Follicular carcinomas cancer is the second most common type of thyroid cancer.
Follicular carcinoma is far more aggressive than papillary carcinoma.
This form of thyroid cancer happens in and age group slightly older than the age group targeted by papillary cancer.
Follicular cancer is also less common in children.
Follicular cancer, unlike papillary cancer, happens rarely after radiation therapy.
The life expectancy of a patient suffering from this kind of cancer will depend on how aggressively the cancer has affected the vascular system.
The patient's age will be an important determining factor for prognosis.
Generally, patients over 40 years of age have a more aggressive type of this cancer.
Usually, in this age group, the tumor does not concentrate the iodine as well as in patients belonging to a younger age group.
One of the main characteristics of follicular carcinoma is vascular invasion or invasion of veins and arteries.
Because of this, distant spread (metastasis) of the disease is common.
The disease can spread to the lungs, bone, liver, bladder, skin and even the brain.
In contrast to papillary carcinoma, there is less lymph node involvement.
Characteristics of Follicular Thyroid Cancer
Some medical experts say that if the tumors are small and are not invading other surrounding tissues then simply removing the lobe in the thyroid containing the tumor and the central portion (the isthmus) should be as effective for a cure as removing the entire thyroid.
These experts relate a low rate of clinical tumor recurrence, approximately 5-20%, despite the existence of small amounts of cancerous cells that can be found in up to 88% of the tissues in the opposite lobe of the thyroid gland.
There are also studies indicating an increased risk of hypoparathyroidism.
These studies also show a recurrence of laryngeal nerve injury in patients undergoing total thyroidectomy.
Experts that endorse total thyroidectomy, which is a more aggressive thyroid surgery, state several large studies showing that in skillful hands the recurring nerve injury or permanent hypoparathyroidism are as low as 1%.
These studies have also shown that patients with total thyroidectomy radioiodine therapy and thyroid suppression afterward, have a notably lowered the recurrence rate and the mortality rate when tumors measure more than 1 cm.
Other experts have raised an interesting point.
It has been brought out that all patients with follicular thyroid cancer ought to be treated with a total thyroidectomy.
It has been the experience of many patients that surgeons are only willing to take out all of the thyroid gland on the side of the neck containing the cancer and only a certain amount of the thyroid on the opposite side.
Most will not perform total removal of the entire thyroid gland.
If a patient wanted this, those patients, on most occasions, would be directed to see another surgeon.
The reason for a surgeon declining to remove the entire thyroid is because of the fear of cutting into the vital nerve to the voice box.
Surgeons that don't do this procedure often will usually decline this type of operation.
This type of operation would in fact require significant skill.
You should not let a surgeon remove your thyroid if they do not perform this type of operation frequently! Skill and experience are important since there are more risks involved than just partial removal of infected areas of the thyroid tissue.
It also must be kept in mind that merely examining the cancer under the microscope for indications of cancer can be unreliable in making a accurate diagnosis of follicular cancer just before surgery, especially because such examinations are rather brief.
This problem isn't evident with the other types of thyroid cancer.
Based on available studies and the epidemiology (or methodology and research) of follicular carcinoma, the following is a general treatment plan: Follicular carcinomas that are isolated, not too invasive and less than 1cm in a patient under 40 years of age can be treated with hemithyroidectomy and isthmusthectomy.
All other thyroid cancer types should probably be treated with total removal of the entire gland or thyroidectomy as well as removal of any large lymph nodes in the neck area.
Radioactive Iodine (After Surgery) What makes thyroid cells so unique is there ability to absorb iodine.
The thyroid cells can use iodine to make thyroid hormones.
There are no other cells in the body capable of absorbing or concentrating iodine.
Physicians take advantage of this uniqueness and administer radioactive iodine to patients suffering from thyroid cancer.
There are several types of radioactive iodine; only one type has been proven to be toxic to thyroid cells.
The toxic iodine isotope (I-131) is administered to patients suffering from follicular cancer.
The isotope is absorbed by the thyroid and targets cancer cells for destruction.
Not everyone with follicular thyroid cancer will need this treatment, but those patients that have larger tumors, a spread of disease to lymph nodes or other areas, aggressive tumors that appear microscopic, tumors, which infect blood vessels in the thyroid gland, and older patients can derive benefits from this type of treatment or therapy.
Of course, the therapy still will vary from person to person.
However, it has been proven to be an effective type of "chemotherapy" with only a few possible downsides such as hair loss, weight loss or nausea.
Patients should be off of thyroid replacement therapy and on a low iodine diet one to two weeks before radioactive iodine therapy.
It is usually administered 6 weeks after surgery and can be repeated every 6 months if needed with defined dose limits.
Thyroid Hormone Pills After Thyroid Cancer Surgery Most experts agree that regardless of whether a patient had their thyroid partially removed or completely removed, thyroid hormone supplementation is necessary for the rest of the patient's life.
The purpose of the supplementation is to replace the hormone in those patients who have no longer possess a thyroid gland due to the much needed surgery they had to undergo.
It is also necessary to prevent further growth of the gland in those patients who still possess some thyroid tissue after there surgery, since in their case the removal of the gland was only partial.
There is reliable evidence that follicular carcinoma responds well to thyroid stimulating hormone or TSH that is secreted by the pituitary gland, So, exogenous thyroid hormone is administered which causes a decrease in thyroid stimulating hormone levels and a lowers the momentum of growth for any remaining cancer cells.
It has also been shown that recurrences and mortality rates are lower in patients receiving thyroid supplementation for the purpose of suppression.
Long-Term Follow Up It is advisable for patient to get annual chest x-rays and thyroglobulin levels.
Thyroglobulin is not effective for diagnosing thyroid cancer.
It is however, quite useful in the follow up stages for indications of differentiated or distinct carcinoma assuming that a complete removal of the thyroid gland has been performed.
A high thyroglobulin level may be indicative of a recurrence but your doctor will be able to provide you with an accurate finding.
Follicular carcinoma is far more aggressive than papillary carcinoma.
This form of thyroid cancer happens in and age group slightly older than the age group targeted by papillary cancer.
Follicular cancer is also less common in children.
Follicular cancer, unlike papillary cancer, happens rarely after radiation therapy.
The life expectancy of a patient suffering from this kind of cancer will depend on how aggressively the cancer has affected the vascular system.
The patient's age will be an important determining factor for prognosis.
Generally, patients over 40 years of age have a more aggressive type of this cancer.
Usually, in this age group, the tumor does not concentrate the iodine as well as in patients belonging to a younger age group.
One of the main characteristics of follicular carcinoma is vascular invasion or invasion of veins and arteries.
Because of this, distant spread (metastasis) of the disease is common.
The disease can spread to the lungs, bone, liver, bladder, skin and even the brain.
In contrast to papillary carcinoma, there is less lymph node involvement.
Characteristics of Follicular Thyroid Cancer
- Affects ages 40 through 60
- More prevalent tin females than males by a ratio of 3 to 1
- Prognosis related to the size of tumor.
A smaller tumor yields a better prognosis - Rarely related with radiation exposure
- Rarely affects the lymph nodes
- Known for invading vascular structures such as veins and arteries in the thyroid gland
- Does not usually spread to lymph nodes.
This is more consistent with papillary cancer - Has an overall high cure rate.
The rate decreases with older patients
Some medical experts say that if the tumors are small and are not invading other surrounding tissues then simply removing the lobe in the thyroid containing the tumor and the central portion (the isthmus) should be as effective for a cure as removing the entire thyroid.
These experts relate a low rate of clinical tumor recurrence, approximately 5-20%, despite the existence of small amounts of cancerous cells that can be found in up to 88% of the tissues in the opposite lobe of the thyroid gland.
There are also studies indicating an increased risk of hypoparathyroidism.
These studies also show a recurrence of laryngeal nerve injury in patients undergoing total thyroidectomy.
Experts that endorse total thyroidectomy, which is a more aggressive thyroid surgery, state several large studies showing that in skillful hands the recurring nerve injury or permanent hypoparathyroidism are as low as 1%.
These studies have also shown that patients with total thyroidectomy radioiodine therapy and thyroid suppression afterward, have a notably lowered the recurrence rate and the mortality rate when tumors measure more than 1 cm.
Other experts have raised an interesting point.
It has been brought out that all patients with follicular thyroid cancer ought to be treated with a total thyroidectomy.
It has been the experience of many patients that surgeons are only willing to take out all of the thyroid gland on the side of the neck containing the cancer and only a certain amount of the thyroid on the opposite side.
Most will not perform total removal of the entire thyroid gland.
If a patient wanted this, those patients, on most occasions, would be directed to see another surgeon.
The reason for a surgeon declining to remove the entire thyroid is because of the fear of cutting into the vital nerve to the voice box.
Surgeons that don't do this procedure often will usually decline this type of operation.
This type of operation would in fact require significant skill.
You should not let a surgeon remove your thyroid if they do not perform this type of operation frequently! Skill and experience are important since there are more risks involved than just partial removal of infected areas of the thyroid tissue.
It also must be kept in mind that merely examining the cancer under the microscope for indications of cancer can be unreliable in making a accurate diagnosis of follicular cancer just before surgery, especially because such examinations are rather brief.
This problem isn't evident with the other types of thyroid cancer.
Based on available studies and the epidemiology (or methodology and research) of follicular carcinoma, the following is a general treatment plan: Follicular carcinomas that are isolated, not too invasive and less than 1cm in a patient under 40 years of age can be treated with hemithyroidectomy and isthmusthectomy.
All other thyroid cancer types should probably be treated with total removal of the entire gland or thyroidectomy as well as removal of any large lymph nodes in the neck area.
Radioactive Iodine (After Surgery) What makes thyroid cells so unique is there ability to absorb iodine.
The thyroid cells can use iodine to make thyroid hormones.
There are no other cells in the body capable of absorbing or concentrating iodine.
Physicians take advantage of this uniqueness and administer radioactive iodine to patients suffering from thyroid cancer.
There are several types of radioactive iodine; only one type has been proven to be toxic to thyroid cells.
The toxic iodine isotope (I-131) is administered to patients suffering from follicular cancer.
The isotope is absorbed by the thyroid and targets cancer cells for destruction.
Not everyone with follicular thyroid cancer will need this treatment, but those patients that have larger tumors, a spread of disease to lymph nodes or other areas, aggressive tumors that appear microscopic, tumors, which infect blood vessels in the thyroid gland, and older patients can derive benefits from this type of treatment or therapy.
Of course, the therapy still will vary from person to person.
However, it has been proven to be an effective type of "chemotherapy" with only a few possible downsides such as hair loss, weight loss or nausea.
Patients should be off of thyroid replacement therapy and on a low iodine diet one to two weeks before radioactive iodine therapy.
It is usually administered 6 weeks after surgery and can be repeated every 6 months if needed with defined dose limits.
Thyroid Hormone Pills After Thyroid Cancer Surgery Most experts agree that regardless of whether a patient had their thyroid partially removed or completely removed, thyroid hormone supplementation is necessary for the rest of the patient's life.
The purpose of the supplementation is to replace the hormone in those patients who have no longer possess a thyroid gland due to the much needed surgery they had to undergo.
It is also necessary to prevent further growth of the gland in those patients who still possess some thyroid tissue after there surgery, since in their case the removal of the gland was only partial.
There is reliable evidence that follicular carcinoma responds well to thyroid stimulating hormone or TSH that is secreted by the pituitary gland, So, exogenous thyroid hormone is administered which causes a decrease in thyroid stimulating hormone levels and a lowers the momentum of growth for any remaining cancer cells.
It has also been shown that recurrences and mortality rates are lower in patients receiving thyroid supplementation for the purpose of suppression.
Long-Term Follow Up It is advisable for patient to get annual chest x-rays and thyroglobulin levels.
Thyroglobulin is not effective for diagnosing thyroid cancer.
It is however, quite useful in the follow up stages for indications of differentiated or distinct carcinoma assuming that a complete removal of the thyroid gland has been performed.
A high thyroglobulin level may be indicative of a recurrence but your doctor will be able to provide you with an accurate finding.