Papillary carcinoma of the thyroid is the most common cancer of the thyroid gland.
See also: Thyroid cancer
About 80% of all thyroid cancers diagnosed in the United States are papillary carcinoma type. It is more common in women than in men. It may occur in childhood, but is most often seen in adults around the age of 45.
The cause of this cancer is unknown. A genetic defect may be involved.
Radiation increases the risk of developing thyroid cancer. Exposure may occur from:
Radiation given through a vein (through an IV) during medical tests and treatments does not increase the risk of developing thyroid cancer.
Thyroid cancer usually begins as a small lump (nodule) in the thyroid gland, which is located at the center part of the front of the neck.
While some small lumps may be cancer, most thyroid nodules are harmless and are not cancerous.
Most of the time, there are no other symptoms.
If you have a lump on your thyroid, your doctor will order blood tests and possibly an ultrasound of the thyroid gland.
If the ultrasound shows that the lump is bigger than 1.0 centimeter, a special biopsy called a fine needle aspiration (FNA) will be performed. This test helps determines if the lump is cancerous.
Thyroid function tests are usually normal in patients with thyroid cancer.
There are three types of thyroid cancer treatment:
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 patients should 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 or radioactive iodine, the patient will need to take medication called levothyroxine sodium for the rest of their life. This replaces the hormone that the thyroid would normally make.
Most patients who had thyroid cancer need to a blood test every 6 - 12 months to check thyroid levels. Other follow-up tests that may done after treatment for thyroid cancer include:
The survival rate for papillary thyroid cancer is excellent. More than 95% of adults with such cancer survive at least 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:
Complications include:
Call your health care provider if you have a lump in your neck.
Papillary carcinoma of the thyroid
Ladenson P, Kim M. Thyroid. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 244.
National Comprehensive Cancer Network. NCCN Guidelines in Oncology 2010: Thyroid Cancer. Version 1.2010.
Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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