Thanks to medical wonders, average longevity has increased. However, it is not only about the number of years that you live, but the quality of life is also very important. In this journey towards optimal health, certain health concerns often evade our immediate attention. One such condition is papillary thyroid cancer. Let’s understand what it is from Dr Amita Jain who is one of the leading thyroid surgeons in Delhi in the field of laparoscopic surgery.
What is Papillary Thyroid Cancer?
Papillary thyroid cancer, also known as papillary thyroid carcinoma, emerges from the thyroid’s follicular cells responsible for producing thyroglobulin. As the most prevalent form of thyroid cancer, it typically progresses slowly and is often confined to one lobe of the thyroid gland. The thyroid, a butterfly-shaped gland in the neck, is responsible for regulating metabolism through the production of certain hormones.
Types
This type of cancer exhibits various subtypes, with the follicular subtype, also termed the mixed papillary-follicular variant, being the most common. While other subtypes tend to grow and spread more rapidly, papillary thyroid cancer generally develops at a gradual pace.
Other subtypes are:
- Columnar.
- Tall cell.
- Insular.
- Diffuse sclerosis.
The best part is that papillary thyroid cancer can be cured in most patients if detected early.
Causes
What really causes Papillary Thyroid Cancer is yet to be discovered, but scientists have identified the following risk factors:
1. Radiation Exposure: Exposure to ionizing radiation, especially during childhood, is a known risk factor for thyroid cancer. This exposure can come from medical treatments (such as radiation therapy for head and neck cancers), certain diagnostic tests, or nuclear plant disasters.
2. Gender and Age: Papillary thyroid cancer is more commonly found in middle-aged adults. Women and people assigned female at birth (AFAB) are more prone to develop this cancer than men and people assigned male at birth (AMAB). While rare in children, it is the most common pediatric thyroid cancer. Most cases are diagnosed before age 40.
3. Genetics:
a) Familial adenomatous polyposis (Gardner syndrome): Rare inherited condition causing precancerous polyps in the large intestine; increased risk of thyroid tumors due to APC gene mutation.
b) Werner syndrome: Rare condition with accelerated aging; higher predisposition to cancers, especially thyroid cancers; caused by mutations in the WRN gene.
c) Carney complex type 1: Condition linked to an elevated risk of various tumors, including thyroid tumors; PRKAR1A gene mutations are the primary cause.
Only 5% of papillary thyroid cases are associated with these genetic conditions.
What are the Symptoms?
Dr. Jain says symptoms that might occur are:
- Papillary thyroid cancer often manifests as a painless lump or nodule on the thyroid gland in the neck which may enlarge over time.
- As the cancer spreads, it may affect the vocal cords, leading to hoarseness or changes in voice.
- Large thyroid cancers can compress the esophagus, causing difficulty swallowing food or liquids.
- Weakness, fatigue, and unexplained weight loss
Diagnosis and Treatment
- Imaging tests like ultrasound, CT scan, or MRI are used to find and identify thyroid nodules.
- Fine needle aspiration biopsy (FNAB) is a crucial test where a small needle collects tissue from the nodule.
Papillary thyroid cancer (PTC) treatment varies based on tumor size and metastasis (spread of cancer cells). Surgery, the primary approach, involves either removing part (lobectomy) or all (thyroidectomy) of the thyroid, with lymph node removal if necessary. Total thyroidectomy usually proves most effective, but in specific cases, a thyroid lobectomy may be considered. Following total thyroidectomy, lifelong thyroid hormone replacement is essential.
Possible Complications
Thyroidectomy and radioiodine therapy for papillary thyroid cancer may lead to permanent hypothyroidism. Potential complications include infection, inadvertent damage to parathyroid glands causing calcium level issues, and harm to the recurrent laryngeal nerve, resulting in voice problems like hoarseness. Monitoring for these complications is crucial during and after treatment.
Papillary thyroid cancer, despite its prevalence, can be effectively managed through early detection and comprehensive treatment. So, don’t hesitate to consult a doctor when needed.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi