Papillary thyroid cancer is the most common type of thyroid cancer. about 80% of all thyroid cancers fall into this category. papillary ( as well as its buddy, follicular) form in the follicular cells of the thyroid gland. these are the cells that make and store thyroid hormone. as a side note, it is important to mention here that this hormone contains iodine. this explains why RAI works in the treatment of these cancers. the variants of papillary thyroid cancer, which i will mention, but not go into detail about, are as follows: columnar, diffuse sclerosing, follicular variant of papillary( i had this,too), hurthle cell, and tall cell. while papillary cancer is considered slow growing, the variants of papillary thyroid cancer can grow and spread quicker than " just plain" papillary thyroid cancer. this is where it gets a little confusing. the follicular variant of papillary thyroid cancer is different than " just plain" follicular cancer. it is considered to be slower growing than the other papillary thyroid cancer variants. HOWEVER, papillary cancer can certainly spread to the lymph nodes in the neck, as well as to other parts of the body. i have been told by my radiologist, that when thyroid cancer spreads, two of the favored locations in the body are the lungs and bones. this may explain some tests you may receive if you have this type. examples: chest x-rays, cat scans, etc.
people in their twenties to sixties tend to get this type of thyroid cancer. but a person of any age, even a small child, can get thyroid cancer. according to the American Academy of Otolaryngology- head and Neck Surgery, " thyroid cancer is the third most common solid tumor malignancy and the most common endocrine malignancy in children. it occurs four times more in females than in males. " papillary thyroid cancer is the most common kind of thyroid cancer in children, as well as in adults. the signs and characteristics of papillary cancer in children are pretty much the same as in adults.
it is not clear what causes thyroid cancer. some sources state possible exposure to radiation. two things that i have heard mentioned as possible links are : dental x-rays without the proper precautions and x-rays of children's feet for easier shoe fitting ( this was done in the 1950's i think. i did not have that done, by the way). there are several theories, but no one knows of a definitive cause as yet. a FORMER endocrinologist of mine, kept asking me " why do you think you got thyroid cancer?" she made me feel like it was my fault somehow. i only saw this doctor briefly. my current endocrinologist has never asked me this question. since no one can be sure what causes thyroid cancer, all that we can do is to make wise decisions when it comes to our testing and health care.
treatment for papillary thyroid cancer is generally surgery, and possibly RAI ( radioactive iodine) dosing. my treatment was a total thyroidectomy, removal of eleven lymph nodes, removal of two parathyroids, which were also cancerous, and a large dose of the RAI ( 155 milicuries). i received the RAI a couple of months after my surgery. the decision to have RAI therapy or not is generally decided by the radiologist or oncologist after the surgery. my tumors had ruptured and spilled out into my neck area. i had three tumors, two of which were fairly large. some patients do not want the RAI, due to side effects. it is an individual decision, with no " one size fits all" solution. my endocrinologist told me that even the most brilliant surgeon can not get all of the tiny bits of the thyroid cancer cells that have made it out of the tumor into the neck area. i decided to have the RAI since it made the most sense for me. i would make that decision again, by the way, even with the salivary stones issues that i have had. traditional chemotherapy drugs do not work for this cancer, which is another fact to consider when coming up with an individual treatment plan.
papillary cancer is slow growing, yes, but it can spread. depending on the staging, papillary cancer can have an excellent survival rate.( about 90% if diagnosed early ). but, the rate of recurrence is about 30%. and recurrences can occur decades after an initial diagnosis. monitoring- ultrasounds and blood work,usually- will continue for a lifetime. changes in doses of thyroid hormone replacement drugs will also occur. it is not easy to suppress TSH, therefore hopefully preventing recurrence, and at the same time, finding the dose that the patient feels good on. it is a slippery slope, and one that i can attest to.
next blog: follicular thyroid cancer, 101
No comments:
Post a Comment