Thyroid cancer Flashcards
What are the types of thyroid cancer?
papillary; follicular; medullary; anaplastic
What does differentiated thyroid cancer refer to?
papillary and follicular cancer
What are the features of differentiated thyroid cancer?
take up iodine and secrete thyroglobulin
What hormone drives DTC?
TSH
What factors increase risk of thyroid cancer?
radiation (eg Chernobyl) but NOT any lifestyle factors
How do the majority of thyroid cancers present?
palpable nodule
What is the most common type of thyroid cancer?
papillary
How does papillary tend to spread?
via lymphatics
What other thyroid condition is papillary associated with?
Hashimotos
In what areas is the incidence of follicular carcinoma higher?
regions of iodine deficiency
How does follicular tend to spread?
haematogenously
Where does follicular tend to spread to?
lungs; liver; bone; brain
What is the investiagtion of thyroid cnacer?
USS FNA
What is the treatment for thyroid cancer?
surgery
What are the surgical options for thyroid cancer?
thyroid lobectomy with isthmusectomy; sub-total thyroidectomy; total thyroidectomy
What is the risk stratification system for thyroid cancers?
AMES- A=age; M=mets; E=extent of primary; S=size of priamry
What is the practice for lymph nodes for papillary?
central compartment clearnace and lateral lymph node sampling
What is the practice for lympn nodes for follicular?
central lymph node clearnace
What electrolyte needs to be checked post-op?
calcium
Why might calcium be decreased post-op?
if parathyroids have been taken out along with thyroid gland
What should patients have who have undergone sub-total or total thyroidectomies?
wole body iodine scans
When are whole body iodine scans carried out?
3-6 months post-op
Why does TSH need to be high for iodine scan?
makes cancer cells hungry for iodine- will light up on scan
How is TSH increased before the iodine scan?
can either- stop T4/T3 before scan (makes patient feel rubbish) so give rhTSH before scan
What should you be able to see on an iodine scan?
salivary glands; gastric muscosa; bladder
What happens if there is a remnant of thyroid cancer?
thyroid remnant ablation
What are the side effects of thyroid remnant ablation?
sore throat, inflam of salivary glands
What is used as a tumour marker following treatment?
thyroglobulin
What should be suppressed in patients after cancer treatment?
TSH- would make cancer cells grow
Is there evidence of infertility or subsequent genetic abnormalities in children follwing TRA?
no
