Thyroid cancer because of its relatively good prognosis, high survival rate, the risk and harm to the human body is relatively low, so both professionals and the general public will call thyroid cancer "good cancer". But, is this really the case?
Differentiated thyroid cancer is a type of thyroid cancer with a low degree of malignancy and a high incidence, and surgery is currently the main treatment of differentiated thyroid cancer. However, studies have shown that 20% to 30% of patients with differentiated thyroid cancer can have recurrence or metastasis[1], which is ultimately life-threatening!
What factors increase the risk of recurrence of thyroid cancer?
There are many and complex risk factors for postoperative recurrence and metastasis in patients with differentiated thyroid cancer, and it cannot be said that it is caused by one or two factors, and many times postoperative recurrence and metastasis may be caused by the combination of several factors.
Thyroid cancer has a higher risk of recurrence if:
Tumors ≥5 cm in diameter, preoperative lymph node metastasis, multiple lesions, and TNM stages III.-IV. are independent risk factors for postoperative recurrence in patients with differentiated thyroid cancer[2].
As the tumor volume increases, the degree of invasion of surrounding tissues deepens, and the difficulty of complete resection of the lesion during surgery increases, resulting in an increased risk of recurrence of postoperative thyroid cancer.
Preoperative lymph node metastasis and multiple lesions may lead to the presence of multiple occult lesions in the patient's body at the same time, and although the lesions are removed and lymph node dissected during surgery, it is difficult to completely remove the occult lesions, increasing the risk of postoperative recurrence.
With the increase of TNM staging, the degree of malignancy of the lesion increases significantly, and the recurrence rate after surgery increases.
TNM staging
T represents the primary tumor size, N represents the state of lymph nodes, and M represents the presence or absence of distant organ metastases
What are the "signals" of thyroid cancer recurrence?
Postoperative review of ultrasound B found new masses, and further clarification of benign and malignant diseases is required.
Patients who have completely cleared the thyroid gland, there is no thyroid cancer foci and thyroid tissue that can secrete thyroglobulin (Tg) in the body, Tg should be reduced to a very low level, and regular detection of serum Tg levels is an important means to determine whether the patient has tumor recurrence or metastasis.
Does the presence of neck pain or discomfort indicate a recurrence?
There is no scientific basis.
Pain or discomfort is not clearly related to recurrent metastasis, and it is possible that during surgery or treatment, muscle tissue, nerves, etc. of the neck are damaged, resulting in prolonged pain and discomfort.
How to reduce the risk of recurrence and metastasis after thyroid cancer surgery?
Review regularly
Regular postoperative review of thyroid function and ultrasound can help with better recovery and prevent recurrence of the disease.
Follow-up should be regular and regular, and in general, it is advisable to repeat 4-5 times a year after surgery, and 2-3 times a year after one year after surgery.
Keep taking your medication
Most patients should take levothyroxine sodium tablets (Eumethyl) for life after surgery to supplement the lack of thyroxine in the body and use levothyroxine sodium tablets to lower thyroid-stimulating hormone (TSH) values to reduce the rate of preventing thyroid cancer recurrence.
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Note: It is recommended to eat less foods with high iodine content such as kelp and seaweed.
bibliography
1. Gao Lini, Zhang Min, Yang Dayan, et al. Relationship between ultrasound characteristics of primary mass before surgery for differentiated thyroid cancer and postoperative cervical lymph node metastasis[J]. Chinese Journal of General Surgery,2019,28(5):630-635.
2. Sun Weijing, Tong Ronghui, Su Siwen. Risk factors for postoperative recurrence in patients with differentiated thyroid cancer[J]. Chinese Journal of Health Engineering, 2019(18) 5: 794-796.