Fundamentals of Medullary Thyroid Cancer
Medullary Thyroid Cancer
is carcinoma of the thyroid gland, which begins in “C” cells that
release the hormone, calcitonin. At present there is no known cause for this type of thyroid cancer.
While the other types of thyroid cancer may be caused by radiation
therapy to the neck to treat childhood cancers, it is unlikely that
radiation causes this disease.
There are two different forms of medullary thyroid cancer:
sporadic, which mostly manifest in older adults and inherited, which
runs in families. You are at increased risk if you
have:
- Family history and/or multiple endocrine neoplasia (MEN)
- Past history of pheochromocytoma, mucosal neuromas or hyparathyroidism.
- Narrowing of airways leading to breathing difficulties
- Cough containing blood
- Chronic diarrhea
- Goiter
- Lump on thyroid gland
Be aware that when medullary thyroid cancer
presents, most physicians order additional medical tests to rule out
tumors characteristically seen in people with MEN 2 syndromes.
Potential presence of tumors such as parathyroid or pheochromocytoma,
must be excluded, since they would make it dangerous for the person to
have anesthesia and surgery. Even if the tumors have manifested, the
person can be treated medically to ensure safe surgery.
Diagnosis
In order to correctly diagnose medullary thyroid cancer, your medical
practitioner will perform a complete physical assessment. Lymph nodes in
your neck may be swollen, but thyroid function tests are generally
normal.
Various medical tests include:
- Calcitonin blood test – Calcitonin is a hormone, which the C cells
in the thyroid gland produce. Medical professionals are uncertain about
its role in the human body. However, animal testing has shown that
calcitonin controls blood calcium by reducing the amount of calcium
released from their bones. - Genetic testing
- Biopsy thyroid gland
- Thyroid ultrasound
- CEA blood test
Treatment
A total thyroidectomy is the first line of treatment.
If you’re diagnosed with this cancer and are in stages I or II,
this surgery usually provides a cure. You should be aware that the
surgery usually involves complete removal of the surrounding lymph
nodes.
Also thyroid hormone therapy will be necessary on an ongoing basis to
help maintain your health. However, hormone therapy does nothing to
reduce the risk of recurring thyroid cancer.
Since medullary cancer cells do not take up iodine, radioactive
iodine therapy is not a desired or effective treatment following
surgery. Although if the malignant tumor has already spread to other
body tissues and/or it can’t be totally removed, external beam radiation
therapy is sometimes given in an attempt to reduce the risk of
recurrent cancer.
Reocurrence
Several treatment options are available for recurrent medullar
thyroid cancer. Your surgeon may elect to perform another surgery or try
external radiation therapy. Some cases require targeted therapy – such
as cabozantinib or vandetanib – or chemotherapy may be indicated.
Finally, stay abreast of upcoming clinical trials for new medicines and treatment alternatives.
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Medullary Thyroid Cancer