Papillary thyroid cancer care

Papillary thyroid cancer, also known as papillary thyroid carcinoma, is a prevalent form of thyroid cancer primarily found in the thyroid gland, which is located at the base of the neck.

This type of thyroid cancer accounts for up to about 80% of all thyroid cancer cases. It’s more frequently diagnosed in women, particularly those in their childbearing years. Papillary thyroid cancer is very treatable and often has a positive outcome.

Papillary thyroid carcinoma may not show any noticeable symptoms. However, as the cancer cells grow, you may notice a lump or nodule in your neck. Additionally, other symptoms such as swollen lymph nodes or discomfort in your throat or neck area may become more apparent over time.

What is papillary thyroid cancer?

Papillary thyroid cancer is one of two of the most common forms of thyroid cancer. The other is follicular thyroid cancer.

A key characteristic of papillary thyroid cancer is how it looks under a microscope. These cancer cells appear as tiny finger-like projections. These cells grow in the thyroid gland and may metastasize to other parts of the body, including the nearby lymph nodes, bones and lungs.

Your thyroid gland is a butterfly-shaped gland that plays a crucial role in regulating your body's metabolism, heart rate, blood pressure and body temperature by producing hormones. The primary hormones produced by your thyroid are triiodothyronine (T3) and thyroxine (T4).

• T3: This thyroid hormone is produced in smaller amounts but is a more potent form of thyroid hormone. It impacts metabolic activity and facilitates cellular activity throughout your body.
• T4: This is the most prevalent thyroid hormone produced by the thyroid. T4 is important for metabolic function and regulating heart rate and body temperature. It’s produced in larger quantities compared to T3.

When papillary thyroid cancer develops in the cells of your thyroid, it causes the mass production of thyroglobulin, a protein necessary for making thyroid hormones. While this protein itself is not harmful, too much can lead to thyroid dysfunction, enlargement of the thyroid gland, iodine deficiency or inflammation.

Papillary thyroid cancer symptoms

In the initial stages of papillary thyroid cancer, you may not notice any symptoms. However, if you do experience symptoms, they may include:

• Changes in your voice or hoarseness
• Difficulty breathing
• Difficulty swallowing
• Elevated or lowered heart rate
• Fatigue
• Neck pain or discomfort
• Noticeable lump in your neck or an enlarged thyroid
• Rapid weight gain or weight loss
• Sensitivity to hot or cold temperatures
• Swollen lymph nodes

These symptoms may be associated with various conditions, such as benign thyroid nodules, inflammation of the thyroid or other thyroid disorders including Hashimoto’s or Graves' disease.

If you notice any symptoms, schedule an appointment with your Advocate Health Care provider.

Diagnosing papillary thyroid cancer

If your doctor believes you have papillary thyroid cancer, they’ll begin by reviewing your medical history and conducting a physical exam. During the exam, your provider will check for any abnormalities such as a lump in your neck, enlarged thyroid or swollen lymph nodes.

If your doctor suspects the presence of cancer, they may recommend additional diagnostic tests including:

• Biopsy: This involves the removal of a small piece of thyroid tissue for examination under a microscope to detect cancer cells.
• Fine needle aspiration biopsy: A thin needle is inserted into a lump to extract cells for microscopic analysis, aiding in the detection of cancer.
• Digital imaging tests: Your doctor may order an ultrasound to assess the mass and guide biopsy procedures. Additionally, a CT scan or MRI may be recommended to obtain detailed images of the thyroid gland for evaluation.
• Thyroid blood tests: These tests assess your thyroid function by measuring levels of thyroid stimulating hormone (TSH) and T4.

These diagnostic tests help your provider accurately diagnose papillary thyroid cancer and create an appropriate treatment plan.

What is the first line of treatment for papillary thyroid cancer?

Nearly all treatments for thyroid cancer involve surgery. The main treatment option for papillary thyroid cancer is a thyroidectomy, which is the partial or complete removal of the thyroid gland. The specific type of thyroidectomy depends on various factors, including the cancer stage and how much it’s spread. In some cases, your surgeon may remove the nearby lymph nodes if the cancer has spread there.

After surgery, your provider may perform radioactive iodine ablation (RAI). This procedure involves injecting radioactive iodine into any remaining thyroid tissue after a thyroidectomy. The thyroid gland absorbs the iodine, and the radiation kills it.

If you had a partial or total thyroidectomy, you’ll take thyroid hormone pills to replace the missing thyroid hormones your body needs. Thyroid hormone therapy is used to stop any remaining cancer cells from returning by lowering the amount of thyroid-stimulating hormones back to optimal levels.

Your surgical approach will be based on factors such as the size of the tumor, its location and whether it has metastasized to other areas.

What are nonsurgical treatments for papillary thyroid cancer?

Nonsurgical treatment approaches may be considered in some cases for managing papillary thyroid cancer, particularly if the cancer has metastasized.

Your provider might suggest radiation therapy, often utilizing radioactive iodine, or chemotherapy. Although chemotherapy may be used with surgery or as a standalone treatment, it is not typically the primary choice for papillary thyroid cancer due to its lower efficacy.

In advanced cases when the cancer has spread to adjacent tissues, external-beam radiation therapy could be employed. This therapy involves directing high-energy radiation beams at the tumor site to eradicate cancerous cells.

Your multidisciplinary care team including endocrinologists, surgeons, oncologists and radiation oncologists will tailor a treatment plan for you to address your specific condition and needs.