cases, injury cannot be avoided. Hoarseness or loss of voice, coughing occurs. Often this phenomenon is temporary, but sometimes the consequences can last a lifetime.

Hypoparathyroidism occurs when the parathyroid glands malfunction. This condition is associated with a lack of calcium in the body. It manifests itself in muscle pain and muscle cramps in the limbs and face, burning and tingling in the lips and fingertips. To correct the situation you need to take calcium supplements.

Nutrition after thyroid surgery

After surgery to remove a thyroid tumor, you do not need to follow a strict diet. The menu should be varied and satisfy all the needs of the body. Remember, there are many foods that inhibit the growth of tumor cells. Scientists have named the healthiest food for preventing tumors. These are vegetables: different varieties of cabbage, turnips, radishes, radishes. Legumes: soybeans, peas, beans, lentils. And plants of the umbrella family: carrots, parsley, celery, parsnips.

If you include these and other “right” foods in your diet, you can prevent a relapse (recurrence) of the disease.

Squirrels- building material for body cells and the basis of immunity. It is best to get proteins from fish and seafood, cottage cheese, eggs, legumes and soybeans, buckwheat and oatmeal. You can eat lean meats several times a week.

Carbohydrates is a source of energy. After surgery, it is better to limit the amount of sugar and confectionery products. It is better to get carbohydrates from honey, fruits, fresh juices, marshmallows, marmalade, jam. Complex carbohydrates - pectins and fiber are found in vegetables, grain bread, and cereals.

Fats- a necessary component for hormones and cell membranes. Vegetable oils: olive and rapeseed can be a source of the necessary unsaturated fatty acids. It is better to avoid lard, margarine and other animal fats.

The diet should contain a wide variety of vitamins. Most of them are antioxidants and help fight tumors. It is better to get vitamins from fresh fruits and greens. But if this is not possible, then you need to take a vitamin-mineral complex.

Traditional methods of treating thyroid cancer

Traditional methods of treating thyroid cancer are used in two cases.

1. Tinctures and decoctions are drunk before and after surgery, as an addition to the treatment prescribed by the oncologist. During surgical treatment and chemotherapy, you should not take concentrated infusions that contain plant poisons.
2. In the event that official medicine is unable to help a person. For example, surgery cannot be performed. The patient may not survive it due to advanced age, diseases of the cardiovascular or respiratory systems, or because the tumor has grown into vital organs. Then traditional methods help improve the condition and reduce the tumor.

Treatment with herbs is more gentle than with drugs, but takes longer. Therefore, you need to take herbal medicines from 6 months to 5 years. Every six months they take a break for 2 weeks. You should not stop treatment if you notice improvement. Only a full course will ensure health and prevent the disease from returning.

Treatment with traditional methods before surgery

Cleansing the body
To prepare the body for surgery, it is necessary to do a cleansing. Enemas with apple cider vinegar are well suited for this: a tablespoon of vinegar per 2 glasses of water. The first week of enemas is done daily, the second week - every other day, the third - every 2 days, the fourth - once a week. During this period, you need to drink more water and eat plant foods. Drink one tablespoon of flaxseed oil 3 times a day before meals.

Three-ingredient recipe
Wash and dry 1.8 kg lemons, remove the seeds and grind together with the peel in a meat grinder. Prepare a glass of aloe juice. Do not water the plant for a week, then pick it, wash and dry the leaves. Grind and squeeze the juice through cheesecloth. Mix with lemons and add half a glass of honey. Mix the components thoroughly. Store the product in the refrigerator, take 1 tsp. 3 times a day before meals. The course of treatment is 1 month.

Traditional medicine traditionally uses plants that contain a lot of iodine and other useful substances for the treatment of thyroid cancer: common cocklebur, chickweed, common chickweed, tenacious bedstraw, and lesser duckweed. They are used in the form of decoctions prepared in a water bath.

Traditional treatment after surgery

Nut tincture
At the beginning of July, collect 30 walnuts. They need to be chopped together with the green peel. Pour 0.5 liters of vodka and add a glass of honey. Mix the product in a glass container and place in a dark place. Leave for 15-20 days at room temperature. Drink 1 tablespoon of the tincture in the morning on an empty stomach. During one course of treatment you need to drink all the medicine.

Black poplar buds
This remedy helps reduce the production of thyroid-stimulating hormone. 2 tbsp. pour a glass of boiling water over the kidneys, cover and leave for 2 hours. Strain the infusion. Take 1 tbsp. 3-4 times a day before meals.

Plant poisons
Hemlock and celandine contain toxic substances. These substances destroy malignant cells that may remain in the body after surgery. Do not forget that these tinctures should not be taken during radiation therapy or radioactive iodine treatment.

Hemlock tincture You can make it yourself or buy it ready-made at the pharmacy. Scheme for taking the tincture: on the first day, drink 3 drops 3 times a day, on the second day, 6 drops 3 times a day, and on the third day, 9 drops 3 times a day. Gradually increase the dose to 75 drops per day. This treatment lasts 3 months. Then the dose is gradually reduced to 3 drops per day.

Tincture of celandine you'll have to cook it yourself. To do this, the roots of the plant are collected during flowering in May. The roots are dug up, washed and dried on a towel. Grind in a meat grinder and squeeze out the juice through cheesecloth. The resulting liquid is half diluted with vodka. The product must be infused for 2 weeks in a dark place. Take 1 teaspoon 3 times a day.

Treatment of thyroid cancer without surgery

In the event that surgery is contraindicated and only supportive treatment is carried out, it is possible to help a person cope with cancer and improve their general condition.

Djungarian aconite root

You can buy a tincture of this plant or prepare it yourself. To do this, pour 20 grams of root into 200 ml of high-quality vodka. Infuse in a glass container in a dark place.

Take the medicine according to the schedule. The first day, 1 drop 3 times a day before meals. The second day, two drops, the third, three. So by the tenth day the single dose increases to 10 drops or 30 drops throughout the day. From day 11, the dose is reduced by 1 drop. Thus, the course takes 20 days. After this, take a break for 2 weeks and repeat the treatment. You need to take 3 courses in a row.

Remember that the plant contains poisons and strong bioactive substances. Do not exceed the dose! In order to cleanse the body of toxins during treatment, it is recommended to drink an oncological herbal mixture, which can be bought in pharmacies.

What determines the prognosis for thyroid cancer?

The prognosis for thyroid cancer is much more optimistic than for other malignant tumors. For example, in people under 45 years of age with a tumor size of up to 3 cm, there is a complete guarantee of recovery. Older patients with advanced forms of cancer have a less favorable prognosis.

But much depends on the shape of the cancer and the stage of the cancer.

• In people with papillary cancer The five-year survival rate is 95-100%. This means that after treatment all patients remained alive for at least 5 years.
• In people with follicular cancer Stage IV five-year survival rate is 55%. But in less advanced cases this figure also reaches 100%.
• In people with medullary cancer Stage IV, the five-year survival rate is lower - 30%, but in stages I and II, doctors guarantee recovery for 98% of patients.
• At aplastic cancer, the prognosis is worse. Most patients live 6-12 months after diagnosis.

This is due to the rapid growth of such a tumor and the formation of metastases. In addition, such cancer cells are not sensitive to treatment with iodine-131.

But no matter what diagnosis the doctors make, remember that human possibilities are limitless. If you combine your desire to live, the forces of nature and the help of a doctor, then you will cope with even the most severe illness.

This disease is a malignant neoplasm that develops from the tissues of the thyroid gland. Organ tissues consist of three types of cells:

The first 2 groups are responsible for the production of thyroid hormones that are important for humans, such as triiodothyrotine and thyroxine. often develops in differentiated forms:

• very important.
• Follicular.
• Anaplastic is the most dangerous form.
• Medullary.

The first three forms are produced by cells A and B, and the fourth form develops from cells of group C.

Risk factors and prevalence of the disease

At the moment, thyroid cancer is increasingly common in residents of all corners of the planet. Scientists note that, most likely, it is not the incidence rate that is growing, but the number of detected cases, since previously there was too little experience in diagnosing this disease in adults.

Diagnosis of the thyroid gland is carried out using ultrasound and biopsy

Modern equipment makes it possible to diagnose thyroid cancer even when a nodule measuring 4 mm is detected. Such small formations are already capable of affecting lymph nodes with regional metastases and individual metastases - the liver, brain, lungs and skeleton.

But the increase in the percentage of thyroid disease in some regions is associated not only with an increase in diagnostic capabilities. One of the factors of the increase is also disasters at nuclear power plants, which led to massive damage to people by radiation, which provoked the development of mutations in the cells of various organs in the human body and the thyroid gland in particular.

Now the consequences of the tragedies have been eliminated, but the victims still need treatment for this terrible disease.

There is no clear geography of the disease, however, experts note that in areas where there is a deficiency of iodine in the air, there are significantly more patients at risk than in those where this substance is contained in sufficient quantities. This is due to the fact that for the normal functioning of the thyroid gland this component is simply necessary, and if it is lacking from the outside, the gland tries to restore its balance on its own, as a result of which various kinds of dysfunctions arise, even to the point that thyroid cancer develops.

The opinion that the southern climate and sun rays provoke the development of thyroid cancer has no scientific basis or confirmation.

What reasons can cause the disease?

The following factors can cause the development of thyroid cancer:

1. Exposure to ionizing radiation (even a single contact is enough).
2. Presence and untimely treatment of autoimmune thyroid disorders.
3. Hereditary predisposition.

This disease often affects people over 30 years of age, but the development of anaplastic cancer is directly related to age; it usually develops in people over 60 years of age. At the same time, women are more susceptible to developing the disease, since the hormonal levels in their body change several times during their lives and the thyroid gland at this moment is very susceptible to diseases.

There are practically no symptoms of the disease in the early stages.

Methods for diagnosing thyroid cancer

There is currently no more effective initial method than ultrasound examination of an organ for diagnosing the presence of oncological formations in medicine. Cancer is detected in the form of a nodular formation. There are no specific signs that allow an accurate diagnosis of cancer based on ultrasound results. But there are a number of indicators that make it possible to suspect this disease and prescribe a more in-depth study, these include:

1. Fuzzy contours of nodes.
2. Increased blood flow in the node.
3. The presence of a dark node.
4. Presence of microcalcinates.
5. Changes in the position of the lymph nodes near the gland.

If these signs are detected, a fine-needle biopsy is used for further diagnosis. During this study, an endocrinologist can obtain more detailed information about changes in the tissues of the thyroid gland. This procedure makes it possible to accurately identify the presence of:

• Papillary cancer.
• Modular cancer.
• Lymphomas.
• Anaplastic cancer.
• Squamous cell carcinoma.

Follicular cancer of the thyroid gland cannot be detected during a biopsy; it can only be suspected, since the nature of this form of cancer is somewhat different from others.

Thyroid carcinoma in differentiated and anaplastic form does not have specific tumor markers, which makes diagnosis difficult.

An oncometer for detecting medullary cancer is an increase in the hormone calcitone, which is produced by C cells. When a malignant formation of this nature occurs in the blood, the content of this hormone sharply increases (the indicator often exceeds 100 pg/ml).

The first alarm bell is the detection of calcitone levels ranging from 20 to 100 units. In such cases, sodium gluconate is introduced into the body and a study of indicators is carried out before and after the procedure. A comprehensive assessment of all indicators allows the endocrinologist to establish the diagnosis and degree of development of the disease.

Probability of diagnosing thyroid cancer in the early stages

Modern medical knowledge in the field of this issue allows, in many cases, to diagnose thyroid cancer in the early stages, before the metastases begin to penetrate other organs. Detection of the disease at this stage significantly increases the chances of successful treatment, they will help.

A doctor can achieve early diagnosis only if the patient applies in a timely manner. If not everyone can recognize the symptoms at home, then a preventive visit to an endocrinologist can be the key to early diagnosis.

If, upon palpation, the patient himself feels the appearance of a lump on the neck or a bulge, then he should immediately contact a specialized medical institution. For timely diagnosis, it is worth carrying out independent palpation several times a year.

The most common treatment for thyroid cancer is surgery to remove the gland.

There is a high risk of developing cancer in children born into a family with a hereditary predisposition to thyroid cancer. In such cases, a genetic study is carried out and if a high level of likelihood of developing cancer is detected, removal of the gland is recommended. This leads to the need for constant therapy, but sometimes this is the only chance to save life.

Signs of the development of this disease

Quite often, carcinoma does not manifest itself with active symptoms, and the patient does not feel any changes in the body. Also, the difficulty of diagnosis is that symptoms practically do not appear at the level of hormones in the body. Therefore, very often the patient’s diagnosis is simply dumbfounded.

But there are symptoms that should make you wary. The first is the appearance of a nodule on the neck, which is visible externally and felt when palpated. This does not always indicate that thyroid cancer is developing. But 5% of people with such nodes have cancer.

Symptoms of cancer may only appear as an enlarged lymph node in the neck. If the stage of the disease has already crossed the initial stage, then the following accompanying symptoms may appear:

1. Difficulty swallowing.
2. Shortness of breath or occasional difficulty breathing.
3. Hoarseness.
4. There may be pain in the neck area that radiates to the ear.
5. Cough, without other flu-like symptoms.
6. Enlarged veins in the neck.
7. Presence of a feeling of a lump in the throat.

These symptoms are caused by the fact that the formation grows and begins to compress the organs that are nearby. When metastases affect the vocal cords and laryngeal nerve, the voice begins to change, which is no longer restored even after successful treatment.

Thyroid cancer begins to actively manifest itself as the tumor grows

Also, the symptoms of the disease may depend on the type of cancer. For example, medullary cancer has the following symptoms:

• Tides.
• Thyrotoxicosis.
• Strong pressure in the neck area.
• Hypocalcemia.

The symptoms of the disease also depend on the stage of its development; accordingly, the more complex the stage, the more obvious manifestations of the disease. Thyroid cancer can manifest itself in 4 degrees:

1. The tumor is local and has not yet metastasized, there is no deformation of the capsule.
2. The tumor is single and deformation of the capsule has already begun, or there are multiple nodes, but metastases have not yet begun to grow. At this stage, the development of metastases in one part of the lymph nodes may be observed.
3. At this stage, the tumor has already grown into the capsule and begins to compress the surrounding organs. Metastases already affect both sides of the lymph nodes.
4. At the last stage, the malignant tumor has already grown into the surrounding epithelium and metastases have spread significantly.

If left untreated, metastases affect the trachea, lungs and bronchi, resulting in inflammatory processes and corresponding symptoms. That is, weakness, wet cough appears and body temperature rises. You can see the symptoms of cancer in the video below.

What are the prognosis for the development of thyroid cancer?

Modern medical methods make it possible to cure cancer in most cases. Often, of course, this requires removing the gland surgically. But after the operation, the patient can lead a full life without experiencing any special restrictions. The success of surgery depends on the timeliness of the operation.

It has already been proven that the most dangerous form of cancer, anaplastic, is the result of untimely treatment of papillary cancer, which is defined as the least dangerous tumor. Therefore, experts recommend not delaying the operation, but doing it in the early stages. The disease progresses over a period of one to two months. Thyroid cancer detected in advanced stages requires immediate surgical intervention.

To prevent the disease you need to do a genetic test

Papillary cancer has the best prognosis; timely treatment leads to complete recovery, while the duration of therapy is short. Medullary and follicular cancer also has a good treatment prognosis if it is detected early, therapy is carried out by a qualified specialist, and the patient strictly follows the doctor’s recommendations.

Ways to prevent the development of thyroid cancer

There are currently no specific methods that can reliably prevent the development of cancer. Some experts attribute the increase in incidence to the fact that children are often examined with x-rays.

But there are some ways that can reduce the risk factor to a minimum. For example, children born into a family in which several members have suffered from the disease should be sent for a genetic blood test.

“Monastic tea” will help to effectively cure the thyroid gland in a short time and most importantly. This product contains only natural ingredients that have a comprehensive effect on the source of the disease, perfectly relieve inflammation and normalize the production of vital hormones. As a result, all metabolic processes in the body will work correctly. Thanks to the unique composition of Monastic Tea, it is completely safe for health and very pleasant to the taste.

If one of the family members has medullary cancer, the rest need to be regularly examined by a specialist.

If a RET gene mutation is detected during genetic testing even before nodes form, specialists may recommend removal of the organ to prevent the disease. After removal, hormonal therapy is carried out to help replace the function of the thyroid gland.

Thyroid cancer is another form of cancerous malignancy. The disease itself is currently very rare - only about 1% of all malignant tumors. But in the last 10 years, the incidence of this particular disease has increased by 6%. But we hasten to reassure you that many medical minds attribute this growth to the development of early diagnostic tools.

As a rule, people suffer from a tumor of the thyroid gland at a much earlier age than with diseases of other organs. 65% of all patients are under the age of 55, and only 2% are children and adolescents. And the disease itself is not as aggressive as many others; the cancer grows very slowly and may not metastasize for a long time. At the same time, the mortality rate is one of the lowest in oncology – only 0.5%.

But you shouldn’t let the disease get worse – if you turn a blind eye to problems, the result can be disastrous.

Risk factors

Let us highlight the main factors influencing the transformation of cells into cancer cells and further DNA mutations.

• Age and gender– studies have shown that women still get sick more often than men, and even about 3 times, the risk age for women is 45-50 years, for men – 60-70 years. But after 65 years, men noticeably outperform women.
• Iodine deficiency– in places with iodine deficiency in food, people suffer noticeably more often.
• Increased radiation– several areas can be identified at once, but radiation significantly affects the risk of future cancer. Thus, children exposed to radiation in childhood (even on X-rays or computed tomography) suffer in the future more often than those who are not exposed to radiation. At the same time, the risk of occurrence when irradiating adults is noticeably lower. Note that after the Chernobyl explosion, an approximately 10-fold increase in thyroid cancer was recorded. Also, in countries where the influence of radiation is noticeably lower (countries in Africa, Asia, South America), the incidence of this disease is much lower.
• Stress– prolonged stress, smoothly turning into prolonged depression, greatly reduces the immune system, which in turn must fight the emergence of “wrong” cells in the body.
• Heredity– sometimes they notice a predisposition in those who already have a patient in their family. Scientists have even found those same genes, and a mutated cell can be passed on to a child at the moment of conception.
• Bad habits– this is how smoking increases the content of carcinogens in the body, and alcohol again undermines our immunity.

Diseases also affect:

1. Female genital organs.
2. Mammary glands - not only malignant, but also benign.
3. Polyps in the gastrointestinal tract.
4. Endocrine neoplasia.
5. Multinodular goiter.
6. Various thyroid tumors.

Symptoms and signs

The thyroid gland has a butterfly shape and is located on the front surface of the skin, which greatly simplifies its diagnosis - because it can not only be seen, but also palpated well. A new formation on the neck is often visible only on one side, and it is not uncommon for the formation to grow rapidly. Any change in the thyroid gland is a sure signal to contact an endocrinologist.

Other visible signs and symptoms of thyroid cancer that may prompt you to see your doctor:

• Swelling of the neck.
• The appearance of a noticeable “nodule”. Note that if this is detected before the age of 20, it is immediately recommended to consult a doctor. In most cases, these nodules are benign.
• Unpleasant sensations, periodically giving a painful outbreak, in the neck area, can spread all the way to the ears.
• Voice disturbances, hoarseness. Difficulty swallowing. Pain when swallowing produces viscous mucus from the glands, which creates the effect of a “cotton ball in the throat.”
• Enlargement of the lymph nodes bordering the thyroid gland and located on the neck.
• Breathing problems.
• Enlarged veins in the neck area.
• Frequent cough without illness is due to metastases to the lungs.

It is worth remembering that not all of these signs directly indicate cancer. So, if you notice something like this, don’t panic. But it never hurts to see a doctor for prevention!

The development of the disease changes the structure of the gland, and therefore affects the formation of hormones, which can lead to hypothyroidism with symptoms:

• Apathy, lethargy, drowsiness.
• Periodic tingling sensations in the arms and legs.
• Hair loss.
• Breaking the voice into a roughened one.

With follicular cancer, on the contrary, hormones are produced above normal - hyperthyroidism:

• Convulsive processes.
• Increased temperature with a feeling of heat in the body.
• Increased sweating.
• Lack of desire for sleep.
• Accelerated fatigue.
• Weight loss, decreased desire to eat food.

Types

The first three tumors listed are differentiated.

Papillary carcinoma, papillary adenocarcinoma (sometimes confusedly called capillary carcinoma)– 80% of cases. Slow growth, damage to only one lobe. Often spreads to lymph nodes. Low mortality, favorable prognosis.

Follicular carcinoma– 10-15% of cases – In countries with low iodine levels higher – usually does not affect the lymphatic system, but may spread to other parts of the body. The lungs and bones are most often affected. But despite this, treatment also leads to a favorable outcome, although not as often as the previous one.

Medullary carcinoma– 5-8% – Develops from cells that produce the hormone “calcitonin” (controls the level of calcium in the blood). To diagnose this particular type of cancer, an increase in this calcitonin and a special protein of carcinoembryotic antigen can be used as one of the factors. Widespread metastases in the lymph, liver, and lungs. Often appear even before detection. Hence, due to current treatment problems, survival rate is greatly reduced.

Anaplastic cancer- less than 3% - the rarest form, undifferentiated, with this disease the cells completely lose their function, leaving only the ability to divide. Usually appears after 65 years, grows very quickly and metastasizes, the most unfavorable prognosis of all those mentioned above.

Diagnostics

In the early stages it can be detected by self-diagnosis. It is not difficult to detect the first signs - swelling in the neck - it could just be a goiter or any other benign tumor, but there is a risk that without further reaction a cancerous tumor may appear.

In modern medical examinations, ultrasound is often used to diagnose thyroid cancer. It can show the boundaries and presence of a tumor, nodules, but, unfortunately, it cannot diagnose whether the tumor is cancerous or not. Doctors pay special attention to tumors with uneven edges and excellent blood circulation within themselves.

In case of primary suspicion, another technology is used for further pinpoint diagnosis - FNAB - fine-needle aspiration puncture biopsy. The essence of the method is to insert a very thin needle into the tumor and take samples of its cells. Everything is done using ultrasound, and the method itself, despite its relative painlessness, gives accurate readings.

The best method for diagnosing this cancer is a biopsy.

But it happens that a biopsy does not give a 100% result, and then a small operation is performed to take cell samples.

Diagnosis can also be carried out by donating blood for tumor markers:

• Calcitonin– an increase indicates medullary cancer or developed distant metastasis in the body. Calcitonin norms are 0.07-12.97 pg/ml in women, 0.68-30.26 pg/ml in men.
• Thyroglobulin– an increased rate indicates the possibility of the formation of papillary or follicular thyroid cancer. The norm for this analysis lies in the range of 1.4-74.0 ng/ml.
• BRAF– under normal conditions this gene should be absent.
• EGFR– this indicator is measured after surgery to remove tumors; if the indicators are elevated, there is a risk of the disease returning.
• Antithyroid blood antibodies- a sign of papillary cancer, an increase indicates that the immune system for some reason is fighting the thyroid organ itself, and this already indicates something abnormal in the processes of the thyroid gland.
• Proto-oncogene RET– a mutation of this gene indicates medullary cancer; often this gene is tested for all relatives of the patient.

General disturbances in the functioning of the gland are determined through hormone measurements:

• Thyroid-stimulating hormone (TSH).

Do not forget that in case of complications of the disease, research methods atypical for this cancer can also be used: for example, to examine the trachea and esophagus.

To accurately determine the stage of thyroid cancer and make a diagnosis, the following methods are used:

• X-ray.

Differentiated forms up to 45 years

The younger the patient, the lower the likelihood of death.

Stage 1– any size of the thyroid gland, the tumor does not disintegrate, there are no metastases. It may affect nearby lymph nodes.

Stage 2– in continuation of the previous one – gives metastases to distant organs.

Differentiated forms after 45 years

Stage 1– up to 2 cm, no metastases

Stage 2– 2-4 cm, located within the boundaries of the organ, no metastases

Stage 3– more than 4 cm, OR extends beyond the gland, but without metastases in the lymph nodes, OR there are metastases in the nearest lymph nodes without further spread

4 A– any size with distant foci, OR metastases in nearby lymph nodes without distant foci.

4 B– spread of tumor formations deep into the neck, as well as to the spine or into neighboring blood vessels. Metastasis may begin in the lymphatic system.

4 C– metastases in distant organs. The size and extension of the organ does not matter.

Anaplastic forms

The forms are classified as stage 4, the prognosis is unfavorable.

4 A– within the organ, likely to spread to the nearest lymph nodes, distant metastasis is not observed.

4 B– growth of the formation beyond the boundaries of the organ without the formation of distant metastases.

4 C– distant metastases.

Metastases

Finding out that metastases have appeared is not so difficult. Most often, metastases spread to nearby lymph nodes, noticeably increasing their size.

Metastases to the brain may be indicated by severe headaches; in addition, disturbances in coordination of movement, vision, and even the appearance of seizures are possible.

Jaundice, problems with digesting food, intolerance to fatty foods, blood in the stool are signs of a liver problem. A constant cough for no reason and a cold, problems with breathing problems in the form of shortness of breath, the appearance of blood in the sputum - indicate lungs. The ribs, skull, spine hurt, and the x-ray showed voids or strange dark growths in these areas - metastases had caught on the bones.

Treatment

The following methods are used in the treatment of thyroid cancer. In this case, both individual techniques and a set of therapies can be used in cascade application.

• Surgical intervention
• Radioactive iodine
• Radiation therapy
• Hormone therapy
• Targeted or selective therapy
• Less common chemotherapy

Malignant tumors of the thyroid gland are treated with an extremely low mortality rate, but if no metastases have been detected. The main methods are to remove or destroy most of the cancer cells to prevent possible growth and metastasis. In advanced cases, they resort to palliative treatment to reduce the symptoms of cancer - pain and other symptomatic problems.

Surgical treatment

One of the main methods, with the exception of use for anaplastic forms.

Hemithyroidectomy– removal of one lobe of the gland. The method is used for early detection and the process is not very neglected. It can be used as a diagnostic if the biopsy did not give the desired result for taking cell samples. After the operation, there is no need to go on hormones - after all, the second part remains to work.

Thyroidectomy– surgery to remove the entire gland. Total or subtotal - in the latter case, incomplete removal is performed due to tumor growth or the anatomy of the thyroid gland.

After removal, you need to take a hormone - levothyroxine.

When removing, they immediately take in the lymph nodes and tissue of the neck - especially with medullary cancer and anaplastic forms.

Stages of the operation

1. They begin to prepare the patient for the operation - they set a day, perform an ultrasound, collect tests, make sure that on the day of the operation the patient does not have any problems, be it chronic exacerbations or infections.
2. Consultations with the doctors involved in the operation - therapist, anesthesiologist, surgeon.
3. General anesthesia is administered. No local anesthesia.
4. The operation is performed - usually within 1 hour. If there are metastases and it is necessary to remove lymph nodes, the operation can take up to 2-3 hours.
5. After the operation, the patient is transferred to a ward with strict bed rest. On the first day, a drainage is placed to drain the fluid; on subsequent days, a dressing is done. In just 2-3 days the patient can be discharged.

Consequences of the operation

1. Voice problems - from hoarseness to loss
2. Can affect and disrupt the functioning of the parathyroid glands
3. Bruising or bleeding in the neck
4. Infection

After surgery and discharge

The operation does not end everything; you need to continue to monitor the development of the disease and stop it.

After 6 weeks after removal, a study is carried out with Iodine-131 to identify residues, and, if necessary, they proceed to treatment with radioactive iodine.

After 6 months a repeat examination with ultrasound is performed.

According to the decision of the oncologist every six months you need to come for a re-examination.

Control checks also carried out 1 year and 3 years after surgery.

Radioactive iodine

When iodine-131 enters the body, it is deposited in the cells of the thyroid gland. Taking the drug even through the esophagus is subsequently absorbed by the thyroid gland. When gland cells consume radiation in this iodine, they completely disappear (both cancerous and healthy), without damaging other organs.

Used to completely destroy the remains of the removed gland after surgery. It is also effective in combating metastases in lymph nodes and organs. The method significantly increases survival at stage 4.

Iodine is absorbed by the gland with an increased concentration of TSH in the blood. To increase it, before introducing iodine, you can either limit the intake of medications after surgery for a couple of weeks, or introduce the drug Thyrogen - it is administered for 2 days, 1 time per day, and after that you can administer radioactive iodine.

Complications from the received dose are possible:

• Cervical swelling.
• Feeling of dryness in the oropharynx.
• Nausea and vomiting.
• Enlargement of salivary glands.
• The sense of taste changes.
• "Dry eye"

Hormone therapy

The method, as the name implies, involves taking hormonal drugs for the following purposes:

1. Maintaining body function after removal of the thyroid gland.
2. Preventing further growth of cancer cells after surgery.

Complications after taking hormones: arrhythmia, osteoporosis.

Radiation therapy

Point radioactive irradiation of cancer tumors. Usually not used where radioactive iodine would be more effective. Therefore, for thyroid cancer, treatment is used only for anaplastic forms.

If the tumor grows beyond the organ, radiation therapy can help stop the formation of metastases and reduce the risk of cancer recurrence.

Irradiation is usually carried out for several weeks, 5 times a week. Before a course of treatment, doctors carefully make preliminary measurements, calculations for dosage and irradiation area. The session itself takes a few minutes and does not cause pain.

Side effects:

• Burns of adjacent tissues.
• Feeling of dry mouth.
• Change in skin color.

Selective therapy

The use of drugs that only affect cancer cells. With the development of medicine, the precision of drugs increases, and the need for full chemotherapy sometimes disappears.

Medullary cancer

Hormonal therapy and radioactive iodine are ineffective for this type of cancer. It is important to use drugs:

• Vandetanib – cessation of tumor growth within 6 months.
• Cabozantinib – 7 months.

Papillary and follicular cancer

For these types of cancer, other treatments are more effective, and drugs are used more to improve treatment.

List of possible drugs for current use: Sorafenib, Sunitinib, Pazopanib, Vandetanib.

Nutrition

After surgery to remove the thyroid gland, you do not need to adhere to any special diets. We eat everything that is necessary to keep the body in healthy shape, maintaining a balance of proteins, fats and carbohydrates, as well as vitamins (you can drink multivitamin complexes). The most useful foods for preventing the return of cancer were:

• Vegetables: cabbage, radishes, turnips
• Beans: peas, beans, soybeans
• Carrots, parsley

But it is recommended to temporarily avoid eating animal fats, lard and margarine.

Traditional methods

Remember! Not a single folk method of “treatment” can replace a full visit to the doctor. Before using any advice from the Internet, we recommend that you consult a medical institution so as not to provoke the development of a tumor.

We will announce here what people are already using before and after surgery to enhance the healing effect, as well as simply to smooth out unpleasant symptoms.

Cleansing the body

The method is used to prepare for surgery. It is recommended to drink more water and switch to plant foods. Before meals, drink a tablespoon of flaxseed oil. Cleansing will be facilitated by using an enema with apple cider vinegar (a tablespoon of vinegar to two glasses of plain water).

Enema schedule:

• Week 1 - every day.
• Week 2 – every other day.
• Week 3 – in 2 days.
• Week 4 – once a week.

Use before surgery

Use after surgery

The most common tips for use after surgery include:

• Nut tincture
• Poplar buds
• Tinctures of hemlock and celandine

Treatment without surgery

If you simply need to alleviate the condition of the body, but surgery is contraindicated, traditional healers recommend using tincture from the root of Aconite Dzungarian. Since this plant also contains poisons, be careful about the dosage and do not overdo it.

Survival prognosis

Depends on the type of tumor and the stage at which treatment begins. The forecast for five-year survival of patients is presented in the table below; please note that the table also gives forecasts after surgery.

Type of cancer	1 tbsp.	2 tbsp.	3 tbsp.	4 tbsp.
	~100%	~100%	93%	51%
	~100%	~100%	71%	50%
	~100%	98%	81%	28%

With anaplastic forms, survival rate drops sharply to 7%,

Disability

Treatment of such a complex disease cannot occur instantly, and the patient may be partially unable to work. Fortunately, this particular disease is not the most terrible among cancer ones, and the patient will sooner or later fully recover during the rehabilitation process. But the recovery process can take varying amounts of time - from 3 months, and up to 5 years when using complex treatment methods (radiation or chemotherapy).