This form of care is offered alongside curative or other treatments you may be receiving. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease. A diagnosis of thyroid cancer can be frightening. You might feel as if you aren't sure what to do next.
Everyone eventually finds his or her own way of coping with a cancer diagnosis. Until you find what works for you, consider trying to:. If you have signs and symptoms that worry you, start by seeing your family doctor. If your doctor suspects you may have a thyroid problem, you may be referred to a doctor who specializes in diseases of the endocrine system endocrinologist. Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared.
Here's some information to help you get ready, and what to expect from your doctor. Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For thyroid cancer, some basic questions to ask your doctor include:. Your doctor is likely to ask you a number of questions.
Being ready to answer them may reserve time to go over points you want to talk about in-depth. Your doctor may ask:. Thyroid cancer care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version.
Papillary Thyroid Cancer Treatment
This content does not have an Arabic version. Needle biopsy During needle biopsy, a long, thin needle is inserted through the skin and into the suspicious area. Cells are removed and analyzed to see if they are cancerous. Parathyroid glands The parathyroid glands, which lie behind the thyroid, manufacture the parathyroid hormone, which plays a role in regulating your body's levels of the minerals calcium and phosphorus. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. References AskMayoExpert. Anaplastic thyroid cancer.
Rochester, Minn. Differentiated thyroid cancers. Medullary thyroid cancer. Melmed S, et al.
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Nontoxic diffuse goiter, nodular thyroid disorders and thyroid malignancies. In this surgery, about half of the thyroid gland is removed. A small incision in the lower neck is required which is about an inch in length unless the thyroid mass requires a longer length to allow it to be "delivered". All of the critical structures on the side of the removed thyroid lobe are maintained including both parathyroid glands the glands that control the calcium and the nerves that provide movement and sensation to the voice box.
The lymph nodes along the side and beneath the thyroid gland are also examined during this surgery to make sure that they are not cancerous as well. Editors note: A thyroid lobectomy is generally not recommended when there are nodules present in both sides of the thyroid gland both lobes possessing nodules. In this surgery, the entire thyroid gland is removed. The length of a total thyroidectomy incision is no longer than an incision for a thyroid lobectomy. All of the critical structures on both sides of the thyroid are maintained including all four parathyroid glands and all four nerves that provide movement recurrent laryngeal nerves and sensation to the voice box superior laryngeal nerves.
The removal of the lymph nodes of the central neck can be performed initially when the thyroid gland is removed in the treatment of papillary thyroid cancer or following the initial surgery in the less common circumstances when papillary thyroid cancer recurs or persists. The central compartment lymph node surgery spares all critical structures including the nerves to the voice box and all parathyroid glands not directly involved by cancer.
Central compartment dissection extends from the carotid arteries on both sides of the neck, below to the blood vessels of the upper chest, and above to where the blood vessel of the upper portion of the thyroid gland begins off of the carotid artery called the superior thyroid artery. That risk increases with the size of the papillary thyroid cancer.
Even prior to surgery, most central compartment lymph nodes can be well examined with high quality ultrasound to determine if they are cancerous. Here, the arrow points to an abnormal lymph node seen on ultrasound next to the thyroid gland before surgery. Abnormal lymph nodes undergo fine needle aspiration FNA examination to determine whether cancer is present. Some lymph nodes which lay immediately underneath the thyroid gland cannot be seen until the time of surgery and required a skilled surgeon to identify them and can then be confirmed during the surgery by a process called frozen section pathology.
Warning : The linked video here is a video of an actual thyroid surgery up close, so if you are in any way squeamish about seeing an actual surgery in progress please do not follow this link! Video: Tiny Discoveries During Thyroid Surgery Result in Big Changes If papillary thyroid cancer is determined to be present in central compartment lymph nodes at any time in a patient's lifetime, an expert surgeon who does this surgery routinely is needed to remove the lymph nodes in the central compartment, on both sides and spare the nerves to the voice box and the critical glands that control calcium parathyroid glands.
In larger papillary thyroid cancers which are greater than one inch or have grown outside of the capsule of the thyroid, removal of the lymph nodes of the central compartment on the side of the cancer should be done routinely since: 1. The nerve to the voice box recurrent laryngeal nerve has already, by necessity from the thyroid surgery itself, been significantly identified along most of its course and another surgery on the same side would be more difficult because of scarring and this subsequent surgery would put the nerve to the voice box at high risk for injury.
Papillary thyroid cancer may sometimes be more aggressive than ultrasound or CT imaging suggested prior to undergoing surgery. In these cases, an expert surgeon that recognizes those "more aggressive" intraoperative findings such as growth or extension of the cancer outside of the thyroid gland or invasion of the cancer into adjacent structures such as the nerve to the voice box recurrent laryngeal nerve , breathing tube trachea , voice box, or esophagus must adapt the surgery to adequately address the complete removal of the cancer.
Unfortunately, occasional thyroid surgeons are commonly unprepared to perform the appropriate surgery and a subsequent surgery for persistent disease will be required. Papillary thyroid cancer surgery is uncommonly proposed as a treatment approach when disease has spread to distant sites.
Although surgery is not commonly proposed for distant spread of papillary thyroid cancer, consideration for surgery for distant disease is based upon the expert thyroid cancer team evaluation and considers the following issues: Where is the papillary thyroid cancer distant disease located? What are the risks and benefits of surgery? Are there other sites of distant spread? What papillary thyroid cancer treatments have already been used? What were the outcomes of other treatments for the papillary thyroid cancer?
How fast is the papillary thyroid cancer growing? What are the patient's treatment desires? What are the other treatment options? What is the papillary thyroid cancer pathologic type what do the cells look like under the microscope?
What are the papillary thyroid cancer genetic mutations? Robotic surgery for the thyroid was developed largely in South Korea and brought to the United States several years ago as a "tool" in thyroid surgery. Its proposed benefits were to be the following: Absent or less noticeable neck incisions Improved visualization Less Surgeon Fatigue. Although we have been trained and performed robotic thyroid surgery, the following is the reality of robotic thyroid surgery: Incisions are tremendously longer but just not located on the front of the neck In papillary thyroid cancer, it is a one sided surgery approach to a frequently required two-sided surgery!
The instruments used to perform the surgery are not as refined or delicate as the instruments used to perform the minimally invasive neck surgeries. The fingers are the surgeon's third eye. Subtle changes in feel, hardness or extension of cancer can be totally unappreciated. It is not minimally invasive by any measure. It is maximally invasive but just at a distance from where the surgery is focusing.
It is a much longer surgical procedure by any measure the set up of the robot is longer than the average thyroid lobectomy. It is an inferior surgical approach to manage papillary thyroid cancer Unanticipated findings during surgery may not be able to be adequately addressed robotically. It may be an acceptable surgical approach for clearly known benign thyroid surgery.
Thyroid Cancer: Burden of Illness and Management of Disease
Most importantly, the ability to perform a surgery well is not an indication for a surgery! Robotic thyroid surgery is an inferior surgical approach in managing papillary thyroid cancer, any other type of thyroid cancer, or any thyroid lesion at risk of being a potential thyroid cancer. Papillary thyroid cancer, itself, is not an indication for RAI treatment. RAI treatment is a type of internal radiation therapy. RAI treatment was the first true "targeted therapy" developed in the treatment of cancer.
The papillary thyroid cancer patient swallows a radioactive iodine form of iodine called iodine I in a liquid or pill capsule form.
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The RAI is absorbed through digestion and circulated throughout the body in the bloodstream. Papillary thyroid cancer cells can pick up the radioactive iodine wherever they are located in the body. If you had a papillary thyroid cancer 25 years ago, you would have almost certainly been treated with surgery and RAI. RAI therapy is primarily beneficial only when the papillary thyroid cancer patient has undergone a total thyroidectomy complete removal of the thyroid gland for their papillary thyroid cancer.