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Thyroid cancer come back after treatment Recurrent or persistent disease
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Papillary thyroid cancer is the most common type of thyroid cancer. It accounts 85 % of cases of thyroid cancer. • Generally papillary thyroid cancer has good prognosis, 10 year survival is around 93 % of cases. But even for this cancer, recurrent or persistent disease is not uncommon. up to 20% of patients developing recurrent disease at some point during their lifetime • Although, tumor-specific mortality is infrequent. • According to studies most cases after initial treatment, thyroidectomy and or radioiodine therapy, cancer return is the result of persistence disease and very rare cases of true recurrence. • Persistence disease at this case means, it was not treated completely and or effectively. And there was residual tissue after surgery, or radioiodine ablation was not effective enough. • We can defined persistent disease if: • Positive Tg level, an abnormal ultrasound, or persisting elevated Tg antibodies • True recurrent disease can be defined, when thyroglobulin was undetectable. Also no elevated antibodies to thyroglobulin. • And on ultrasound no abnormal tissue in thyroid bed, no abnormal or suspicious lymph nodes in the central or lateral neck, and no any growth of mass or lymph nodes. • Over half of the patients required re-operation within the first two years. It means many cases of persistence disease is caused by incomplete initial treatment. • It strongly suggests, that improvements in the pre-operative assessment and adequacy of initial surgery need to improve. At this case, many reoperations can be avoided. • Another problem related to thyroid cancer is second cancer. • Some people with thyroid cancer have increased risk or second , different cancer, which is not thyroid cance, specifically: • Breast cancer (in women), Prostate cancer, Kidney cancer, Adrenal cancer. Adrenal cancer risk is especially high in people who had the medullary type of thyroid cancer. • Patients treated with radioactive iodine also have an increased risk of acute lymphocytic leukemia (ALL), stomach cancer, and salivary gland cancer. • By Hellerhoff - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index...
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