Monday, April 8, 2024

Thyroid Cancer Lung Metastasis Symptoms

What About Other Treatments I Hear About

Thyroid Cancer (Papillary, Follicular, Medullary & Anaplastic) | Symptoms, Diagnosis, Treatment

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.

Characteristics Of Papillary Thyroid Cancer

  • Peak onset ages are 30 to 50 years old.

  • Papillary thyroid cancer is more common in females than in males by a 3:1 ratio.

  • The prognosis is directly related to tumor size. Less than 1.5 cm is a good prognosis.

  • The prognosis is also directly related to age. Patients under 55 years of age do much better than patients who are over 55 years of age.

  • The prognosis is directly related to gender. Women have a much better prognosis than do similarly aged men.

  • This cancer accounts for 85% of thyroid cancers due to .

  • In more than 50% of cases, it spreads to lymph nodes of the neck.

  • Distant spread is uncommon.

  • The overall cure rate is very high .Management of Papillary Thyroid Cancer

Considerable controversy exists when discussing the management of well-differentiated thyroid carcinomas both papillary thyroid cancer and even follicular thyroid cancer.

Some experts contend that if these tumors are small and not invading other tissues then simply removing the lobe of the thyroid that harbors the tumor will provide as good a chance of cure as removing the entire thyroid.

These proponents of conservative surgical therapy relate the low rate of clinical tumor recurrence despite the fact that small amounts of tumor cells can be found in up to 88% of the opposite lobe thyroid tissues. They also cite some studies showing an increased risk of and recurrent laryngeal nerve injury in patients undergoing total thyroidectomy .

Different Kinds Of Thyroid Cancer

There are 4 main types of thyroid cancer. They are listed below. Your doctor can tell you more about the kind you have.

  • Papillary thyroid cancer is the most common kind of thyroid cancer. It may also be called differentiated thyroid cancer. This kind tends to grow very slowly and is most often in only one lobe of the thyroid gland. Even though they grow slowly, papillary cancers often spread to the lymph nodes in the neck.
  • Follicular cancer is the next most common type. Its more common in countries where people dont get enough iodine in their diet. These cancers do not tend to spread to lymph nodes, but they can spread to other parts of the body, like the lungs or bones.
  • Medullary cancer is a rare type of thyroid cancer. It starts in a group of thyroid cells called C-cells. C-cells make calcitonin, a hormone that helps control the amount of calcium in the blood.
  • Anaplastic cancer is a rare type of thyroid cancer. It often spreads quickly into the neck and to other parts of the body, and is very hard to treat.

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What Is Papillary Thyroid Cancer

Papillary thyroid cancer begins in the follicular cells in your thyroid that produce thyroglobulin . Its the most common type of thyroid cancer.

Your thyroid is a small, butterfly-shaped gland located at the front of your neck under your skin. Its a part of your endocrine system and controls many of your bodys important functions by producing and releasing certain hormones.

PTC tends to grow very slowly and usually develops in only one lobe of your thyroid gland.

There are several subtypes of papillary thyroid cancers. Of these, the follicular subtype is the most common. Other subtypes of papillary cancer arent as common and tend to grow and spread more quickly. They include:

Papillary thyroid cancer is also called papillary thyroid carcinoma.

How Is Lung Cancer Diagnosed And Treated

Papillary thyroid cancer chest x ray

Lung cancer is usually diagnosed after a visit to your family doctor, who will ask you about your health history, symptoms, and perform a physical exam. You may also take a blood test, or get an X-ray, MRI or CT scan.

If lung cancer is diagnosed, other tests are done to find out how far it has spread through the lungs, lymph nodes, and the rest of the body. This process is called staging.

Screening for lung cancer is another important step that can help detect the condition early. With lung cancer, early detection is vital. The sooner the disease is diagnosed, the greater chances of survival.

“Its unfortunate that there isnt really screening for people who arent smokers yet, but hopefully soon.”Dr. Susanna Cheng

“Its unfortunate that there isnt really screening for people who arent smokers yet, but hopefully soon,” says Cheng.

When it comes to treatment, Cheng believes it’s going in a positive direction.

“In the last 20 years things have transformed significantly. We used to only have chemotherapy, but now it’s based on their pathology and their genetic mutations, which predicts what kind of treatment they get, such as immunotherapy and targeted drugs,” Cheng explains.

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My Short Time As A Lab Rat

Sadly, the next scan found the cancer was progressing. This became my time as an official lab rat.

I signed away my precious bodily fluids, my tissue, and all the data that can be generated about me when I agreed to participate in a clinical trial. Technically this is called

20130918

which is a fancy way of saying its a Phase II, Open-label, study in subjects with BRAF V600E-mutated rare cancers with several histologies to investigate the clinical efficacy and safety of the combination therapy of Dabrafenib and Trametinib. Which is another fancy way of saying Ill be taking pills designed to slow or shrink thyroid cancer tumors that have metastasized to my lungs.

My job was simple, just wash down a couple of pills a day and return over and over and over again to Houston for scans. Just meeting the study criteria was daunting. I had to visit the doc, sign a consent form, do blood work, EKG, chest X-ray, echocardiogram, and then visit skin, heart, eye, and lung doc. The skin doc was the most fun. Two female doctors gave me a thorough going over and when done they asked if they should leave the room while I dressed.

Why bother I said. Youve seen everything there is to see.

And thats just to see if I met the study criteria, which I did, and I then had to fly to Houston every two weeks for checkups, at least for a couple of months, all on my dime.

Why participate in a clinical trial?

Other Reasons That Might Necessitate An Ultrasound

Expert ultrasound may also help confirm a diagnosis of papillary thyroid cancer which has spread to the lymph nodes of the neck. The ultrasonographer will look for multiple changes. Although unskilled observers might believe that size is a major issue, in fact, it is not. High-resolution ultrasound is able to detect a diagnosis of papillary thyroid cancer in the lymph nodes as small as 1-2 mm .

When looking at the lymph nodes in the neck with ultrasound, the following criteria are important considerations in confirming the presence of thyroid cancer:

  • enlarged or cystic lymph nodes

  • changes in the normal architecture of a lymph nodes

  • small calcifications within lymph nodes

  • disorganized or irregular blood flow to the lymph node

  • asymmetric lymph nodes when comparing one side of the neck to the other

In the end, the most important factor will be location, location, location. A diagnosis of papillary thyroid cancer that has spread to neck lymph nodes is quite predictable.

There is one important weakness in relying on ultrasound findingsit cannot distinguish cancerous from inflammatory lymph nodes. Both conditionsenlarged and inflammatory lymph nodesmay appear very similar on ultrasound. Therefore, ultrasound-guided fine needle aspiration biopsy would be a necessary next step to confirm or rule out a diagnosis of papillary thyroid cancer.

The quality of the ultrasound will depend upon four critical and equally important factors. The best quality will be determined by:

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What Are The Possible Side Effects And Complications Of Papillary Thyroid Cancer Treatment

Permanent hypothyroidism is an expected side effect of thyroidectomy and radioiodine therapy. Because of this, youll need to take replacement thyroid hormone medication for the rest of your life if you undergo either or both of these treatments.

Possible complications of thyroid surgery include:

  • Accidental removal of or damage to your parathyroid glands, which help regulate your blood calcium levels.
  • Damage to your recurrent laryngeal nerve, which runs behind your thyroid gland, resulting in hoarseness and a weak voice.

Potential side effects of radioactive iodine therapy include:

What Are The Most Common Sites Of Metastatic Cancer

Thyroid Cancer: Targeted Therapies for Progressing Metastases. Dr. Schweppe. ThyCa Conference

The most common sites for cancers to metastasize include the lungs, liver, bones and brain. Other places include the adrenal gland, lymph nodes, skin and other organs.

Sometimes, a metastasis will be found without a known primary cancer . In this situation, your healthcare provider will search extensively for the primary cancer source. If none can be found, its called cancer of unknown primary .

Read Also: What To Expect After Thyroid Cancer Surgery

Molecular Testing Of Primary Tumors

We screened for known single point mutations in 10 of the 20 patients studied. The remaining patients were not studied because tissue from the original tumors was not available. No mutation was found in any of the genes cited in the Methods section in the 10 patients studied, except that one tumor carried two mutations in the PIK3CA gene . As a control, we concurrently tested tumor samples with known positive and negative mutations, and the results of those tests were consistent with the known mutation status.

Surgical Resection Offers Long

Idit Tessler1,2 MD, MPH, Oded Cohen1,2 MD, Judith Diment2,3 MD, Yonatan Lahav1,2 MD, Doron Halperin1,2 MD, MPH and Taiba Zornitzki2,4 MD

1Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel

2Hadassah School of Medicine, Hebrew University, Jerusalem, Israel

3Department of Pathology, Kaplan Medical Center, Rehovot, Israel

4Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, Rehovot, Israel

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Diagnostic Criteria For Dtc Pulmonary Metastases

Definitive cytological or pathologic confirmation was not possible in all patients therefore, diagnosis of pulmonary metastases was based on clinical and postoperative or follow-up chest CT findings, diagnostic or therapeutic 131I whole-body scan and serum Tg levels. A patient satisfying the following criteria was considered to have pulmonary metastases: i) pathological results confirmed ii) pulmonary 131I uptake on 131I-WBS+pulmonary node on chest CT+elevated serum Tg level iii) pulmonary 131I uptake on 131I-WBS+normal chest CT+elevated serum Tg level or iv) no pulmonary 131I uptake on 131I-WBS+pulmonary nodes on chest CT+elevated serum Tg level.

According to the results of 131I-WBS, pulmonary metastases were classified as 131I-avid and non-131I-avid . According to the chest CT results, patients were divided into three categories: i) included patients with negative chest CT but 131I uptake on 131I-WBS, defined as fine miliaric ii) included patients with micronodular pulmonary metastases, defined radiologically as 1cm in diameter and iii) included patients who had macronodular pulmonary metastases, defined radiologically as > 1cm in diameter. According to the discovery time, pulmonary metastases were defined as initial and developed .

Lung Metastases From Papillary Thyroid Cancer With Persistently Negative Thyroglobulin And Elevated Thyroglobulin Antibody Levels During Radioactive Iodine Treatment And Follow

Image
  • Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

Background: The lung is the most frequent site of distant metastasis from differentiated thyroid cancer . However, lung metastasis from papillary thyroid cancer with persistently negative thyroglobulin and elevated Tg antibody levels is an extremely rare entity, and the prognosis is therefore elusive. We investigated the clinical characteristics, long-term outcomes, and prognostic factors of lung metastases in PTC patients with persistently negative thyroglobulin and elevated Tg antibody levels during radioactive iodine treatment and follow-up.

Methods: We retrospectively reviewed 10,482 patients with DTC who underwent postoperative 131I treatment from 2007 to 2017 at Shanghai Sixth’s People’s Hospital. The relationships between progression-free survival and several variables were assessed by univariate and multivariate analyses using the KaplanMeier method and a Cox proportional hazards model, respectively.

Lung metastases from PTC in patients with persistently negative Tg and elevated TgAb levels had an excellent prognosis and survival rate during 131I treatment and follow-up. The loss of 131I avidity remained the strongest independent predictor of a poor prognosis and survival in these patients.

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How Do I Take Care Of Myself

Being diagnosed with metastatic cancer comes with many challenges. These challenges vary from person to person, but you might:

  • Feel sad, angry or hopeless.
  • Worry that treatment wont work and that your cancer will get worse quickly.
  • Get tired of going to so many appointments and making so many important decisions.
  • Need help with daily routines.
  • Feel frustrated about the cost of your treatment.

Talking with a counselor or social worker can help you cope with these complicated emotions. Managing stress is also an important aspect of self-care. Practice meditation, mindfulness or find other ways to reduce stress and anxiety.

What Are The Signs And Symptoms Of Lung Cancer

In its early stages, lung cancer might not cause any signs or symptoms. As the tumour grows and causes changes in the body, it usually results in coughing and shortness of breath.

However, if you have any of the below signs and symptoms that are linked to lung cancer, it’s important you see a doctor or medical professional as soon as possible:

  • A cough that gets worse or doesn’t go away

  • Shortness of breath

  • Chest pain that you can always feel, and that gets worse with deep breathing or coughing

  • Blood in mucus coughed up from the lungs

  • Hoarseness or other changes to your voice

  • Difficulty swallowing

  • Swollen lymph nodes in the neck or above the collarbone

Cheng notes that she usually sees “cough, infection or pneumonia” as precursors to lung cancer.

However, she reveals that “COVID put a stint in it.”

“Nowadays when someone has has COVID they they can be coughing for weeks and weeks,” she says. “Some cannot really tell what the symptoms are for sometimes, which can make it hard to diagnose at first.”

She adds that cough, shortness of breath , unexplained weight loss, loss of appetite, chest pain, and hoarse voice are other possible warning signs of lung cancer.

“In smokers they may always have a chronic cough but in non-smokers they may never have a cough or develop it over time. Which can delay a lung cancer diagnosis,” adds Cheng.

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What Should I Do If I Have Symptoms Of Metastatic Thyroid Cancer

As with other types of cancer, thyroid cancer that is detected in its early stages is more easily treatable and more likely to lead to a positive outcome and quality of life. If you are experiencing any symptoms associated with thyroid cancer, it is important to consult a physician as soon as possible to receive an accurate diagnosis and treatment plan.

Moffitt Cancer Center offers comprehensive diagnostic, treatment and supportive care services for individuals with thyroid cancer. Whether you have been diagnosed with thyroid cancer or are experiencing metastatic thyroid cancer symptoms, you can find all of the services you need under a single roof at Moffitt.

Call or fill out a new patient registration form online to learn more about thyroid cancer treatment services at Moffitt. We welcome patients with or without a referral.

What Are The Symptoms Of Metastatic Cancer

Metastatic Thyroid Cancer

Some people will have minimal or no symptoms of metastatic cancer. If symptoms are present, theyre based on the location of the metastasis.

Bone metastasis

Bone metastasis may or may not cause pain. The first sign of bone metastasis is bone breakage after a minor injury or no injury. Severe back pain accompanied by leg numbness or difficulty with bowel or bladder control must be evaluated immediately.

Brain metastasis

If a tumor has metastasized to the brain, symptoms may include headache, dizziness, visual problems, speech problems, nausea, difficulty walking or confusion.

Lung metastasis

Cancer symptoms of lung metastasis are usually very vague. This is because they can be similar to symptoms of other health conditions. Warning signs may include a cough , coughing up blood, chest pain or shortness of breath.

Liver metastasis

Liver metastasis can cause pain, weight loss, nausea, loss of appetite, abdominal fluid or jaundice .

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Magnetic Resonance Imaging Scan

MRI scans use radio waves and strong magnets instead of x-rays, therefore there is no radiation exposure. A contrast material called gadolinium is often injected into a vein before the scan to better show details.

MRI of thyroid, neck and chest to evaluate for papillary thyroid cancer.

MRI of a patient with papillary thyroid cancer of the left thyroid lobe. . The arrow points to the thyroid cancer which is more invasive and aggressive than the usual papillary thyroid cancer. This cancer has spread to the overlying muscles.

Like CT scans, MRI scans can be used to look for a diagnosis of papillary thyroid cancer in the thyroid, for cancer that has spread to nearby or distant parts of the body. But ultrasound is usually the first choice for looking at the thyroid and neck structures.

MRI scans are very sensitive to movement and moving during the scanning process produces artifacts that make interpretation difficult. Because people are constantly swallowing and unconsciously moving their voice box and swallowing structures (and therefore their thyroid gland and surrounding lymph nodes, CT of the neck is the preferred cross-sectional study of the neck in patients with a diagnosis of papillary thyroid cancer.

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