Papillary thyroid cancer symptoms & treatment

Papillary thyroid cancer is a type of thyroid cancer that forms in the thyroid gland, the butterfly-shaped gland at the base of your neck. It is sometimes called papillary thyroid carcinoma.

Papillary thyroid cancer accounts for up to 80% of all cases of thyroid cancer and is more common in women, especially those in their childbearing years. Papillary thyroid cancer is often treated successfully and is rarely fatal.

Symptoms are typically not noticeable in the initial stages of papillary thyroid cancer. As the cancer cells grow, a lump or nodule in the neck may become noticeable along with other symptoms such as swollen lymph nodes or pain in your throat or neck.

What is papillary thyroid cancer?

Papillary thyroid cancer, along with follicular thyroid cancer, is one of the more prevalent types of thyroid cancer. When viewed under a microscope, papillary cancer cells look like tiny fingers.

These cancerous cells grow in the thyroid gland, which produces hormones that control your heart rate, blood pressure and body temperature. The two primary hormones produced by your thyroid include:

• Thyroxine (T4): This is the main type of thyroid hormone produced by the thyroid gland. T4 is produced in higher amounts and regulates metabolism, heart rate and body temperature.
• Triiodothyronine (T3): This is a more potent form of the thyroid hormone but produced in smaller quantities. T3 helps regulate metabolism and supports cell activity throughout the body.

Papillary thyroid cancer develops in the follicular cells in your thyroid that produce thyroglobulin, a protein used to signal the release of T4 and T3 hormones. Papillary thyroid cancer causes the levels of this protein to increase in the thyroid. While thyroglobulin isn’t harmful, too much cand lead to inflammation, iodine deficiency, enlargement of the thyroid or thyroid dysfunction.

Papillary thyroid cancer symptoms

Most people don’t experience any symptoms of papillary thyroid cancer, especially in the early stages. However, you may experience:

• A lump in your neck or enlarged thyroid gland
• Difficulty swallowing
• Hoarseness or voice changes
• Difficulty breathing
• Neck pain or discomfort
• Swollen lymph nodes
• Fatigue
• Weight changes
• Sensitivity to hot or cold temperatures
• Changes in heart rate

It's important to note that these symptoms can be caused by conditions other than papillary thyroid cancer, such as benign thyroid nodules, thyroiditis or other thyroid disorders.

If you experience persistent or concerning symptoms, especially neck lumps, difficulty swallowing or breathing or voice changes, schedule an appointment with your Aurora Health Care provider.

Diagnosing papillary thyroid cancer

To diagnose papillary thyroid cancer, your doctor will review your medical history and perform a physical exam. During the exam, they’ll check for a lump in your neck or thyroid and for swollen lymph nodes.

If your doctor suspects you have cancer, they may order other tests to include:

• Biopsy: Your doctor will remove a small piece of thyroid tissue and examine it for cancer cells.
• Thyroid blood tests: This test checks your thyroid function by testing your levels of thyroid stimulating hormone (TSH) and T4 levels.
• Fine needle aspiration biopsy: A thin needle is placed into the lump in your neck and cells are drawn out and then examined under a microscope to look for cancer.
• Digital imaging tests: An ultrasound may be ordered to evaluate the mass and may be used to perform a biopsy. To get a clearer image of the thyroid, your provider may order a CT scan or MRI.

What is the first line of treatment for papillary thyroid cancer?

The primary treatment for papillary thyroid cancer is surgery, particularly a thyroidectomy. This type of surgery involves the removal of part or all of your thyroid gland. Whether you have a partial or total thyroidectomy depends on various factors, such as how far it has spread and the tumor’s size.

After surgery you will need to take thyroid hormone pills to replace the missing thyroid hormones due to no longer having a thyroid gland.

Your surgeon will also perform radioactive iodine ablation (RAI) to kill any remaining thyroid tissues after surgery. Thyroid tissue absorbs iodine, and the radiation kills the tissue.

What are nonsurgical treatments for papillary thyroid cancer?

If the cancer is more advanced or has spread to surrounding tissues, external-beam radiation therapy may be used to deliver high-energy radiation beams to the tumor site to destroy cancer cells.

It's important to discuss your treatment options with a multidisciplinary care team including endocrinologists, surgeons, oncologists and radiation oncologists, to develop a personalized treatment plan. Early detection and appropriate treatment can significantly improve outcomes and prognosis for papillary thyroid cancer.