Papillary Thyroid Carcinoma (Cancer): Symptoms, Causes and Treatment

Overview

Your heart rate, blood pressure, metabolism, and growth are influenced by various hormones released by your thyroid gland. When your thyroid gland fails to function efficiently for several reasons, it causes havoc in your body. One of the reasons for the inefficient functioning of your thyroid gland can be papillary thyroid carcinoma. 

It is one of the most common types of thyroid cancer. Papillary thyroid carcinoma is slow-growing cancer. Your doctors can successfully cure cancer with timely treatment and surgery. 

The blog explains papillary thyroid carcinoma, its causes, symptoms, diagnosis, treatment options, and various types.

What Is Papillary Thyroid Carcinoma?

When you notice lumps on your neck, it may indicate thyroid problems. Mostly, these lumps are harmless and benign. However, it can also be a papillary thyroid carcinoma. 

Papillary thyroid carcinoma is one of the five thyroid cancers affecting adults above the age of 45. Cancer develops in the thyroid’s follicular cells responsible for producing thyroglobulin, a protein. Papillary thyroid cancer typically develops on one lobe of the gland. When papillary thyroid cancer is diagnosed early, doctors have a high success rate of curing your cancer.

What Are The Symptoms Of Papillary Thyroid Carcinoma?

Papillary thyroid carcinoma causes solid or fluid-filled nodules on your thyroid. Usually, this is accidentally detected when your doctor is diagnosing or testing for another health condition. Papillary thyroid carcinoma is asymptomatic, meaning it doesn’t show any symptoms at an early stage. However, as cancer progresses, you may experience the following symptoms:

• Visible lumps that can be felt as well
• Difficulty in  and painful swallowing 
• Food or pills getting stuck in the throat
• Sore throat or constant hoarseness that doesn’t decrease
• Inflammation of the lymph nodes 
• Difficulty breathing, mainly when you are lying down
• In rare cases, you may experience neck, jaw, and ear pain

What are the Causes of Papillary Thyroid Carcinoma?

Experts are continuing to research the cause of papillary thyroid carcinoma as the reason is unknown. It is typically more common among women under 40 than men. However, many experts have found various risk factors for developing papillary thyroid carcinoma, such as the following: 

• Genetic condition: If you suffer from certain rare genetic diseases, including familial adenomatous polyposis (FAP), Gardner syndrome, and Cowden syndrome, your chances of developing papillary thyroid carcinoma are high. Only 5% of the cases are linked to genetic conditions.
• Radiation therapy: If you underwent radiation therapy to treat another type of condition or cancer as a child, it also increases your chances of developing papillary thyroid carcinoma.
• Gender: It is more common among women than men. Experts are unaware of the reason for this. 

What are the different stages of papillary thyroid carcinoma?

Once your doctor diagnoses you with papillary thyroid carcinoma, they will begin the staging process. Staging is a medical term used by doctors to categorize the severity of the disease and the possible treatment required. 

The staging for Papillary Thyroid cancer in patients younger than 55 years is different. The prognosis is outstanding. Experts classify the stages into two groups based on whether cancer has spread to other body parts. 

• Stage 1 (any T, N, M0):  The tumor is any size (any T) and may or may not have metastasized to close-by lymph nodes (any N). The tumor has not spread to other body parts (MO). Here, the tumor is 2 cm or less.
• Stage 2 (any T, N, M1): the tumor is any size (any T) and may or may not have metastasized to close-by lymph nodes (any N). The tumor has spread to other body parts (M1). Here, the tumor is more than 2 cm and not less than 4 cm. 

There are other stages as well:

• Stage 3: In this stage, one of the following applies:

• T3, N0, M0: The tumor size is more than 4cm and has grown slightly outside the thyroid (T3). However, it has not spread to other close by lymph nodes (N0) or spread to other body parts (M0)
• T1 to T3, N1a, M0: The tumor size can be of any size and has developed slightly outside the thyroid gland (T1 to T3). The tumor has also spread to the lymph nodes close to the thyroid gland but not to other lymph nodes or body parts (M0)
• Stage 4A: In this stage, one of the following applies:

• T4a, any N, M0: The tumor size can be any size. It has metastasized to nearby tissues of the neck (T4a). It may or may not have spread to closeby lymph nodes (any N). However, it hasn’t spread to other body parts (M0)
• T1 to T3, N1b, M0: The tumor size can be any size. It has metastasized outside the thyroid gland (T1 to T3). It may have spread to certain lymph nodes in the neck (cervical nodes), lymph nodes in the upper chest (superior mediastinal nodes), or behind the throat (retropharyngeal nodes) (N1b). However, it hasn’t spread to other body parts (M0)

• Stage 4B (T4b, any N, M0): The tumor can be any size. It has metastasized back towards the spin or into closeby large blood vessels (T4b). It may or may not have developed into nearby lymph nodes (any N). However, it has not spread to other body parts (M0). 
• Stage 4C (any T, any N, M1): The tumor can be of any size. It has metastasized outside the thyroid (any T). It may or may not have developed into nearby lymph nodes (any N). However, it has spread to other body parts (M1). 

When to Seek Medical Help?

If you are experiencing symptoms of papillary thyroid carcinoma, you will need to consult a healthcare provider at the earliest. 

Request an appointment at Apollo Hospitals              

What are the Different Types of Papillary Thyroid Cancer?

Papillary thyroid cancer has various subtypes. The most common is the follicular subtype – known as the mixed papillary-follicular variant. Other subtypes are uncommon and grow and spread more quickly. These subtypes include the following:

• Columnar
• Tall cell
• Insular
• Diffuse sclerosis

How Do Doctors Diagnose Papillary Thyroid Carcinoma?

Lumps in the throat could be a sign of papillary thyroid carcinoma. Your doctor may discover lumps during a routine check-up or accidentally find them when diagnosing other health conditions. The following are the different tests performed by your doctor:

1. Physical exam: Your doctor may ask about your symptoms and check your neck for abnormalities.
2. Blood tests: This test helps your doctor check for thyroid hormone levels. However, these tests do not indicate if you have papillary thyroid cancer but can indicate if your thyroid is efficiently functioning. 
3. Ultrasound: The test provides a clear picture of the thyroid, its shape, size, and other features. It also provides vital information that helps your doctor decide whether there is an issue. 
4. Needle biopsy: Your doctor inserts a thin needle to take a sample of the nodule to check if it is cancerous. The procedure is performed if your tumor is bigger than one centimeter. You will only feel a pinch. If the nodule has calcium build-up, numerous blood vessels, or do not have clear borders, those are some red flags that your doctor should look out for. 
5. Other imaging tests: Your doctor may conduct other imaging tests, such as computed tomography (CT scan) or magnetic resonance imaging (MRI).
6. Genetic counseling: Your physician may recommend genetic counseling to check if gene mutation plays a role in your papillary thyroid carcinoma or other tumors. 

What Are The Treatment Options For Papillary Thyroid Carcinoma?

If the nodules are small, your doctor may recommend only regular check-ups to monitor the growth. In such cases, you may not need any treatment. However, the treatment option is based on cancer’s size, location, severity, and if it has spread. The following are various treatment options:

1. Surgery: This is the most common treatment option. You are sedated when your doctor makes an incision on your neck to partially or entirely remove the thyroid or the nearby affected lymph nodes. Follow-up care is vital to ensure that the carcinoma doesn’t return. The partial removal of the thyroid gland is a Hemi thyroidectomy, and the complete removal is a thyroidectomy. If you have your entire thyroid gland removed, you will depend on hormone replacement medications for the remainder of your life. 
2. Radioactive iodine ablation: Surgery may cure cancer in most cases. But in rare circumstances, cancerous nodules remain. You are administered a radioactive iodine pill to eliminate any leftover cancerous thyroid cells. Your doctor may recommend this procedure if your nodules are larger than 4 centimeters, spread to other body parts, and has spread into lymph nodes. Your body will be free from radioactive iodine within a week.
3. External radiation: With state-of-the-art machines, your doctor directs x-ray beams directly on the affected area. Radiation treatment is typically used for other aggressive forms of thyroid cancer. However, it is often used to treat papillary thyroid cancer if it has metastasized to other body parts, and surgery poses certain risks and complications. 
4. Chemotherapy: You will receive chemotherapy medication, orally or intravenously, to kill and stop the progress of cancer cells. Only a handful of thyroid cancer patients need this treatment. 
5. Thyroid hormone therapy: If your thyroid is partially removed, you need hormone replacement medicines to ensure sufficient thyroid hormone levels.
6. Targeted therapy: The medication looks out for particular characteristics in cancer cells, such as gene mutation and protein, to attach to and kill the cells. Targeted therapy may also be combined with other treatments, such as chemotherapy, for better results. Vandetanib, cabozantinib and sorafenib are some of the approved targeted therapy drugs. 

Conclusion

The prognosis is good with papillary thyroid carcinoma. Timely treatment is vital, and the individual should continue attending follow-up check-ups to prevent cancer recurrence. 

Frequently Asked Questions (FAQs): 

What is the survival rate of papillary thyroid carcinoma?

Nearly 90% of adult patients survive 10 to 20 years after treatment. Therefore, the survival rate is excellent.

What are the complications of thyroid surgery?

You may experience the following complications:

1. Infection
2. Accidental removal or damage to the parathyroid glands, responsible for regulating blood calcium levels.
3. Damage to the laryngeal nerve, present behind the thyroid glands, leads to a hoarse and weak voice.