| Follicular carcinomas cancer is the second most | | | | are important since there are more risks involved than |
| common type of thyroid cancer. | | | | just partial removal of infected areas of the thyroid |
| Follicular carcinoma is far more aggressive than | | | | tissue. |
| papillary carcinoma. This form of thyroid cancer | | | | It also must be kept in mind that merely examining the |
| happens in and age group slightly older than the age | | | | cancer under the microscope for indications of cancer |
| group targeted by papillary cancer. Follicular cancer is | | | | can be unreliable in making a accurate diagnosis of |
| also less common in children. Follicular cancer, unlike | | | | follicular cancer just before surgery, especially because |
| papillary cancer, happens rarely after radiation therapy. | | | | such examinations are rather brief. This problem isn't |
| The life expectancy of a patient suffering from this | | | | evident with the other types of thyroid cancer. |
| kind of cancer will depend on how aggressively the | | | | Based on available studies and the epidemiology (or |
| cancer has affected the vascular system. The | | | | methodology and research) of follicular carcinoma, the |
| patient's age will be an important determining factor for | | | | following is a general treatment plan: Follicular |
| prognosis. Generally, patients over 40 years of age | | | | carcinomas that are isolated, not too invasive and less |
| have a more aggressive type of this cancer. Usually, in | | | | than 1cm in a patient under 40 years of age can be |
| this age group, the tumor does not concentrate the | | | | treated with hemithyroidectomy and isthmusthectomy. |
| iodine as well as in patients belonging to a younger age | | | | All other thyroid cancer types should probably be |
| group. One of the main characteristics of follicular | | | | treated with total removal of the entire gland or |
| carcinoma is vascular invasion or invasion of veins and | | | | thyroidectomy as well as removal of any large lymph |
| arteries. Because of this, distant spread (metastasis) of | | | | nodes in the neck area. |
| the disease is common. The disease can spread to | | | | Radioactive Iodine (After Surgery) |
| the lungs, bone, liver, bladder, skin and even the brain. In | | | | What makes thyroid cells so unique is there ability to |
| contrast to papillary carcinoma, there is less lymph | | | | absorb iodine. The thyroid cells can use iodine to make |
| node involvement. | | | | thyroid hormones. There are no other cells in the body |
| Characteristics of Follicular Thyroid Cancer | | | | capable of absorbing or concentrating iodine. |
| - Affects ages 40 through 60 | | | | Physicians take advantage of this uniqueness and |
| - More prevalent tin females than males by a ratio of 3 | | | | administer radioactive iodine to patients suffering from |
| to 1 | | | | thyroid cancer. |
| - Prognosis related to the size of tumor. A smaller | | | | There are several types of radioactive iodine; only one |
| tumor yields a better prognosis | | | | type has been proven to be toxic to thyroid cells. The |
| - Rarely related with radiation exposure | | | | toxic iodine isotope (I-131) is administered to patients |
| - Rarely affects the lymph nodes | | | | suffering from follicular cancer. The isotope is |
| - Known for invading vascular structures such as veins | | | | absorbed by the thyroid and targets cancer cells for |
| and arteries in the thyroid gland | | | | destruction. Not everyone with follicular thyroid cancer |
| - Does not usually spread to lymph nodes. This is more | | | | will need this treatment, but those patients that have |
| consistent with papillary cancer | | | | larger tumors, a spread of disease to lymph nodes or |
| - Has an overall high cure rate. The rate decreases | | | | other areas, aggressive tumors that appear |
| with older patients | | | | microscopic, tumors, which infect blood vessels in the |
| Management of Follicular Thyroid Cancer | | | | thyroid gland, and older patients can derive benefits |
| There is a great deal of controversy around the | | | | from this type of treatment or therapy. Of course, the |
| management of differentiated or clearly distinct thyroid | | | | therapy still will vary from person to person. However, |
| carcinomas. Some medical experts say that if the | | | | it has been proven to be an effective type of |
| tumors are small and are not invading other | | | | "chemotherapy" with only a few possible downsides |
| surrounding tissues then simply removing the lobe in the | | | | such as hair loss, weight loss or nausea. |
| thyroid containing the tumor and the central portion (the | | | | Patients should be off of thyroid replacement therapy |
| isthmus) should be as effective for a cure as | | | | and on a low iodine diet one to two weeks before |
| removing the entire thyroid. These experts relate a low | | | | radioactive iodine therapy. It is usually administered 6 |
| rate of clinical tumor recurrence, approximately 5-20%, | | | | weeks after surgery and can be repeated every 6 |
| despite the existence of small amounts of cancerous | | | | months if needed with defined dose limits. |
| cells that can be found in up to 88% of the tissues in | | | | Thyroid Hormone Pills After Thyroid Cancer Surgery |
| the opposite lobe of the thyroid gland. There are also | | | | Most experts agree that regardless of whether a |
| studies indicating an increased risk of | | | | patient had their thyroid partially removed or |
| hypoparathyroidism. These studies also show a | | | | completely removed, thyroid hormone supplementation |
| recurrence of laryngeal nerve injury in patients | | | | is necessary for the rest of the patient's life. The |
| undergoing total thyroidectomy. Experts that endorse | | | | purpose of the supplementation is to replace the |
| total thyroidectomy, which is a more aggressive thyroid | | | | hormone in those patients who have no longer |
| surgery, state several large studies showing that in | | | | possess a thyroid gland due to the much needed |
| skillful hands the recurring nerve injury or permanent | | | | surgery they had to undergo. It is also necessary to |
| hypoparathyroidism are as low as 1%. These studies | | | | prevent further growth of the gland in those patients |
| have also shown that patients with total thyroidectomy | | | | who still possess some thyroid tissue after there |
| radioiodine therapy and thyroid suppression afterward, | | | | surgery, since in their case the removal of the gland |
| have a notably lowered the recurrence rate and the | | | | was only partial. There is reliable evidence that follicular |
| mortality rate when tumors measure more than 1 cm. | | | | carcinoma responds well to thyroid stimulating |
| Other experts have raised an interesting point. It has | | | | hormone or TSH that is secreted by the pituitary gland, |
| been brought out that all patients with follicular thyroid | | | | So, exogenous thyroid hormone is administered which |
| cancer ought to be treated with a total thyroidectomy. | | | | causes a decrease in thyroid stimulating hormone |
| It has been the experience of many patients that | | | | levels and a lowers the momentum of growth for any |
| surgeons are only willing to take out all of the thyroid | | | | remaining cancer cells. It has also been shown that |
| gland on the side of the neck containing the cancer | | | | recurrences and mortality rates are lower in patients |
| and only a certain amount of the thyroid on the | | | | receiving thyroid supplementation for the purpose of |
| opposite side. Most will not perform total removal of | | | | suppression. |
| the entire thyroid gland. If a patient wanted this, those | | | | Long-Term Follow Up |
| patients, on most occasions, would be directed to see | | | | It is advisable for patient to get annual chest x-rays |
| another surgeon. The reason for a surgeon declining to | | | | and thyroglobulin levels. Thyroglobulin is not effective |
| remove the entire thyroid is because of the fear of | | | | for diagnosing thyroid cancer. It is however, quite useful |
| cutting into the vital nerve to the voice box. Surgeons | | | | in the follow up stages for indications of differentiated |
| that don't do this procedure often will usually decline | | | | or distinct carcinoma assuming that a complete |
| this type of operation. This type of operation would in | | | | removal of the thyroid gland has been performed. A |
| fact require significant skill. You should not let a | | | | high thyroglobulin level may be indicative of a |
| surgeon remove your thyroid if they do not perform | | | | recurrence but your doctor will be able to provide you |
| this type of operation frequently! Skill and experience | | | | with an accurate finding. |