Staging of thyroid tumor cells or cancer cells

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What is thyroid cancer?

Thyroid cancer is the abnormal growth or multiplication of the thyroid gland’s cells and tissues and the capacity to invade other parts of the body. The thyroid is a gland situated at the bottom of the neck below Adam’s apple. It is a butterfly-shaped gland that produces the hormones Thyroxine, triiodothyronine, and calcitonin. The hormones are directly or indirectly responsible for controlling the body’s metabolism, growth, and energy utilization.

Signs and Symptoms of thyroid cancer:

There are various thyroid cancer symptoms that can appear common or go unnoticed.

• Lump in the neck.
• Swelling of the lymph nodes
• Painful neck and throat
• Hoarseness or change in voice.
• Trouble swallowing
• Trouble breathing
• Constant cough, unrelated to cold.
• Symptoms similar to hyperthyroidism or hypothyroidism may be observed.

There can be more symptoms of thyroid cancer that are not documented yet.

Causes of thyroid cancer:

There are a few factors and thyroid cancer causes:

1.       Environmental factors, like exposure to ionizing radiations, from natural sources, as well as man-made sources. Many nuclear disaster victims were diagnosed with various types of cancer; one of the most prevalent was thyroid cancer.
2.       Genetic mutation in the body, predisposed altered genetic makeup from birth, or familial history of thyroid disorders, can also lead to thyroid cancer symptoms manifestation.
3.       The presence of underlying diseases of the thyroid gland like thyroiditis, hyperthyroidism, etc., can lead to thyroid cancer.  Also, a bowel condition known as familial adenomatous polyposis (FAP) is linked with thyroid cancer symptoms.

Types of thyroid cancer:

Basically, there are five thyroid cancer types.

1. Papillary thyroid cancer: The tumor begins to grow slowly in the follicular cells and manifests as cancer.
2. Follicular thyroid cancer: An aggressive form of papillary thyroid cancer.
3. Hurthle cell cancer: Hurthle cells are present in the thyroid; they stain pink when observed under the microscope. However, due to the accumulation of altered mitochondria in one place of the cell, there is abundant eosinophilic glandular cytoplasm, which causes Hurthle cell cancer.
4. Medullary thyroid cancer: A condition where the tumor grows in parafollicular cells, which produces calcitonin. Increased levels of calcitonin in the blood indicate the sign of medullary thyroid cancer.
5. Anaplastic thyroid cancer: This is the most aggressive form of thyroid cancer. The medication can act poorly, due to which the cells multiply in an uncontrolled manner. This condition is resistant to cancer treatment. The survival chances are less, but this is a very rare type of cancer.

Staging of thyroid tumor cells or cancer cells 

• TX: the tumor is not detected.
• T1: the tumor is smaller than 2cm and bounded to the thyroid gland.
• T2: the tumor is spreading, and it is now up to 4cm in the thyroid area.
• T3: the tumor is more than 4 cm bounded in the thyroid gland
• T4: the tumor is beyond the thyroid region and has become much more extensive.

Types of diagnostics:

•         Physical exam:

During a physical examination, the doctor will check for the presence of thyroid nodules. Thyroid nodules are relatively common, and the presence of one is not immediately associated with cancer. If the thyroid nodules are growing in size and cause physical symptoms like hoarseness of voice, pain in the neck, swollen lymph nodes, etc., the doctor will refer the patient for further tests.

•         Blood tests:

The TSH levels, T4, and T3 levels are checked in the blood test. The presence of thyroid antibodies in serum is also accounted for. These tests assist in differentiating other thyroid diseases like Hashimoto’s thyroiditis from thyroid cancer symptoms.

•         Imaging Tests:

Various imaging tests like MRI, CT scan, PET scan is employed, but ultrasonography is the most widely used imaging test. It is a non-invasive test that helps determine the size, texture, position, and other parameters of the enlarged nodules.

•         Fine Needle Aspiration Cytology (FNAC) or biopsy:

The biopsy of the thyroid tissue is obtained by using a needle and a syringe. The tissue specimen is compared with the Bethesda system to determine whether it is benign or malignant.

•         Radioactive Iodine Uptake Test:

The Iodine-123 radioisotope is used as a radioactive marker agent for the test. If the thyroid nodules take up the iodine normally, and subsequently low TSH levels are found, it is called a hot nodule and is considered non-cancerous. But if the nodule doesn’t take up iodine, then it is called a cold nodule and can be considered benign or malignant.

Thyroid Cancer Treatment

•         Surgical Treatment:

Surgical treatments are done for removing aberrant tissues of the thyroid gland from the body. As surgery is a major procedure, the doctor might recommend you go for surgery only when the tumor is large or spread to the different parts, including the thyroid. Surgeries that are performed on thyroid cancer might remove all the thyroid tissues or some tissues containing tumors. The procedure is commonly referred to as thyroidectomy; it has different subtypes like Hemithyroidectomy, Subtotal thyroidectomy, Partial thyroidectomy, and Hartley Dunhill operation.

•         Radioactive Iodine Therapy:

In radioactive iodine radiation therapy, radioactive iodine doses are given to shrink or kill the tumor cells. In this treatment, nausea, vomiting, and neck swelling may occur as per the given treatment; it can be mild radiation or intense radiation. In radioactive iodine treatment, there is a capsule or liquid taken up by the cancerous cell; thus, there is a low risk of harming other cells. However, this treatment has some side effects such as dry mouth, mouth pain, eye inflammation, fatigue.

•         External radiation therapy:

In external radiation therapy of thyroid cancer, high-energy particles are deployed to destroy the cancerous cell and kill their growth. Here, the machines emit high-energy protons on specific points of the body. The types of thyroid cancers mostly treated with external radiation therapy are medullary thyroid cancer and anaplastic thyroid cancer.

•         Chemotherapy:

Chemotherapy is not the first choice for thyroid cancer treatment; it is only employed when other treatment methods are insufficient. Chemotherapeutic drugs like Dacarbazine, Vincristine, Doxorubicin, Fluorouracil, etc., are used, along with external radiation therapy.

•         Targeted drug therapy:

Target therapy is done with tyrosine kinase inhibitors, thyrotropin hormone, and levothyroxine. These pseudo hormones are given as supplements after the thyroid gland is completely destroyed, or unable to produce thyroid hormones anymore. Other drugs used for thyroid cancer treatment are Cabozantinib, Vandetanib, Lenvatinib, and Trametinib.

•         Alcohol injection:

If the cancer size is very small, alcohol ablation might be the option for treatment. In this procedure, radiologists inject small thyroid cancer tissues with alcohol to ensure precise placement of the syringe.

•         Palliative care:

Palliative care is a specialized treatment that concentrates on providing relief from pain. It offers additional support for ongoing care.

Management

•         Vegetables, whole grains, dried beans, and a limited amount of non-vegetarian foods can keep you safe and healthy; these foods can also be taken during the therapy.
•         Foods that are harmful during the therapy are soy foods, tofu, starchy plants, nuts, seeds, and some vegetables such as cauliflower, cabbage, etc.

FAQ

 

Is thyroid cancer curable?

Most thyroid cancers are curable; however, when the person reaches stage four of anaplastic or Hurthle cell thyroid cancer, the treatments can become ineffective.

Can Ayurveda treat thyroid cancer?

Ayurveda can effectively treat thyroid cancer; however, it shouldn’t be used as a replacement as it cannot complete the standard procedures necessary to remove the malignancy or metastasis of cells. Medicines such as ashwagandha can treat hypoparathyroidism, thyroid problems, etc. However, Ayurveda needs time and depends on the body’s requirements.

Are thyroid diagnosis tests painful?

Imaging tests like Ultrasonography, CT Scan, MRI, etc., are not painful. The same thing can be said about blood tests, physical examination, and Radioiodine marker tests. However, a biopsy can be a bit painful.

How much time is required to obtain the results for thyroid cancer?

The answer depends on what type of test you have done. If it is a physical examination, and you are not suspected of having cancer, you can get your results instantly. But if cancer or some other conditions are suspected, results from tests like imaging tests, biopsy, and blood tests can be produced in 3 days and even 2 weeks.

What is the cost of thyroid cancer treatment?

It depends on what stage of cancer the patient is dealing with. If the cancer is in the earlier stage, the treatment will usually include drug therapy, radiation therapy, and surgery and can take a few weeks. The cost can be between $8,000 to $10,000. But if the cancer is in a later stage, then the treatment can prolong, with the estimated cost between $12,000 to $15,000.