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Thyroid cancer is a type of tumor that most often has a cure when its treatment is started very early, so it is important to be aware of symptoms that may indicate the development of cancer, especially:
- Lump or lump in the neck, which usually grows quickly;
- Swelling in the neck due to enlarged waters;
- Pain in the front of the throat that can radiate to the ears;
- Hoarseness or other voice changes;
- Difficulty breathing, as if something is stuck in the throat;
- Constant cough that does not accompany a cold or flu;
- Difficulty swallowing or feeling stuck in the throat.
Although this type of cancer is more common after 45 years of age, whenever any of these symptoms appear, the most common being the palpation of a lump or lump in the neck, it is recommended to consult an endocrinologist or head or neck surgeon to have it done. diagnostic tests, identify if there is any problem with the thyroid and start the appropriate treatment.
However, these symptoms can also indicate other less serious problems such as gastroesophageal reflux, respiratory infections, vocal cord problems, and even thyroid cysts or nodules, which are usually benign and do not present any health hazard, and should be investigated, because in most cases, thyroid cancer does not cause symptoms.
See also the signs that may indicate other changes in the thyroid: Thyroid symptoms.
How to diagnose thyroid cancer
To diagnose thyroid cancer it is advisable to go to the endocrinologist to observe the individual's neck and identify changes such as swelling, pain or the presence of a nodule. However, it is also important to perform a blood test to check the amounts of the hormones TSH, T3, T4, thyroglobulin and calcitonin, which when altered may indicate changes in the thyroid.
In addition, it is necessary to do an ultrasound of the thyroid gland and fine needle aspiration (PAAF), to confirm the presence of malignant cells in the gland, which really determines if it is cancer.
People diagnosed with low-risk thyroid cancer usually have normal values on blood tests, which is why it is so important to perform the biopsy whenever the doctor indicates and to be repeated, if this indicates an inconclusive result, or until it is proven that it is of a benign nodule.
Sometimes, the certainty that it is a thyroid cancer only happens after having surgery to remove the nodule that was sent to the analysis laboratory.
What types of thyroid cancer
There are different types of thyroid cancer that vary according to the type of cells that are affected. However the most common include:
- Papillary carcinoma: it is the most common type of thyroid cancer, representing about 80% of cases, it usually develops very slowly, being the easiest type to treat;
- Follicular carcinoma: it is a less frequent type of thyroid cancer than papillary, but it also has a good prognosis, being easy to treat;
- Medullary carcinoma: it is rare, affecting only 3% of cases, being more difficult to treat, with less chance of cure;
- Anaplastic carcinoma: it is very rare, affecting about 1% of cases, but it is very aggressive, almost always fatal.
Papillary or follicular thyroid cancer has a high survival rate, although it can halve when the cancer is diagnosed at a very advanced stage, especially if there are metastases spread throughout the body. Thus, in addition to knowing what type of tumor the person has, they must also know its stage and whether there are metastases or not, because this determines which treatment is best for each case.
How to treat thyroid cancer
The treatment for thyroid cancer depends on the size of the tumor and the main treatment options include surgery, iodotherapy and hormone therapy. In the most severe cases, chemotherapy and radiation therapy may be indicated, but all types of treatment are always indicated by the endocrinologist or head and neck surgeon.
- Surgery: known as thyroidectomy, consists of removing the entire gland, in addition to making the neck empty, to remove the ganglia from the neck that may be affected. Find out how the surgery is done at: Thyroid surgery.
- Hormone replacement: Next, medication should be taken to replace the hormones produced by the thyroid, for life, every day, on an empty stomach. Know what these medications may be;
- Chemo or Radiotherapy: Can be indicated in case of advanced tumor;
- Taking radioactive iodine: About 1 month after thyroid removal, the 2nd treatment step, which is the taking of radioactive iodine, which serves to completely eliminate all thyroid cells and, consequently, all traces of the tumor, should be started. . Learn all about iodotherapy.
Also watch the following video and find out what diet to adopt to perform this treatment:
Chemotherapy and radiotherapy are almost never recommended in the case of thyroid cancer because this type of tumor does not respond well to these treatments.
How is the follow-up after treatment
After treatment to remove a thyroid tumor, tests are needed to assess whether the treatment has completely eliminated the malignant cells and whether hormone replacement is adequate for the person's needs.
The required exams include:
- Scintigraphy or PCI - whole body research: it is an examination where the person takes a medication and then enters a device that generates images of the entire body, in order to find tumor cells or metastases throughout the body. This examination can be done, from 1 to 6 months, after iodotherapy. If malignant cells or metastases are found, the doctor may recommend taking a new radioactive iodine tablet to eliminate any trace of cancer, but usually a single dose of iodotherapy is sufficient.
- Neck ultrasound: It can indicate if there are changes in the neck and cervical nodes;
- Blood tests for TSH and thyroglobulin dosage, every 3, 6 or 12 months, the goal is that your values are <0.4mU / L.
Usually the doctor only asks for 1 or 2 full-body scintigraphy and then the follow-up is done only with ultrasound of the neck and blood tests. Depending on the age, the type and stage of the tumor, and the general state of health that the person has, these tests can be repeated periodically for a period of 10 years, or more, at the medical discretion.
Can thyroid cancer come back?
It is unlikely that a tumor discovered early will be able to spread through the body, with metastases, but the best way to find out if there are malignant cells in the body is to perform the tests that the doctor requests, especially ultrasounds and scintigraphy, and to take some care as if eat well, exercise regularly and have good lifestyle habits.
However, if the tumor is aggressive or if it is discovered at a more advanced stage, there is a possibility that the cancer may appear in other parts of the body, and metastases are more frequent in the bones or lung, for example.