Thyroid cancer

Thyroid cancer

Description thyroid cancer

In the beginning it is necessary to define the term cancer. The general public conceives cancer for cancer of any kind, which is not correct. The term cancer should be reserved only for epithelial malignant tumors – cancers.

In this text, we will therefore be understood cancer in their proper meaning. Cancer is the term for carcinomas. For integrity, it is necessary to provide additional malignant (malignant) tumors, which are not so common, but they have to be reckoned with.

One example is the primary lymphoma of the thyroid, which often develops in people with thyroid autoimmunity.

Generally, the thyroid tumors are the most common tumors of the endocrine glands of humans (endocrine glands are endocrine glands when their products, hormones, go into the blood where in nanogram quantities may be at a great distance in the body to cause a specific reaction on the basis of signal transmission – transmission, which results from the interaction of the hormone and its receptor). An example of an endocrine gland is the thyroid gland, then the parathyroid glands, adrenal glands etc.

Malignant tumors of the thyroid are 1,3% of all malignant tumors. Of the total number of people who die as a result of any malignant disease, 0.4% of people who succumb to being a malignant thyroid disease. Malignant Thyroid disease affects twice as often than men.


Risk factors for thyroid cancer

The only precisely known risk factor is exposure to ionizing radiation. To ionizing radiation is more prone man at a younger age, with increasing age is the susceptibility of course lower. It was found that over 7% of people who are exposed to doses 2Gy to the area around the thyroid gland, is vitiated by the emergence of cancer, the most common papillary thyroid carcinoma, as I will explain below.

Another major risk factor is a genetic predisposition or mutations in genes characteristic (in connection with thyroid carcinomas indicates mutations in the RET protooncogene).

One type of thyroid carcinomas, which is based on C-cells, and which is called medullary thyroid carcinoma, is associated with the development of other tumors in the body. These groups form a tumor syndromes called MEN MEN IIa and IIb. MEN abbreviation means multiple endocrine neoplasia. Part of these syndromes is common incidence of cancer: medullary thyroid carcinoma, pheochromocytoma, parathyroid carcinoma and the like.


Prevention of thyroid cancer

No specific prevention of thyroid tumors exist. The only possible prevention is avoiding ionizing radiation, which in certain situations is not realistic.


Signs and symptoms of thyroid cancer

The first sign of cancer of the thyroid is usually fast growing node that is palpable in the thyroid.This node is hard consistency. In some cases it may be fixed to the skin, the other to the base.

If arriving increase in cervical lymph nodes and nadklíčkových is already a sign of advanced tumor.

Rarely may be the first symptoms of the disease symptoms that result from the oppression of the trachea or difficulty swallowing. These symptoms usually appear in advanced stages of the disease.

The tumor can also occur in both lobes of the thyroid suddenly, often metastasizes lymphatic route (lymfatogenně) to the cervical lymph nodes around the germ for pharynx in the thoracic cavity and the like. The blood may metastasize to the lung, bone and liver. Thyroid hormone production is preserved for a long time even when extensive damage to the gland.


Description of individual thyroid tumors

Thyroid contains two main cell types: follicular cells that produces follicles typical of the gland, and so forth. Parafollicular cells (syn .: C-cells), which produce the hormone calcitonin. For both types of cells may develop cancer.

Follicular cell derived differentiated carcinomas, which are divided further papillary carcinoma, follicular and oxyfilní.

As already noted, C-cell carcinoma arises medullary. Cancers can also be mixed and undifferentiated.

The rest consists of lymphomas, teratomas, sarcomas, which represents 5% of all cancers of the thyroid.

In the thyroid gland may also occur secondary bearing (metastases) other tumors, e.g. breast cancer.

Follicular carcinoma may arise from its benign variant, which is a follicular adenoma. Follicular adenoma under a microscope can remind her very malignant variant, especially if it is well-differentiated follicular carcinoma. Noticeable is that follicular carcinoma invades the blood vessels (the cancer tends to spread rather via the blood, which is not entirely typical carcinoma), and further grows through fibrous casing thyroid. This tumor metastasizes to lymph nodes, bones, lung and brain.

Papillary carcinoma is the most common malignant tumor in the thyroid gland, which can also occur in the first decade of life. Very often they are papillary cancer affects women of middle age.Tumor dimensions vary from the smallest to several millimeters (ie. Microcarcinoma which are clinically not show) to the largest, that have more than 10 cm and more.

Oxyfilních carcinoma cells is considered as a variant to their respective differentiated thyroid carcinoma (papillary and thus follicular carcinoma), with which has similar properties.

Medullary carcinoma or carcinoma, which is based on parafollicular thyroid cells constitute 5-10% of all cancers. It can occur in their sporadic form (a sick family member) or familial form (more family members become sick). The familial form may be presented first, one isolated tumor or as part of multiple endocrine neoplasia (see above).

Undifferentiated carcinoma is the worst and most dangerous tumor of the thyroid at all. It occurs in old age (7 to 8 decade). Like medullary carcinoma accounts for about 10% percent of thyroid tumors. This tumor is also called an anaplastic thyroid carcinoma. Very quickly and intensively growing, which creates a huge mass in the neck. It is said that growing before our eyes. Aggressively grows into the surrounding structures. Under the microscope we can distinguish several forms of cancer: small cell, large cell, sarkomatosní and metaplastic. This tumor causes death within two to six months.

The thyroid is an endocrine gland like any well-supplied with blood, so there is quite often develop metastases there. To a thyroid metastatic renal cancer, lung cancer and malignant melanoma and lymphomas.


Treatment of thyroid cancer

Basically, the treatment of malignant thyroid tumors is very complex and has many opportunities to intervene. Above all, it is a surgical procedure, administration of radioiodine, external beam radiation, hormonal therapy, interstitial treatment and chemotherapy.

Surgical treatment usually involves the performance of TTE, which is the total removal of the thyroid gland. The entire gland must be removed if the tumor is located in multiple locations, which may not always be apparent. During surgery to remove and enlarged lymph nodes. If the operating performance of anaplastic carcinoma possible (it is not), it must follow the most radical.

Radioiodine therapy is useful only for tumors that have preserved the ability to accumulate iodine (iodine normal follicular cells accumulate), that are sufficiently differentiated. Radioactive iodine then destroys the thyroid gland. This treatment is used to eliminate residues which may remain after TTE Additional treatment of metastases and sometimes also in tumors that can not operate for some reasons. In this way, it is necessary to destroy the remnants of thyroid within two months of operation.

Hormonal therapy is again effective only in differentiated carcinomas. The mechanism is quite simple. It is used the fact that the substance is L-thyroxine has the ability to suppress production of TSH, a hormone, which strongly stimulates tumor growth. This treatment is administered again after surgery, and in early differentiated carcinomas. Sometimes it may be combined with administration of radioiodine.

External beam radiation is also a very important treatment modality. It has its foundation in tumors that do not store radioactive iodine. Following radical and non-radical surgery, and also is used to treat neoperatibilních tumors and metastases.

When interstitial treatment is applied to tumor tissue sources iridium or radioiodine, which then destroy tumor tissue.

Chemotherapy is used as an adjunct therapy in anaplastic carcinomas and metastases. As monotherapy (treatment with one preparation) proved the best adriamycin. Other applications anthracyclines plus cisplatin.


How can I help myself

Like any oncological disease requires professional help. Possibility of self-help is excluded.


Complications thyroid cancer

The largest complication is secondary enlargement of the tumor, therefore, metastasis to lung,bone, brain.

Further, it may be complications associated with radioiodine: bone marrow, lung fibrosis and infertility.

Other Names: thyroid cancer, thyroid cancer, benign tumor of the thyroid, malignant tumor of the thyroid, follicular carcinoma, medullary carcinoma, papillary carcinoma

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