What are the clinical manifestations of differentiated thyroid cancer?
Differentiated thyroid cancer is mostly asymptomatic and usually consists of a single thyroid nodule. 50% of malignant nodules are found as a result of physical examination, such as accidental imaging or surgery for a benign nodule. The remaining 50% are discovered by the patient themselves, usually by noticing an asymptomatic nodule. Unfortunately, most patients do not discover the presence of cancer until after the lesion has worsened and may be relatively advanced by the time of diagnosis.
What are the treatment options for differentiated thyroid cancer?
The combination of surgical resection, 131I therapy and thyroid hormone suppression therapy is internationally recognized as the ideal treatment option for DTC.
What is the purpose of 131I treatment for differentiated thyroid cancer?
1. To remove residual thyroid tissue and possible residual tumor lesions.
2. To treat recurrent and metastatic lesions.
What is the rationale for 131I to remove residual thyroid tissue (clear nail) after surgery for differentiated thyroid cancer?
Because differentiated thyroid cancer lesions show a tendency of bilateral, microscopic, multifocal, local invasion and local lymph node metastasis, and a long local latency and development period with high recurrence rate, 131I removal of residual thyroid gland has the following effects.
1. 131I can destroy microscopic thyroid cancer lesions that are difficult to detect in postoperative residual thyroid tissue.
2. facilitating the treatment of systemic metastases
3. facilitating the monitoring of thyroid cancer by whole-body 131I imaging and determination of serum hTg level.
Some studies have shown that the tumor recurrence rate is three times higher with surgical resection alone than with surgical resection plus postoperative radioactive 131I nail clearance, and 131I clearance of residual thyroid tissue after DTC significantly reduces the chance of tumor recurrence and metastasis, and decreases the rate of morbidity and mortality.
What treatment measures can be taken when metastatic differentiated thyroid cancer is found?
1.Surgical resection: Applicable to metastases that can be removed surgically, such as superficial lymph nodes and partial bone metastases.
2.131I treatment: Applicable to metastases that cannot be removed surgically and have good poly131I, such as intrapulmonary metastases, lymph nodes and bone metastases with great risk of surgery.
3.Radiotherapy or chemotherapy: it can be used when the metastases cannot be resected by surgery and have poor poly131I; medullary thyroid cancer and undifferentiated cancer are applicable, but the overall efficacy is not satisfactory for DTC.
4.Other treatment methods: such as tumor targeting therapy, microwave (radiofrequency) interventional therapy, radioimmunotherapy, argon helium knife, gamma knife, radioactive particle implantation, Chinese medicine treatment and other therapies.
What is the prognosis of differentiated thyroid cancer?
Among all malignant tumors, differentiated thyroid cancer (mainly papillary and follicular carcinoma) has a better prognosis, with many metastatic patients surviving for more than 10 years. The important factors affecting the prognosis are tumor volume, extent of invasion, metastases, and differentiation of tumor. Therefore, the earlier the tumor is detected and treated, the better the prognosis of the disease.
Most of the DTC tumor cells have the function of 131I uptake, so the radioactive 131I treatment can effectively kill the tumor cells and achieve a very good prognosis, which is the first choice for postoperative DTC treatment. Even if metastases are found at the time of surgery, some patients can eventually be cured after 131I treatment.