Thyroid cancer- follicular

Synonyms

1

Overview

Follicular thyroid cancer is a form of thyroid cancer which occurs more commonly in women of over 50 years old. Thyroglobulin (Tg) can be used as a tumor marker for well-differentiated follicular thyroid cancer. About 33,500 Americans are diagnosed with thyroid cancer each year, with incidence rates increasing by about 11 percent asnnually. Follicular Thyroid Cancer makes up about 15 percent of these cases. Follicular Thyroid Cancer begins in the follicular cells and grows slowly; it can be treated successfully if diagnosed at an early stage. About 1,500 Americans die from all types of thyroid cancer each year. This relatively low death rate is due to successful early detection and treatment in most cases.

Symptoms

• Asymptomatic in early stages 
• Neck lump
• Difficulty breathing 
• Difficulty swallowing 
• Hoarseness

Diagnosis

If your symptoms suggest the possibility of thyroid cancer, your primary care physician will order a blood test that the pathologist will check for abnormal levels of thyroid-stimulating hormone (TSH). Too much or too little TSH shows that the thyroid is not working well.

Prognosis

The overall 5-year survival rate for follicular thyroid cancer is 91%, and the 10-year survival rate is 85%.

By overall cancer staging into stages I to IV, follicular thyroid cancer has a 5-year survival rate of 100% for stages I and II, 71% for stage III, and 50% for stage IV.

Treatment

Follicular Thyroid Cancer may be treated with surgery, external radiation therapy, thyroid hormone treatment, radioactive iodine therapy, or chemotherapy. Many patients receive a combination of these treatments. Surgery and external radiation therapy are local therapies that remove or destroy cancer in the thyroid. When the cancer has spread beyond the thyroid, these two therapies can control the disease in the thyroid. The most common surgical procedure for Follicular Thyroid Cancer is the total thyroidectomy (removal of the thyroid), with lobectomy (removal of part of the thyroid) used in some cases of stage 1 cancer. In addition, a surgeon will perform a lymphectomy if the cancer has spread to nearby lymph nodes. External radiation therapy is generally used after surgery; this therapy uses high-energy beams projected from outside the body to destroy any remaining cancer. Thyroid hormone treatment, radioactive iodine therapy, and chemotherapy are systemic therapies that are delivered through the bloodstream to destroy or stop the progression of cancer cells present throughout the body. These therapies also can reduce pain. Any of these treatments may cause side effects and alter your normal activities. Ask your primary care physician or specialist to explain possible side effects thoroughly so that you know what to expect. If your treatment removes or destroys your entire thyroid, or a large portion of your thyroid, you will be required to take thyroid hormone pills for the rest of your life to replace the natural thyroid hormone. If the surgeon removes the parathyroid glands, located behind the thyroid, you will need to take calcium and vitamin D supplements for the rest of your life. Follow-up care is very important because thyroid cancer comes back in up to 30 percent of all cases. Also, if you receive radioactive iodine therapy or external radiation therapy, you have an increased chance of developing other cancers later in your life. You should receive regular blood tests to check your levels of TSH and thyroglobulin (thyroid hormone stored in the thyroid). Your physicians also may recommend repeating some of the diagnostic and staging tests to see if the cancer has returned. Clinical trials of new treatments for Follicular Thyroid Cancer may be found at www.cancer.gov/clinicaltrials. These treatments are highly experimental in nature but may be a potential option for advanced cancers. Some trials may involve biologic therapy, which uses the natural defenses of the immune system to fight cancer. For more information, go to www.cancer.gov (National Cancer Institute), www.medicinenet.com (owned and operated by Web MD), or www.thyca.org (Thyroid Cancer Survivors’ Association) Type the keywords: thyroid cancer into the search box.