Extent of thyroid cancer – why?
Thyroid cancer is a difficult diagnosis in a disease originating from the epithelial cells. This is because it has no pathognomonic symptoms, that is allowing you to speak with confidence about this disease. So often diagnosis is made late. In addition, the allocation of degrees of thyroid cancer allows one to determine the prognosis for the patient. Obviously, the sooner diagnosed, the better the survival rate.
Classification of thyroid cancer
Classification of thyroid cancer is necessary in order to develop specific treatment programs for each stage, and to determine the prognosis for the patient. Therefore, the main classification approaches are:
- taking into account the degree of differentiation of tumor cells;
- extent of thyroid cancer;
- histological structure of the tumor, i.e., its tissue composition.
The determination of a particular degree of cancer takes into account the following characteristics:
- the size of the tumor and its prevalence;
- the increase in regional lymph nodes;
- the presence of distant metastases.
The degree of differentiation of cancer cells of the thyroid gland can be:
- highly differentiated (the most favorable variant of the tumor);
- moderately differentiated;
- low-differentiated (least favorable option due to the rapid multiplication of the tumor cells).
On histological structure distinguish the following types of tumor.
- papillary of adenocarcinoma – has a papillary structure;
- follicular adenocarcinoma;
- medullary adenocarcinoma;
- squamous cell carcinoma.
The allocation of degrees of the cancer process does not depend on the degree of differentiation of the tumor, either from its histological structure. When determining the extent of thyroid cancer is taken into account the histological structure of the tumor. Also, be aware that for papillary and follicular cancer should take into account the patient's age as 45 years, one classification, and over 45 different.
Cancer first degree
First, consider the clinical classification of papillary and follicular thyroid cancer in the first degree.
Cancer of the thyroid gland of 1 degree in the age of the patient up to 45 years is characterized by the following features:
- the tumor is any size;
- the increase in regional nodes either exists or not;
- metastases do not exist.
If the patient is older than 45 years, the degree of cancer risk increases. Therefore, the signs of the 1st degree of cancer will be the following:
- the diameter of the tumor less than 1 cm, while its tissue is clearly demarcated from the surrounding thyroid tissue;
- regional lymph nodes were not enlarged;
- distant metastases no
For medullary thyroid cancer of the first degree has the following characteristics:
- the tumor has a diameter of 1 cm;
- no enlarged lymph nodes;
- no metastases.
Cancer second degree
Thyroid cancer 2nd degree is classified the same way according to the histological structure and age of the patient.
So, to 45 follicular and papillary cancer 2 evident presence of metastases, while the size of the tumor and status of regional lymph nodes is irrelevant. If patient's age over 45 years, that cancer refers to the 2-nd degree in the case when a primary tumor in a diameter of up to 1cm, with metastases and increase of regional lymph nodes is absent.
Medullary carcinoma of the 2nd degree is characterized by the following features:
- primary tumor greater than 4 cm;
- lymph nodes not affected by cancer.
- no distant metastases.
Follicular and papillary thyroid cancer grade 3 is characterized by:
- the presence of tumors having different sizes, while it extends beyond the capsule of the thyroid gland;
- lymph nodes were not enlarged;
- distant metastases are absent.
There is another situation when the tumor size does not matter. It is important that determines the increase in regional lymph nodes, while metastases do not exist.
Medullary cancer should be referred to the 3rd degree in the case when in addition to the primary tumor of any size has a lesion of the regional lymph nodes without metastases.
Cancer fourth degree
Cancer 4-th degree is the most unfavourable option, and tells about the late diagnosis. Talk about it when there are distant metastases, the size of the tumor and status of regional lymph nodes is not taken into account. Also to this degree should include any cancer that is composed of undifferentiated cells. They are always associated with a poor prognosis for the patient, as they are rapidly dividing and before lead to various complications of the cancer process.
How to detect a thyroid tumor?
The main clinical signs of cancer thyroid lesions are:
- tumor formation, which is palpable in the gland;
- discomfort in the neck;
- difficulty swallowing;
- sore throat;
- change the voice, maybe his osiplosti;
- impaired swallowing (dysphagia).
How to identify the defeat of the regional lymph nodes?
If tumor cells spread to regional lymph nodes, then this leads to the following symptoms:
- swollen lymph nodes;
- the emergence of their pain;
- symptoms of compression of adjacent organs (discomfort in the armpit, breast pain, lose neck, etc.).
Instrumental methods are able to diagnose this condition.
The symptoms of metastases
The clinical pattern of metastases is determined by:
- lesion of an organ, so symptoms are very diverse;
- cancer intoxication.
In this stage, a sick man looks anguished – he's skinny, skin has an earthy pale shade. There is a constant pain, which requires the use of narcotic analgesics as the pain no other drugs can not be cropped. The use of additional research techniques to determine which organ is involved in cancer, except for thyroid. It can be distant lymph nodes, kidneys, liver, lungs, etc.
To determine the extent of thyroid cancer, it is necessary to use additional methods of diagnosis. Modern Oncology proposes to use the following:
- radioisotope scintigraphy;
- ultrasound examination of the thyroid gland;
- computed tomography;
- magnetic resonance imaging;
- positron emission tomography;
- fine-needle aspiration biopsy with subsequent cytological examination;
- molecular genetic techniques (determination of the expression of specific genes);
- histological study, which is the gold standard for the diagnosis of the cancer process.
Thus, for the timely diagnosis of thyroid cancer it is necessary to use ultrasound examination of this organ, and aspiration biopsy using a fine needle. It gives the opportunity to study the cellular structure of the thyroid gland and to detect atypical cells. If they are detected, further diagnosticsearch aimed at identifying the extent of the disease, that is, the detection of pathologically altered regional lymph nodes and distant metastases.
In conclusion, it should be noted that thyroid cancer is an insidious disease. It is therefore very important to carry out timely diagnosis, i.e. before the development of clinical symptoms. Their appearance always suggests that cancer already has a certain prevalence, which negatively affects the condition of the patient. That is why there are degrees of this disease. On the basis of the extent it is possible to make a rough treatment program, and to determine the prognosis for the patient.