Patient Education - Endocrine Encyclopedia
Endocrine Surgery Encyclopedia
Definition:
Papillary carcinoma of the thyroid is the most common cancer of the thyroid gland.
See also: Thyroid cancer
Alternative Names: Papillary carcinoma of the thyroid
Causes, incidence, and risk factors:
About 75-85% of all thyroid cancers diagnosed in the United States are papillary
carcinoma. It is more common in women than in men. It may occur in childhood, but
is typically seen in people between age 20 and 40.
The cause of this cancer is unknown. A genetic defect may be involved.
High-dose external radiation to the neck increases the risk of developing thyroid
cancer. Papillary thyroid cancer in children has also been linked to atomic bomb
testing in the Marshall Islands and the 1986 Chernobyl nuclear disaster in the Ukraine.
Radiation given by an I.V. during medical tests and treatments does not increase
the risk of developing thyroid cancer.
Symptoms:
Thyroid cancer usually begins as a small bump (nodule) in the thyroid gland. However,
it should be emphasized that most thyroid bumps are harmless and noncancerous (benign).
Signs and tests:
If you have a lump on your thyroid, your doctor will order blood tests and an ultrasound
of the thyroid gland.
If the ultrasound shows that the lump is bigger than 1.0 centimeters, a special
biopsy called a fine needle aspiration (FNA) will be performed. This test determines
if the lump is cancerous or benign.
Thyroid function tests are usually normal in patients with thyroid cancer.
Treatment:
There are three types of thyroid cancer treatment:
- Surgery
- Radioactive iodine
- Medication
Surgery is done to remove as much of the cancer as possible. The bigger the
lump, the more of the thyroid gland must be removed. Frequently, the entire gland
is taken out. After the surgery, most (but not all) patients receive radioactive iodine, which
is usually taken by mouth. This substance kills any remaining thyroid tissue. It
also helps make medical images more clear, so doctors can see if there is any additional
cancer.
If surgery is not an option, external radiation therapy can be useful.
After surgery, the patient will need to take medication called levothyroxine sodium
for the rest of their life. This replaces the hormone that they thyroid would normally
make.
The patient will need a blood test every 3 to 6 months to check thyroid levels,
and an imaging test called a radioactive iodine (I-131) uptake scan once a year.
Support Groups:
Expectations (prognosis):
The survival rate for papillary thyroid cancer is excellent. More than 95% of adults
with such cancer survive 10 years. The prognosis is better for patients younger than
40 and for those with smaller tumors.
The following factors may decrease the survival rate:
- Large tumor
- Age over 40
- Cancer has spread to soft tissue
- Cancer has spread to distant parts of the body
Complications:
Complications include:
- Accidental removal of the parathyroid gland, which helps regulate blood calcium
levels
- Damage to a nerve that controls the vocal cords
- Spreading of cancer to lymph nodes (rare)
- Spreading of cancer to other sites (metastasis)
Calling your health care provider:
Call your health care provider if you have a lump in your neck.
Prevention:
References:
Larsen PR, Kronberg HM, Schlomo M, et al. Williams Textbook of Endocrinology. 10th
ed. St. Louis, MO: WB Saunders; 2003:469-473.
Hemminki K. Familial risks for nonmedullary thyroid cancer. J Clin Endocrinol
Metab. 2005; 90(10): 5747-53.
Kumar V, Abbas AK, Fausto N. Robbins and Cotran Pathologic Basis of Disease. 7th
ed. St. Louis, MO: WB Saunders; 2005:1177-1180.
Review Date: 2/7/2006
Reviewed By: William Matsui, MD, Assistant Professor of Oncology, Division of HematologicMalignancies,
The Sidney Kimmel Comprehensive Cancer Center at JohnsHopkins, Baltimore, MD. Review
provided by VeriMed Healthcare Network.
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