Treatment of thyroid cancer

  The treatment of thyroid cancer emphasizes on the correct, effective, reasonable and adequate treatment based on the correct initial diagnosis and following the principles of oncologic surgery.  Surgery is the main treatment for thyroid cancer. Surgery is decided according to the size of the mass, the degree of infiltration of surrounding tissues, the presence or absence of lymph node metastasis in the neck, the extent of metastasis and the presence or absence of distant metastasis. (1) lobectomy + isthmus of one side of the thyroid gland: When the tumor is confined to one side of the thyroid gland, lobectomy + isthmus of one side of the thyroid gland can be performed, and tumor excision and local excision cannot be performed. When the tumor has invaded into the contralateral thyroid gland, subtotal thyroidectomy or total thyroidectomy should be performed.  (2) Combined radical thyroid cancer surgery: If thyroid cancer is accompanied by metastatic lymph nodes in the neck, cervical lymph node dissection + lobectomy of one side of the thyroid gland + isthmus should be performed. Whether thyroid cancer has lymph node metastasis in the neck or not should be determined by detailed physical examination by oncologists, ultrasound or CT examination and intraoperative investigation. If there is no lymph node metastasis after comprehensive judgment, lymph node dissection in the neck may not be possible. At this time, lymph node dissection will bring greater trauma to patients, long surgical incision and many complications, which will affect patients’ quality of life.  2.Radiotherapy Papillary thyroid carcinoma and follicular carcinoma are not sensitive to radiotherapy, and the adjacent organs of thyroid gland such as thyroid cartilage, trachea and crestal medulla have low tolerance to radiotherapy, so radiotherapy is not available for these two types of carcinoma if they are completely removed by surgery.  When papillary thyroid cancer and follicular carcinoma have distant metastasis, such as lung and bone metastasis, total thyroidectomy + 131I therapy is feasible. 4. Endocrine therapy: Papillary thyroid cancer and follicular carcinoma are stimulated to grow by TSH, and inhibition of TSH secretion can reduce the recurrence rate and metastasis rate of thyroid cancer.