Thyroid cancer: When to remove the entire thyroid

This is an automatically translated article.

Thyroid cancer is one of the most common diseases of the head, face and neck in both men and women. The disease often has no obvious signs, so it silently metastasizes to many other parts, when the disease is detected at a late stage.

1. What is thyroid cancer?

Thyroid gland is an endocrine gland, located in the neck trachea, has 2 lobes right and left, connected by a thyroid isthmus. The pyramidal lobe is the triangular portion of the thyroid gland that extends from the superior isthmus.
Thyroid cancer occurs when normal cells in the thyroid gland change into abnormal cells and grow out of control.
In Vietnam, thyroid cancer ranks 6th among cancers in women with an age-related incidence of 5.6/10,000 population in women, 1.8/100,000 population in men.
Thyroid cancer has many different types but the most common are papillary, medullary, and undifferentiated thyroid cancers, in which medullary and undifferentiated have a worse prognosis. However, thyroid cancer, especially the differentiated type, is a cancer with a very good prognosis.

2. Causes of Thyroid Cancer

Some factors are diagnosed as the cause of thyroid cancer such as:
Immune system disorders: When the immune system is disturbed, there is an opportunity for harmful bacteria and viruses to attack on body, including the thyroid gland. Radiation contamination: The body can be contaminated with radiation from the outside when using radiation to treat diseases or infected inside the body through the digestive tract and respiratory tract due to radioactive iodine. Genetic factors: About 70% of thyroid cancer patients have close family members (father, mother, brother, sister,...) who have had the disease. Age factors, hormone changes: Patients with this disease are mainly in the age group of 30-50 years. Women have a 2-4 times higher risk of thyroid cancer than men due to the effects of pregnancy and childbirth. Thyroid disease: Patients with goiter, basedow disease or hormone Chronic thyroid disease has a higher risk of thyroid cancer than other people. Or those who have had thyroiditis before, even though it has been cured, the risk of recurrence is very high.

3. Signs to recognize thyroid cancer

Through some of the following signs, you can immediately go to a reputable medical facility to check if you are having thyroid cancer:
The appearance of a thyroid tumor with hard characteristics, clear margins, and clear surface The face may be smooth or rough, moving with the rhythm of swallowing. The neck region where lymph nodes appear are usually small, tender, mobile, and on the same side as the tumor. Large, solid tumor, fixed in front of the neck. Hoarseness, possibly difficulty breathing. Difficulty swallowing, entangled swallowing, due to tumor compression. The skin of the neck may be infiltrated or ulcerated with bleeding. Ultrasound can aid in the diagnosis of thyroid cancer.

4. Thyroid Cancer Treatment

In the treatment of thyroid cancer, surgery plays a key role. Depending on each specific case, appropriate surgery is indicated or accompanied by adjuvant treatment with I131 or external radiation.

4.1 Thyroidectomy

Patients only need to have one of the following factors to be indicated for total thyroidectomy.
Age > 40. Have a history of radiation exposure. Tumor size > 4 cm Anatomical pathology: Undifferentiated, differentiated carcinoma Invasion: Multiple foci in thyroid gland Metastasis in cervical lymph nodes Distant metastasis (lung, bone...) Surgery Total thyroidectomy is contraindicated for patients who are too old and weak, large tumors invade the esophagus, trachea, and are no longer able to remove the entire thyroid gland. Patients with heart failure, severe kidney failure are not able to withstand major surgery.
After surgery: Thyroid cancer patients who need to be monitored may have the following complications:
Temporary vocal cord paralysis: The patient has mild hoarseness, voice changes but still speaks well. Permanent vocal cord paralysis: Due to severing of the retrograde fanatic nerve. Patients speak with severe hoarseness or loss of voice or may have difficulty breathing after extubation. Does not restore voice back to normal. Postoperative hypoparathyroidism: The first postoperative day may appear Tetani due to hypoparathyroidism. Treatment of tetany attack with calcium chloride 1g intravenously. Vitamin D3 should be used immediately after that, usually Rocaltrol is used at a dose of 0.25 mg. If Tetani does not subside, increase dose to 0.5-0.75 mg. The symptoms will gradually subside, the attacks will become less frequent and will go away. Combining Rocaltrol with oral calcium 1000 mg/day will work faster. Other complications: bleeding, difficulty breathing....

4.2 Treatment of I131 (RAI- Radioactive iodine)

Treatment I131 is indicated for the treatment of differentiated thyroid cancer cases with residual disease after surgery, distant metastases and locally invasive cancer cases.

4.3 Hormone replacement therapy

Hormonal replacement therapy is indicated if there is failure of total thyroidectomy or there is widespread metastasis after radical treatment.

4.4 External radiation therapy and chemotherapy

External radiation therapy and chemotherapy are commonly used for undifferentiated thyroid cancer and medullary thyroid cancer, with little value for differentiated thyroid cancer.
Any questions that need to be answered by a specialist doctor as well as customers who need to be examined and treated at Vinmec International General Hospital, please book an appointment on the website for the best service.

In April & May 2021, when there is a need for thyroid cancer examination and treatment at Vinmec Times City International General Hospital, customers will enjoy double incentives:
- Free specialist examination and 50% off Thyroid Cancer Screening Packages such as:
+ Standard Thyroid Screening Package
+ Advanced Thyroid Screening Package
+ Special Thyroid Screening Package
- 50% off cost for customers with only post-examination treatment. The program is limited to the corresponding technique of each hospital and to customers who perform this treatment technique for the first time at Vinmec.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.