What are the treatment methods for thyroid cancer?

  Thyroid cancer is common in women. It used to be rare, but now it is not uncommon or even common. Thyroid cancer has a complex etiology and is most often seen in women, which may be related to excessive stimulation by estrogen and progesterone. It is now believed that excessive exposure to radiation causes thyroid cancer. In recent years, the incidence of thyroid cancer, especially papillary thyroid cancer, has been increasing year by year, and in 2013, our neighboring country, South Korea, ranked the first in terms of malignant tumors among women. According to the Life Times in December 2014, thyroid cancer ranks 2nd-6th among malignant tumors in women in major cities in China.  Among them, differentiated thyroid cancer (including papillary carcinoma and follicular carcinoma) accounts for more than 90% of thyroid cancer and responds well to treatment. This is the difference between differentiated thyroid cancer and other malignant tumors. Medullary thyroid carcinoma originates from parafollicular cells of thyroid gland (C cells), which accounts for less than 3% of the cases. even if no thyroid nodules are palpated.  Treatment: Differentiated thyroid cancer requires a combination of surgery, iodine 131 and thyroid hormone therapy.  Surgery is the first step in the treatment of differentiated thyroid cancer. It is the most effective basic treatment. In principle, the primary focus, thyroid tissue and metastases are removed as much as possible, which facilitates the subsequent iodine-131 treatment to eliminate the residual thyroid tissue and also minimizes the recurrence, as well as laying a good foundation for later review and testing of Tg (recurrence index) to predict recurrence.  Iodine-131 is often required after surgery for differentiated thyroid cancer, which is an essential treatment for comprehensive thyroid cancer. External radiotherapy is rarely applied because of insensitivity, and is only used when thyroid cancer cannot be completely excised and when undifferentiated or poorly differentiated cancer is present. In addition, oral thyroxine is routinely administered for suppressive therapy, which is also an essential step in the comprehensive treatment of thyroid cancer. Oral thyroxine after surgery and iodine-131 therapy is not only used to maintain thyroid function but also to suppress the stimulating effect of TSH on thyroid cancer growth. In principle, the maintenance dose should keep TSH below normal levels. Oral calcium and vitamin D should be taken if necessary. Iodine 131 treatment for differentiated thyroid cancer (papillary and follicular carcinoma): After strict iodine abstinence and oral iodine-131 for 4-5 weeks after surgery, so that iodine 131 will be rapidly concentrated on residual thyroid tissue and some metastases, and eliminated or suppressed by releasing beta rays for continuous irradiation of the lesions. Side effects such as decreased saliva formation and altered taste sensation are rare after treatment. iodine-131 has been used for the treatment of thyroid cancer since 1946, and practice over the past 60 years has confirmed that this treatment is relatively safe, and serious early or late side effects are rare. It does not usually affect fertility after treatment.  Thyroid hormone suppression therapy for thyroid cancer requires monitoring of the heart and bones and, if necessary, preventive protective therapy.  After standardized treatment of thyroid cancer, lifelong review is required, including color ultrasound of thyroid gland and lymph nodes in the neck, X-ray chest or CT, blood Tg measurement, whole body scan of iodine 131 and blood calcium concentration test if necessary.  With standard treatment, the 5-year and 10-year survival rates of differentiated thyroid cancer are over 90%, so the prognosis is very optimistic. The risk of recurrence is increasing in patients with thyroid cancer over 45 years of age.