Papillary thyroid cancer is the term used for several forms of cancers that occur in the thyroid gland. Together, these cancers account for roughly 80 percent of all thyroid cancer. They most commonly affect adults between the ages of 30 and 50, with women in this age group accounting for a large majority of cases. Fortunately, papillary thyroid cancer is rarely fatal. Effective options for treatment include surgery, radiation therapy and medication.
Symptoms of Papillary Thyroid Cancer
The most common symptom of papillary thyroid cancer is a lump in the front of the neck. You may also experience hoarseness, as well as swollen lymph nodes and trouble breathing or swallowing. If these symptoms are present, see your doctor as soon as possible. Be aware that these signs may indicate conditions other than cancer, including the presence of benign growths.
Determining the Spread of Cancer
If you are diagnosed with papillary thyroid cancer, your doctor will then determine the extent of its spread. The thyroid gland consists of two lobes joined by a central section known as the isthmus. Cancer may involve one lobe, a lobe and the isthmus, or the entire gland. In over 50 percent of cases, the nearby lymph nodes are also involved. Once the spread of the disease is known, your doctor will proceed with surgery to remove the affected tissue.
Surgery
The choice of appropriate surgical procedure depends partially on the size of the primary tumor. If your tumor is half an inch or smaller in diameter, your doctor may decide to remove only the affected lobe as well as the adjoining isthmus. This is particularly true if your cancer has not spread to your lymph nodes. If your tumor is larger than half an inch, or if your lymph nodes are also affected, your doctor may opt for total removal of your thyroid gland. In many cases, doctors decide to remove the entire gland even if a small tumor is present. However, since total thyroid removal (thyroidectomy) carries considerable risk for damage of healthy tissues, the validity of this approach has come under question. Potential side effects of thyroidectomy include destruction or injury of the nearby parathyroid gland and injury of the nerves associated with the larynx. Consult your doctor for a full explanation of the surgical approach planned in your case.
Radioactive Iodine Treatment
In many cases, surgery is followed by oral doses of radioactive iodine. Once this iodine enters the body, it will be absorbed by any remaining thyroid cells and kill off any cancer that may still be present. The decision to use this therapy will be made based on your doctor's assessment, but you are a likely candidate if your primary tumor was large or if your cancer has spread to your lymph nodes.
Medication
Decreased hormone production is an inevitable side effect of thyroid surgery. In order to counter this effect---and to avoid the possibility of cancerous reactivation of any remaining thyroid tissue---your doctor will prescribe the thyroid hormone medication levothyroxine (Synthroid, Levothroid). In almost all cases, levothyroxine therapy is necessary for life.
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