At present, surgery is the most common treatment for thyroid cancer . According to the pathological type, thyroid cancer can be divided into multiple subdivided types, among which the treatment effect and risk of postoperative recurrence are also different for different types of thyroid cancer.
differentiated thyroid cancer, with a postoperative recurrence rate of about 30%
differentiated thyroid cancer (DTC) includes papillary carcinoma and follicular carcinoma. It is the most important type of thyroid cancer, covering more than 90% of patients. Its main treatment is surgery. So, does the surgery mean that it has been cured?
In fact, there is currently no recognized standard for "curing" thyroid cancer in the professional world. About 30% of DTC patients will experience postoperative recurrence or metastasis, of which 2/3 of them occur within ten years after surgery.
What factors may increase the risk of recurrence?
Some factors may have planted seeds for postoperative recurrence, such as cervical lymph node metastasis, thyroid external invasion or distant metastasis during the operation, a family history of thyroid cancer, and residual cancer foci during the operation.
According to the 2015 American Thyroid Association Association, ATA)'s opinion, thyroid cancer with the following factors has a high risk of recurrence:
1. The tumor can be seen to invade the soft tissue around the thyroid gland;
2. The tumor has not been completely removed;
3. Distant metastasis occurs;
4. The pathological stage is N1 (there is regional lymph node metastasis), and the maximum diameter of the metastatic lymph node is greater than 3 cm;
5. The doctor judges that the level of serum Tg ( thyroglobulin , thyroglobulin) is abnormally increased after surgery;
6. Thyroid follicular carcinoma with extensive vascular infiltration (vasolateral invasion is greater than 4 lesions).
There is currently no clear medical evidence that a certain food may increase the risk of recurrence. However, you should pay attention to the iodine in your diet. It is recommended to eat less foods such as kelp and seaweed that contain high iodine. If possible, you can cook without iodine salt, but if there are teenagers and children in the development stage at home, there is no need to demand to eat without iodine salt. Because iodine is indispensable for the development of children's physical and intellectual properties. What "signals" may arise when relapsed?
After radical surgery, almost all patients will feel different degrees of neck pain or discomfort. Is this a sign of recurrence? This is not the case with
. There is no clear relationship between pain and recurrence and metastasis. During the operation, damage to nerves, muscles, blood vessels and other tissues will cause neck discomfort and pain during the recovery period, which can be relieved through rehabilitation exercise. The following situations occur in
, which reminds you to pay special attention:
, a new neck mass was found in the follow-up examination after surgery, and a B-ultrasound examination should be performed in time to clarify the nature.
blood index abnormal.
1. The main biochemical indicators for postoperative tracking are TSH (thyroid-stimulating hormone) and Tg, which are generally reviewed every 3 to 6 months. If you have undergone total thyroidectomy and do not have thyroid cancer lesions and thyroid tissues that can secrete Tg, the Tg should be reduced to extremely low levels. If Tg is detected in the serum and is higher than normal, it often indicates that thyroid cancer lesions remain or recurs.
2. The elevation of serum calcitonin and carcinoembryonic antigen suggests that medullary thyroid carcinoma may recur.
How to detect the "signs" of relapse as soon as possible?
After the operation, we will come to the hospital regularly for follow-up and complete necessary examinations in accordance with the doctor's instructions. This is a reliable way to detect recurrence or metastasis in the early stage. Generally speaking, the re-examination will be conducted every 3 months within one year after the operation; the re-examination interval will be extended as appropriate one year later, such as re-examination every 6 months. If you need to adjust the dose of thyroxine tablets, you should check the thyroid function again one month after the adjustment to observe the effect of the drug.
It is necessary to remind you that the above is a general principle. If your condition fluctuates or the doctor needs you to increase the review, please follow the doctor's advice.
Summary
There may recur after surgery. You should follow the doctor's instructions regularly to detect recurrence and metastatic lesions as soon as possible.
Article source: Fudan University Affiliated Cancer Hospital Head and Neck Surgery
Author: Wang Yu (Head and Neck Surgery Department of Head and Neck Surgery Affiliated Cancer Hospital Affiliated to Fudan University - Chief Physician) Dr. Yang Shuwen (Cancel Hospital Affiliated to Fudan University)
Original title: Will thyroid cancer recur after surgery? How to detect it?
