Thyroid Cancer - slowly growing malignancy of any type of thyroid cells. More common in women of childbearing age.
In the early stages of tumor is not manifest itself and is found by chance, as a seal in the gland. By increasing the size of the tumor, patients complain of difficulty in swallowing, discomfort in the neck, swollen lymph nodes in the neck, hoarseness.
For suspected tumors thyroid specialists Assuta clinic performed objective research: the consistency of the tumor is determined. Slightly touch neoplasm speaks in favor of a malignant process. The denser it is, the higher the probability of malignancy.
Performed laryngoscopy - instrumental examination of the larynx and vocal cords.
In Israel clinics are also conducted ultrasound and radioisotope study of the thyroid gland. are appointed
- CT scan
- determination of tumor markers, thyroid hormones
- clinical tests
- Positron Emission Tomography
- radioisotope scanning with radioiodine
- genetic testing
- Magnetic resonance imaging
The techniques enable us to determine the dimensions of morphological characteristics and location of the tumor.
Under visual control is performed needle biopsy tumor tissue with histological examination.
Biopsy - one of the reliable methods of diagnosis of oncology in Israel .
The clinic "Assuta" Tel Aviv is successfully being treated for thyroid cancer.
Treatment in each case individually planned.
Treatment of cancer of the thyroid gland in Israel
The main treatments for thyroid cancer - surgery and radiation therapy. Probably needs to be taking hormones. Metastatic cancer chemotherapy may be used.
At the stage of development and planning of the treatment of thyroid cancer in Assuta most important factor is the type of tumor. Doctors also take into account:
- stage - as the disease has spread in the body;
- general state of health;
- age and level of fitness.
High chance of recovery noted in papillary and follicular thyroid cancer. It is also possible to cure a large number of people with medullary cancer. Difficult to treat anaplastic cancer.
By surgery for thyroid cancer in Assuta is usually treated first.
Diagnosis of tumors in the early stages and provide high chance of excision treatment. highly qualified doctors clinic team selects the best options for surgical treatment of thyroid cancer in Israel and discuss them with the patient.
If the disease goes beyond the boundaries of the body by only surgery oncology cure is no longer possible, turning to combination therapy. In such a situation resection of the prostate will help control symptoms of the disease.
Operations are also conducted in the later stages of the disease, at relapse, as it improves the condition and the patient's life. The choice of surgery affected by the presence or absence of metastases in the lymph nodes, the value of tumors, the type of cancer.
Depending on the presence or absence of secondary lesions in the lymph nodes, the values of neoplasms, thyroid cancer form will be determined operation type.
Doctors discuss with the patient the most appropriate option, and potential side effects.
Extirpation of the thyroid gland
Extirpation thyroid (thyroidectomy) involves resection of the thyroid or segment thereof. Total removal reduces the chance of the disease returning. Subsequent treatment of thyroid cancer with radioactive iodine increases the effectiveness of surgery. Thyroidectomy - the most common operation.
Initial stages of papillary or follicular cancer can be an indication for hysterectomy or partial lobectomy, when only resecting diseased prostate share and supply the unaffected tissue. For such an operation is characterized by low probability of complications and higher risk of relapse. Lobectomy can also be performed for diagnostic purposes when using a biopsy can not be accurately establish the diagnosis. After partial thyroidectomy gormonozamestitalnaya do not need therapy.
Possible to carry out operations using the cavity, laparoscopic or robotic approach. The choice depends on many factors.
Lymph node dissection is more important in the treatment of anaplastic and medullary cancer. The surgeon removes the affected lymph nodes are cancerous process. Possible variants: partial surgery, or modified radical dissection, the selection determined by the amount of tissue resected.
Restoration and rehabilitation after surgery for thyroid cancer
After surgery, the patient is attached to the number of devices for life support:
- drip, through which a fluid, mainly at night;
- drains to remove fluids from the wound during the day - two.
Encouraging the patient to move, which contributes to more rapid recovery. With patient work physiotherapist. Hospitalization is usually 1-3 days.
To eliminate the pain, discomfort to the patient selects an effective painkillers.
During the first days after the operation can be difficult with the use of solid food, which causes pain. Nutritionist recommends bland foods, giving professional advice.
After the extract must be monitored for further diagnosis and treatment.
Basically, to restore the majority of people after surgery two weeks is required. Return to work depends on the type of activity. If it does not involve significant physical stress - sooner if implies - later. This issue can be discussed with your doctor.
Possible side effects of surgery include:
- Hypothyroidism due to extirpation of cancer, which requires hormone replacement therapy, since the body needs thyroxine and triiodothyronine.
- Hoarse voice is possible in connection with the larynx irritation during operation, damage to nerve endings located near speech organ. Usually violation of a temporary nature, may require professional help.
- Calcium deficiency occurs due to damage to parathyroid glands, or their blood supply. They synthesize paratereoidny hormone that controls calcium levels in the body. The symptoms of hypoparathyroidism are cramps, spasms, muscle twitching, numbness or tingling. Doctors checked by analysis of calcium content. If necessary, the appointed nutraceuticals. The problem is mostly temporary.
- After the surgery the scar may remain.
- Extirpation of the thyroid gland mostly accompanied by fatigue when the body adapts to the effects of surgery.
Chemotherapy in thyroid cancer in Assuta
Himioterapevt Assuta Medical Center along with the team of doctors develop treatment regimen for thyroid cancer. Treatment is divided into cycles, uses one or more chemotherapeutic agents.
With this diagnosis of cytostatic agents used only in the following cases:
- When secondary foci for easing symptoms of the disease or its recurrence.
- In anaplastic cancer in combination with external irradiation.
- When a differentiated cancer no answer to the iodine therapy.
For the treatment of anaplastic thyroid cancer foci and secondary disease following chemotherapy are used:
In most cases, it refers to the combination - doxorubicin and platinol.
Among the possible side effects of this treatment note:
- loss of appetite, diarrhea;
- bone marrow suppression;
- hair loss;
- skin darkening, increased sensitivity to sunlight;
- kidney damage due to exposure platinola;
- hearing loss (application platinola, carboplatin).
Targeted therapy affects precisely on specific genes or proteins that do not lead to the defeat of healthy cells.
The indications for this treatment is medullary cancer. Targeted therapy is recommended for secondary outbreaks of disease in the body and when it is impossible to conduct the operation.
Purpose of therapy is preceded by genetic tests. Israeli researchers are actively developing innovative techniques.
thyroid Assuta for the treatment of medullary cancer treated mainly to two drugs:
- Vandetanib - tyrosine kinase (ITK). Tyrosine kinase - a protein that accelerates the development of tumor cells. The medicine is prescribed, if there are contraindications for surgery, the disease continues to progress, new metastases. The drug is taken daily 300 mg.
- Kometrik - ITC, for the treatment of advanced medullary cancer. Admission is 140 mg daily.
For the treatment of papillary and follicular thyroid cancer using these targeted therapies in Assuta:
- Nexavar recommended metastases and returning the differentiated cancer if I-131 treatment was ineffective.
- Lenvatinib offer when there is no result after surgery and treatment of thyroid cancer with radioactive iodine.
Among the potential negative effects of this therapy is called:
- diarrhea, nausea and vomiting;
- rash and itching of the skin, acne;
- loss of appetite;
- damage to the heart;
- increased risk of infection due to lower levels of leukocytes (at reception vandetaniba).
The specific undesirable effects of the physician in the Assuta will give detailed information to the patient.
Hormone treatment for thyroid cancer in Israel
This method of fighting cancer by affecting the levels of hormones.
Hormone therapy is recommended:
- For the treatment of papillary or follicular thyroid cancer after surgery or treatment of I-131 in order to reduce the risk of recurrence.
- After surgery as a hormone replacement therapy.
In clinic Assuta used thyroxine (T3) and triiodothyronine (T4). Hormone inhibits the production of thyroid stimulating hormone, growth promoting thyroid cells. This reduces the likelihood of a return of the disease.
Levothyroxine (T3) is used as hormone replacement therapy. In order to maintain a healthy metabolism of hormones the body needs. The medicine will need to take throughout their lives. For each case the disease is calculated dose required.
Common possible side effects of hormone treatment
Undesirable effects of therapy are rare, usually it is associated with a dose of drugs. There is an excessive or insufficient amount of hormones. Their content is checked with a blood test and is entered in the remedial dosage. When properly selected dose, side effects are not observed.
- Hypothyroidism manifests through weight gain, fatigue, lethargy, dry skin. The reason - the lack of thyroid hormone.
- Hyperthyroidism is expressed in the following symptoms - diarrhea, weight loss, high pulse, feeling the heat.
- Changes in hormone levels can trigger rashes.
- Taking hormones can sometimes cause slight hair loss.
Radioactive iodine treatment of thyroid cancer in Assuta
For normal functioning of the thyroid gland the iodine required from food. It is needed to produce thyroxine and triiodothyronine. Reduction of the iodine levels will cause an increase in the body thyroid stimulating hormone (TSH) inducing gland absorb iodine, including radioactive.
Iodine-131 therapy, in fact - internal radiotherapy. It is aimed at the destruction of the cells, which can not be affected by surgery and those who have left the original hearth.
This method is recommended for follicular or papillary carcinoma:
- after surgery in order to rid the body of malignant possibly remaining segments;
- if the operation can not be performed;
- When a relapse occurs.
When medullary or anaplastic cancer - is not used, as this type of treatment is not effective in these cases.
During therapy, iodine-131 is used - or in capsules in the form of the drug solution. The patient is in the hospital about two - three days. To the body quickly cleared of the drug, it is recommended to consume plenty of fluids.
Together with the cells of the thyroid gland with iodine receive a radiation dose that destroys cancer cells. Minimal impact are other areas of the body.
Preparation includes compliance nizkoyodovogo diet for 14-21 days. At this time, hormone replacement therapy is stopped.
Mainly the treatment - 1-1,5 months or more after surgery. If thereafter the abnormal cells are detected, treatment is repeated until a total maximum radiation dose.
As a result of this treatment the patient radioactive, four - five days cleared. At this time the patient is in a separate ward of the hospital. Follow the safety precautions.
Potential negative consequences:
- The accumulation of substances toxic nature of the destruction of abnormal cells that provokes fatigue. Maximum body's energy is directed to the healing process. The body returns to normal after weeks or months.
- Upon receiving hormone drugs may experience nausea, which is sometimes accompanied by vomiting.
- The accumulation of radioactive iodine in the thyroid gland leads to puffiness of and pain in this area.
- Dryness in the mouth - dry mouth - developing in rare cases. The reason lies in the absorption of I-131 salivary gland.
- I-131 may also have effects on salivary gland, modifying the taste and smell. Mostly this is a temporary complication.
- Radioactive iodine therapy in high doses can provoke bone marrow suppression. Condition of the body comes back to normal after the release of radiation.
- High-dose treatment could affect the reproductive system, because the drugs through the bloodstream spread throughout the body. The impact of radiation on the ovaries and testes can become a cause of the loss of fertility. Basically it is a temporary problem.
External beam radiation therapy Assuta
External radiation therapy is used much less frequently, mostly in anaplastic cancer, at least - in medullary. The radiation comes from outside, from a linear accelerator.
For each case of the disease in the planning process, doctors expect the overall radiation dose, schedule up procedures specific period of time. Sessions are held on weekdays, approximately one and a half months. The type of cancer and tumors value determined duration. Treatment is carried out in the hospital radiotherapy. The doctor gives detailed information on the treatment.
The main indications:
- after surgery to destroy the surviving malignant cells;
- if you can not perform the operation;
- when there is a return of the disease.
In the treatment of follicular and papillary thyroid cancer are turning to external beam radiation therapy if there are difficulties with the resection of the tumor. It can be performed before and after the internal radiotherapy.
The possible negative consequences
The dose and duration of treatment effect on the side effects. Doctors previously provide information on the potential undesirable consequences:
- taste changes;
- dry mouth;
- pain when swallowing;
- severe fatigue;
- skin darkens and becomes tinged with red.
Provide advice to the patient how to care for the skin during treatment.
Side effects are approximately four weeks after completion of therapy.
Measures to reduce side effects, palliative therapy in Assuta
All methods of cancer treatment provoke certain side effects. Doctors tend addition of the therapy itself, as much as possible to reduce the symptoms of the disease and the negative effects of the treatment for thyroid cancer, enhance the quality of life of the patient. These techniques include:
- drug therapy;
- relaxation technique;
- changes in the power system;
- psychological support, and so on.
Treatment of recurrent cancer of the thyroid gland in the Assuta
After reaching remission, when there are no symptoms of the disease, the situation of occurrence of secondary tumors. It can appear in the area of the original fire, next to him, or in a particular area.
In this situation, the diagnostic procedure is performed, discuss the most suitable treatment options of thyroid cancers. We consider the above methods - radiation, chemotherapy, surgery, clinical trials.