Medullary thyroid cancer

Thyroid cancer occurs when the cells proliferate in the organ. The main function of the body is the production of hormones for the normal operation of the whole organism. There are several forms of thyroid cancer, among which the least widespread is the medullary thyroid cancer (diagnosed in 5% of patients). With this form of cancer, abnormal growth of C-cells occurs, for the disease, characteristic symptoms are facial flushing, upset of the stool. Also, the medullar cancer proceeds more aggressively, in comparison with other forms, metastasizes in a number of located lymph nodes, can affect the trachea, muscles, less often metastases are found in internal organs.

ICD-10 code

Medullary thyroid cancer in ICD 10 belongs to class II (neoplasm) and stands under the code C73.

Causes of Medullary Thyroid Cancer

The main cause of development of this form of cancer is considered to be gene modifications. It is in the genes that information is stored, which is controlled by our body. Experts believe that the development of the tumor in some cases is genetically inherent.

Medullary thyroid cancer can provoke disruption of the body (excessive production of hormones, autoimmune diseases), as well as radiation therapy in the past.

Women are more prone to this form of cancer.

[1], [2]

Pathogenesis

The development of medullary cancer leads to the C-cells, of which the thyroid gland is composed. These cells produce calcitonin, necessary for metabolic processes in the body.

When the structure of the tissue changes, the gland increases, an abnormal growth of C-cells begins and an increased production of calcitonin, as a result, medullary thyroid cancer is diagnosed.

Symptoms of medullary thyroid cancer

With all forms of thyroid cancer, there are similar symptoms - a palpable formation in front of the neck. In the first stages the neoplasm does not disturb the person, but after a while soreness appears, the voice becomes hoarse, breathing, swallowing, lymph nodes increase.

Approximately half of the cases reveal metastases in the adjacent lymph nodes, in 20% of cases, cancer cells affect distant organs, most often affected by bones, liver, lungs.

First signs

The first sign of the pathology is a tumor in the neck (front), medullary thyroid cancer is characterized by early metastasis, and it can often be indicated by enlarged cervical lymph nodes.

[3], [4], [5],

Effects

Medullary thyroid cancer is an extremely aggressive form of cancer, the tumor is developing too fast, in the early stages of cancer already spreads to adjacent lymph nodes, eventually cancer affects distant organs (most often bones).

[6], [7], [8], [9]

Complications

Medullary thyroid cancer is a danger, first of all, by its rapid development - at the initial stages the cancer already metastasizes and can affect the cervical lymph nodes. With early detection of a cancerous tumor and metastasis, properly prescribed complex treatment, the patient's life is not threatened.

If the disease is detected in the late stages, the treatment is aimed primarily at improving the quality of life of the patient.

With the growth of the medullary tumor, metastases can also spread to the lungs, liver, bones.

[10], [11], [12], [13]

Diagnosis of medullary thyroid cancer

To examine the vocal cords of the patient with suspicion of medullary carcinoma, a laryngoscope is used, blood tests, ultrasound or CT of the thyroid gland are assigned, and during the palpation examination the doctor determines the neoplasm and is determined with further diagnosis.

Medullary thyroid cancer is caused by abnormal growth of C-cells, which produce calcitonin, it is the high level of this hormone that can be associated with the development of the pathological process in the thyroid. A high level of calcitonin in the blood is due to the fact that the C-cells continue to produce it, it is this hormone that is a kind of oncomarker that indicates the development of the medullary tumor.

[14], [15], [16], [17], [18]

Analyzes

If suspected of medullary thyroid cancer, a blood test is assigned to help identify cancer markers.

An increased level of calcitonin may indicate the development of medullary carcinoma. If the level of this hormone is increased after the course of treatment, most likely, there are distant metastases.

Metastasis can also be indicated by an elevated level of parathyroid hormone.

It is worth noting that the blood test does not always reliably indicate cancer, sometimes in cancerous processes the level of hormones is normal and, conversely, in a healthy person. The level of hormones can increase due to various factors.

If the patients' relatives had a medullary cancer, a genetic analysis is performed on the mutation of the RET gene.

[19], [20], [21], [22], [23], [24], [25]

Instrumental diagnostics

After the examination, the specialist prescribes a blood test and instrumental diagnostics to confirm the diagnosis.

It is mandatory to undergo ultrasound, which will help determine the size of the tumor, localization, prevalence, as well as identify hidden (not palpable) foci of small size.

Since the medullary thyroid carcinoma is characterized by early metastasis, x-rays or tomography of the esophagus, skeleton, lungs, etc. Are identified to identify the foci of probable tumor spreading.

To establish the cells that formed the tumor using invasive diagnostic methods - fine needle aspiration biopsy, which is carried out under the control of the apparatus of ultrasound. A biopsy allows you to take a small area of the tumor for laboratory testing. The method is quite accurate and low traumatic.

If the results of the biopsy are questionable, an open biopsy is used. This method represents a small surgical intervention, in which a small part of the tumor is excised and sent to the study.

Differential diagnostics

In differential diagnosis, the results of a laboratory study of tumor tissue taken on a biopsy are of primary importance. This study allows you to determine the type of cancer and the histological variety.

If the medullary thyroid cancer is a hereditary disease, a blood test for the level of hormones and RET mutation is prescribed.

[26], [27], [28], [29], [30]

Treatment of medullary thyroid cancer

Medullary thyroid cancer is insensitive to radiation and chemotherapy. C-cells are not susceptible to radioactive iodine, so this treatment is ineffective. Radiation therapy is aimed solely at relieving the patient's condition, but it does not help fight cancer. Treatment of medullary cancer is predominantly prompt, which in most cases allows avoiding relapses. During the operation, the thyroid gland, affected lymph nodes is removed. After the operation, a blood test for the level of calcitonin is mandatory (at high rates, diagnostics is needed to find new cancerous foci).

Medications

Medullary thyroid cancer in addition to surgical treatment may include medication. Among the drugs used target, which block the growth of atypical cells.

Distributed drugs such as Capresa, Pazopanib.

Pazopanib I take inside at 400-800 mg per day, depending on the individual tolerability of the drug. Against the background of treatment, headaches often occur, transient ischemic attack, dizziness, increased pressure, coughing, nosebleeds, chest pain, fatigue, weight loss.

The drug is not prescribed to pregnant women, children and adolescents under 18 years old, with renal and hepatic insufficiency.

Kaprulsa is prescribed at 300 mg per day, usually the drug is prescribed until the time when patients will not cease to receive tangible benefits from the drug.

On the background of treatment, diarrhea, vomiting, abdominal pain, pancreatic inflammation, fatigue, puffiness, weight loss, increased hemoglobin level, insomnia are often observed. Contraindicated in violation of the QT interval, renal and hepatic insufficiency, pregnant women, children and adolescents under 18, with increased susceptibility to the components of the drug.

Alternative treatment

In alternative medicine, cancer plants use poisonous plants that kill cancer cells. There are facilities for both oral and compresses. The course of treatment can last from several months to several years (depending on the type and stage of cancer).

In tumors with metastases, intensive treatment is required, sometimes requiring several medications.

An effective remedy is ointment from Cyclomen: 50 g of root grate (preferably shallow), put in a jar, add unsalted lard and pour on a water bath for 2 hours. Ointment should be applied to the thyroid gland every evening, top covered with gauze (keep the compress until the morning). The course of treatment is not less than a month.

[31], [32], [33],

Herbal Treatment

Medullary thyroid cancer, as already noted, develops rapidly and metastasizes, so treatment in this case should be strengthened.

In alternative medicine for serious diseases use potent herbs, for example, poisonous milestones. For treatment, fresh leaves are needed, which are washed and applied to the thyroid gland for half an hour (it is better to perform the procedure in the evening).

Collections of herbs for oral use are also widely used for the treatment of cancer patients.

The most effective means is the following:

• - 100 grams of sage, Kirkazon, the root of a blood-groove, a chernobylnik, 50 g of poplar buds, hemlock (flowering parts), mistletoe white.
• 3 tablespoons mixture to brew 1 liter of boiling water (it is better to do this in a thermos) and insist 12 hours.

Dosage is calculated for 1 day of intake - 1 glass at regular intervals. The course of treatment is 14 days, if necessary, the course can be repeated after 2 months.

Another tool that is slightly weaker than the previous one, but no less effective (you can take it for a long time).

• For 75 g of shoots of the viburnum, celandine, elderberry flowers, 50 g of bitter wormwood.
• 1 tsp mix the mixture in 250 ml of boiling water, after 10 minutes, drink in small sips.

After a few weeks the condition improves, the symptoms disappear.

Homeopathy

Homeopathic remedies have recently been used in various diseases, and medullary thyroid cancer has also become an exception.

Among homeopaths, the most common remedy is the American lakonos and hemlock spotted hemlock.

Lakonos (phytolaca) contains bitter substances, starch, saponin, essential oils, phytolacicin, vitamin C. It is produced in the form of a dragee. Dosage and treatment is prescribed by a specialist taking into account the severity of the patient's condition.

Hemlock is considered a powerful anti-cancer drug, besides with immunostimulating effect. According to some data, hemlock helps in the last stages of cancer with multiple metastases and can replace even narcotic substances that are used for anesthesia. The opinions of specialists about this herb differ - some consider heredits not effective, others believe that this drug should be included in the list of antitumor drugs.

Take the tincture in a warm form for better absorption. Dosage and duration of treatment is determined by the doctor in each case.

Operative treatment

Medullary thyroid cancer is treated mainly surgically.

The surgeon removes all affected tissues, including adjacent lymph nodes.

The removal of lymph nodes is due to the fact that in palpable tumors, metastases are detected in 90% of cases.

Prevention

Medullary thyroid cancer develops mainly because of genetic mutations. Also affect the abnormal growth of C-cells can be thyroid disease. In this case, it is necessary to treat the diseases of this body in a timely manner, to undergo preventive examinations (especially to people at risk).

Forecast

Medullary thyroid cancer happens in several forms and the predictions in each case will be different. In hereditary diseases, the prognosis is more favorable, since the development of pathology is easier to prevent. 5-year survival is observed in patients with metastases in the cervical lymph nodes (approximately 80% of cases), if the metastases in distant organs the chances of survival sharply decrease.

[34], [35], [36]