Follicular thyroid cancer care

Follicular thyroid cancer, also known as follicular thyroid carcinoma, is one of the two most common forms of thyroid cancer along with papillary thyroid cancer.

In both types, cancerous cells grow in the thyroid gland, located at the base of the neck. However, there are a couple of differences between follicular thyroid cancer and papillary thyroid cancer: where the cancer cells grow, how they appear under a microscope and how likely the cells are to spread to other organs.

What is follicular thyroid cancer?

Follicular thyroid cancer is a type of cancer that originates from the outer layer of the thyroid gland. These cells are the most abundant in the thyroid and are responsible for the creation and release of T3 and T4 thyroid hormones.

T3 thyroid hormones are made in small amounts but are the strongest of the two and regulate your metabolism and cell function. T4 is made in larger quantities and manages your heart rate and body temperature.

Follicular carcinoma is characterized by the formation of small follicles or hollow spherical structures within the thyroid tissue. These cancer cells can invade nearby tissues and spread to distant places, particularly the lymph nodes, lungs and bones.

What are the differences between papillary and follicular thyroid cancer?

Prevalence is the biggest difference. Papillary thyroid cancer is much more common and makes up about 80% of all thyroid cancer cases, while follicular thyroid cancer accounts for about 15% of diagnoses.

Both papillary and follicular thyroid cancers grow in thyroid cells, but they’re unique based on how the cancerous cells look under a microscope. Papillary thyroid cancer is characterized by cells that look like tiny finger-like projections, while follicular thyroid cells that are cancerous appear as follicles or solid structures.

Another stark difference is who is more likely to get it. Papillary thyroid cancer tends to develop at a younger age and affects women more than men. Follicular thyroid cancer typically occurs in older people and impacts men and women equally.

Follicular thyroid cancer symptoms

You may not have any notable symptoms of follicular thyroid cancer, especially in its initial stages. However, as the cancer progresses, it can cause various symptoms such as:

• Presence of a thyroid nodule, a painless lump on the front of the neck
• Enlargement of the thyroid gland
• Difficulty swallowing
• Hoarseness or voice changes
• Difficulty breathing
• Neck pain
• Swollen lymph nodes

Many of these symptoms may be caused by noncancerous conditions affecting the thyroid gland, such as an inflamed thyroid gland. Contact your provider If any of these symptoms persist or if you notice any unusual changes in your neck. Early detection is essential to increasing the success of treatments.

Diagnosing follicular thyroid cancer

Your doctor will review your medical history, ask about any family history of thyroid cancer and do a physical exam of your thyroid gland. They’ll check for a lump on your neck or a goiter, a noticeable enlargement of the thyroid gland.

If your doctor suspects cancer, they may recommend you have additional tests, including:

• Biopsy: This involves the removal of a small piece of thyroid tissue for examination under a microscope.
• Fine needle aspiration biopsy: A thin needle is inserted into a lump to extract cells for microscopic analysis, aiding in the detection of cancer.
• Core needle biopsy: If your fine needle aspiration biopsy is inconclusive, your doctor may use a bigger needle to get tissue from the thyroid gland.
• Digital imaging tests: An MRI or CT scan may be used to obtain detailed images of the thyroid gland.

Once follicular thyroid cancer is diagnosed, further tests may be performed to determine the stage of the cancer and to plan appropriate treatment. These tests may include blood tests, additional imaging studies and sometimes surgery to remove the thyroid gland for both diagnosis and treatment purposes.

Follicular thyroid cancer treatment

Treatment options depend on various factors, including the stage of cancer, your overall health and treatment preference.

A thyroidectomy, the partial or total removal of the thyroid gland, is the most common treatment for most types of thyroid cancer, including follicular cancer. Your surgeon may also remove your lymph nodes if the cancer has spread there, depending on the size and location of the tumor.

After surgery, your doctor will likely perform radioactive iodine ablation to destroy any thyroid tissue that’s left after a thyroidectomy. This procedure involves injecting radioactive iodine into the thyroid tissue. The thyroid absorbs iodine, and the radiation kills the tissue.

If you have part or all of your thyroid removed, you'll need thyroid hormone replacement therapy. Your doctor will prescribe you thyroid hormone pills to provide your body with the essential thyroid hormones it needs. These pills also help stop remaining cancer cells from growing and returning by lowering the level of thyroid-stimulating hormone.

For more advanced follicular thyroid cancer, your treatment may include nonsurgical options such as radiation therapy or chemotherapy.

How treatable is follicular thyroid cancer?

Follicular thyroid cancer is generally considered very treatable, especially when detected early. The treatability of follicular thyroid cancer depends on several factors, including the stage at which it's diagnosed, whether it has spread to other parts of the body, your age and overall health and the characteristics of the cancer cells.

Follicular thyroid cancer is less aggressive compared to other types of thyroid cancer, such as anaplastic thyroid cancer. So, if you detect it early, your chances of successful treatment are better.

It's important to discuss your treatment options with your care team at Advocate Health Care, which could include endocrinologists, surgeons, oncologists and radiation oncologists. They can collaboratively tailor a personalized treatment plan that addresses your specific condition and needs.