Follicular Thyroid Cancer: Symptoms, Causes, Treatment

What are the symptoms of follicular thyroid cancer?

Follicular thyroid cancer is a type of thyroid cancer that originates from follicular cells in the thyroid gland. The symptoms of follicular thyroid cancer can vary, but they may include:

A lump or nodule in the thyroid gland, which is often the first noticeable symptom.
Swelling in the neck, sometimes causing difficulty swallowing or breathing.
Pain in the neck or throat, which can sometimes radiate to the ears.
Hoarseness or other changes in the voice.
Persistent cough that is not related to a cold or other respiratory infection.
Difficulty swallowing (dysphagia).
Enlargement of the lymph nodes in the neck (lymphadenopathy).

It’s important to note that these symptoms can also be caused by other conditions, so it’s essential to see a healthcare provider for an accurate diagnosis if you experience any of these symptoms.

What are the causes of follicular thyroid cancer?

The exact cause of follicular thyroid cancer is not known, but several factors may increase the risk of developing this type of cancer. These risk factors include:

Age: Follicular thyroid cancer is more common in people over the age of 40, and the risk increases with age.
Gender: Women are more likely to develop follicular thyroid cancer than men.
Radiation exposure: Previous exposure to radiation, especially during childhood, increases the risk of developing thyroid cancer.
Family history: Having a close relative, such as a parent or sibling, with thyroid cancer or certain genetic syndromes can increase the risk.
Iodine deficiency: A diet low in iodine may increase the risk of thyroid cancer, including follicular thyroid cancer.
Benign thyroid conditions: Certain benign (non-cancerous) thyroid conditions, such as goiter or thyroid nodules, may increase the risk of developing thyroid cancer.
Genetic mutations: Inherited genetic mutations, such as in the RET gene or the PTEN gene, can increase the risk of developing follicular thyroid cancer.

It’s important to note that having one or more risk factors does not mean that a person will develop follicular thyroid cancer, and many people with thyroid cancer do not have any known risk factors.

How is the diagnosis of follicular thyroid cancer made?

The diagnosis of follicular thyroid cancer is typically made through a combination of medical history, physical examination, imaging tests, and biopsy. Here is an overview of the diagnostic process:

Medical history and physical examination: Your healthcare provider will ask about your symptoms, medical history, and any risk factors for thyroid cancer. They will also perform a physical examination, focusing on the neck to check for any lumps or enlargement of the thyroid gland.
Blood tests: Blood tests may be done to measure thyroid hormone levels (T3, T4, and TSH) and to look for markers of thyroid cancer, such as high levels of thyroglobulin.
Imaging tests: Imaging tests, such as ultrasound, CT scan, or MRI, may be done to evaluate the thyroid gland and surrounding structures for any abnormalities or signs of cancer.
Biopsy: A biopsy is the most definitive way to diagnose follicular thyroid cancer. During a biopsy, a small sample of tissue is taken from the thyroid gland and examined under a microscope for the presence of cancer cells. This is often done using a fine needle aspiration (FNA) biopsy, which is a minimally invasive procedure.
Histopathological examination: If the biopsy indicates the presence of cancerous cells, a histopathological examination of the tissue sample will be done to determine the type and characteristics of the cancer cells. This helps to confirm the diagnosis of follicular thyroid cancer.
Staging: Once a diagnosis is confirmed, further tests may be done to determine the stage of the cancer, which helps to guide treatment decisions. Staging may involve additional imaging tests, such as a PET scan or a thyroid scan.

It’s important to work closely with your healthcare team to undergo the necessary tests and procedures for an accurate diagnosis and to develop an appropriate treatment plan.

What is the treatment for follicular thyroid cancer?

The treatment for follicular thyroid cancer depends on several factors, including the stage of the cancer, the patient’s age and overall health, and whether the cancer has spread to other parts of the body. Treatment options may include:

Surgery: The main treatment for follicular thyroid cancer is surgery to remove the thyroid gland (thyroidectomy). In some cases, the surgeon may also remove nearby lymph nodes to check for the spread of cancer. If only part of the thyroid is removed (lobectomy), close monitoring is needed to ensure the cancer does not return.
Radioactive iodine therapy: After surgery, radioactive iodine therapy may be recommended to destroy any remaining cancer cells. This treatment is often used if the cancer has spread beyond the thyroid gland.
Thyroid hormone therapy: After surgery, thyroid hormone replacement therapy is usually necessary to replace the hormones normally produced by the thyroid gland. This helps to prevent the growth of any remaining thyroid tissue and lowers the risk of cancer recurrence.
External beam radiation therapy: In some cases, external beam radiation therapy may be used after surgery to destroy cancer cells or to treat cancer that has spread to other parts of the body.
Chemotherapy: Chemotherapy is not typically used to treat follicular thyroid cancer, as this type of cancer tends to respond poorly to chemotherapy drugs.
Targeted therapy: Targeted therapy drugs may be used in some cases, especially for advanced or metastatic follicular thyroid cancer that has not responded to other treatments.
Clinical trials: Participation in clinical trials may be an option for some patients, offering access to new treatments that are not yet widely available.

Treatment decisions should be made in consultation with a multidisciplinary team of healthcare providers, including surgeons, endocrinologists, oncologists, and radiation oncologists, to develop a personalized treatment plan based on the individual patient’s needs and circumstances.

What is the survival rate for follicular thyroid cancer?

The survival rate for follicular thyroid cancer (FTC) is generally excellent, with a 5-year overall survival rate of over 90%. According to the American Cancer Society, the 5-year survival rate for FTC is:

98% if the tumor is localized (has not spread to other parts of the body)
83% if the tumor has spread to regional lymph nodes
62% if the tumor has spread to distant parts of the body (metastatic)

The overall 10-year survival rate for FTC is also high, at around 80-90%.

There are several factors that can affect the survival rate for FTC, including:

Size and location of the tumor
Presence of distant metastases
Age of the patient
Presence of certain genetic mutations (e.g., RET/PTC or BRAF mutations)
Response to treatment

Overall, early detection and treatment of FTC can significantly improve survival rates. Treatment options for FTC typically include surgery, radioactive iodine (I-131) ablation, and sometimes external beam radiation therapy or chemotherapy.