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Treatment of thyroid cancer (carcinoma) abroad

Thyroid cancer rates as one the highest incidence among all the other tumours of the endocrine system. Illness often arises because of other thyroid gland pathologies and can affect adults as well as children.

 

The most dangerous is anaplastic thyroid cancer.However, it is also a rare form of thyroid cancer. It is often diagnosed late due to its aggressive growth rate, early metastasis and generally has a resistance to treatment. 

 

Causes of Thyroid cancer

Main risk factors of thyroid cancer are: 

  • Female sex
  • Women - age of 40-50, men – age of 60-70
  • Poor genetic background
  • Deficiency of iodine in the body
  • Ionizing radiation (the most significant risk factor in the age of 21 years)

 

Thyroid cancer treatment abroad

 

Background diseases that increase the risk of cancer:

  • Hyperplasia of the thyroid gland
  • Nodular goiter
  • Adenoma and adenomatosis of the thyroid gland
  • Diffuse hyperplasia of the thyroid
  • Inflammatory processes

 

Patients who suffer from thyroid cancer have: 

  • Benign tumours  - 65% of patients
  • chronic thyroiditis - 15% of patients
  • nodular goiter - 10% of patients

 

If a person was diagnosed with nodular goiter, the risk of thyroid cancer during his/her lifetime increases by 6%. If diagnosed with toxic adenoma, it exceeds 8%. Only 15% of all cases arise without any background illness. 

 

Thyroid cancer symptoms

 

Symptoms of Thyroid cancer

Thyroid cancer symptoms are nonspecific. They are also characteristic for benign formations.

 

Main symptoms of the illness are: 

  • Presence of a palpable formation in the neck that grows in size over time. Its growth can be slow or rapid, depending on the histological type of cancer.
  • Swelling in the neck.
  • Hoarseness or changed voice tone quality. Hoarseness does not disappear. It is associated with the germination of the tumour into the larynx.
  • Dysphagia (swallowing malfunction). It is caused by mechanical squeezing of the pharynx and oesophagus.
  • Pain in the front of the neck. Irradiation in the ear is often noted.
  • There is usually difficulty breathing if thyroid cancer sprouts into the trachea.
  • Persistent cough, usually without sputum.

 

Some forms of thyroid cancer are asymptomatic for several years and the size of the tumour can be less than 1 cm for a long time. 20% of patients experience first symptoms of cancer as a result of metastasis into the lymph nodes, lungs or bones. 

 

Thyroid cancer diagnostics

 

Diagnostics of thyroid cancer

Instrumental and laboratory research methods make a basis for the diagnostics. Clinical examination do not confirm alot, since malignant and benign thyroid gland formations are not much different in size and shape.

 

Ultrasound of the thyroid gland reveals what type of formation there is in the thyroid gland. It can be hard (a nodule) or a cavity with fluid (cystic formation). With the help of an ultrasound, a number of nodules can be counted. Ultrasound is also used to control the puncture biopsy procedure.

Fine needle biopsy of the node is carried out with the help of a needle. Several tissue samples are taken for cytological examination. The doctor conducts a biopsy of all nodules with more than 1cm in diameter. Also, all suspicious (according to ultrasound) nodules are investigated. If necessary, a lymph node biopsy is done to identify possible metastases. 

Excisional biopsy is performed under anaesthesia. Main indications are: vague results of cytological examination. A fragment of the thyroid gland is taken with the help of surgery. Then, its histological examination is carried out. If the cancer is detected in the sample, the extent of the operation increases. The diagnostic procedure in this case turns into a fully-fledged surgical operation aimed at removing the thyroid gland, lymph nodes, and, if necessary, other affected tissues. 

Positron-emission tomography is a high-tech research method, available in German hospitals. A method based on the iodine ability to accumulate in the tissues of the malformation. PET evaluates the stage of the pathological process, to detect metastases, to detect the recurrence of cancer in time after treatment. 

 

Additional research methods are:

  • Computed tomography
  • Chest X-ray
  • MRI
  • Laryngoscopy
  • Blood tests for thyroid hormones, TSH, calcitonin
  • Analysis for the carcinoembryonic antigen

 

Thyroid cancer treatment abroad

 

Treatment of thyroid cancer abroad

Surgery is the main treatment for thyroid cancer. Patients can achieve a complete recovery if the cancer is detected at the beginning stages of the illness.To achieve this, is common that  a whole affected organ is removed. Also, a surgeon can also remove the lymph nodes in the neck area. 

 

Other treatment techniques are:

  • Radioiodine therapy. Malignant cells absorb iodine more intensively than normal cells. Therefore, when radioactive iodine is introduced into the patient's body, the tumour is destroyed. The technique is effective for the destruction of metastases of thyroid cancer, as well as those areas of the tumour that cannot be removed surgically.
  • Remote radiation therapy is used for certain types of cancer (medullary, anaplastic), which do not respond to radioiodine therapy. In this case, the tumour or metastases are irradiated remotely. This allows you to destroy the tumour or slow down the growth of thyroid cancer. Radiation therapy is also used to reduce pain in later stages of the disease.
  • Hormonal therapy is prescribed after surgery on the thyroid gland. This is used to replace hormones that are no longer produced in the body, to maintain normal metabolism. Hormonal therapy is prescribed as a life-long treatment. Also hormone therapy slows the growth of the tumour, if it was not completely removed. This is due to the suppression of the formation of thyroid-stimulating hormone (TSH) in the pituitary gland.
  • Chemotherapy is rarely used as it is not effective for thyroid cancer treatment. This is used during the latter disease stages of anaplastic cancer treatment when the other methods don’t bring any results. 

 

 

Thyroid cancer latest treatment methods

 

Thyroid cancer latest treatment methods - Latest treatment methods

The implementation ofnew treatment techniques helps to increase patients’ life-expectancy, to reduce the risk of recurrence and to make the whole process of therapy safer.

 

The latest medical developments of recent years are:

Endoscopic surgeries.  After an open removal of the thyroid gland, a scar remains on the neck, which creates a cosmetic defect. Endoscopic removal of the thyroid gland is used as an alternative method of surgical treatment. Thin instruments are inserted through small incisions in the neck.

 Robot-associated surgeries. In the best German hospitals, endoscopic surgeries are performed to remove the thyroid gland with the help of robotic equipment. This is an improvement of the aesthetic effect, reducing the risk of complications, and shortening the rehabilitation period.

Overcoming resistance to radioiodine therapy. Some types of thyroid cancer do not respond to radioiodine therapy. Currently, new drugs targeted at cells with changes in the BRAF genes are being investigated. As a result of drugs, thyroid cancer cells begin to accumulate radioactive iodine, and the disease becomes susceptible to this type of treatment.

Targeted therapy. Standard chemotherapy has low efficacy for the thyroid cancer. But there are new drugs that are aimed at atypical cells.

 

The following medicines have been already used:

  • Inhibitors of kinases
  • Inhibitors of angiogenesis

 

German university clinics are developing new chemotherapy regimens that could slow down the growth of the tumour and prolong life for patients with anaplastic thyroid cancer.

 

Thyroid cancer prognosis

 

Prognosis for thyroid cancer

Prognosis is relatively favourable for thyroid cancer thanks to considerable progress of an advanced healthcare system. The illness can be detected much earlier and be treated more effectively, especially in the European clinics and in other states with a first class healthcare system. 

The following are the results of  approximate 5-year patients’ survival prognosis. Approximate survival rate doesn’t include mortality from other causes (not associated to the thyroid cancer).

 

 

 

Only anaplastic type of cancer has a negative prognosis and approximate 5 year survival rate of patients’ at the fourth stage is only 7%. 

 

 


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