Thyroid Cancer Types, Symptoms, Diagnostics, and Treatment
Thyroid Cancer Types, Symptoms, Diagnostics, and Treatment
Aug 18, 2009
Types of thyroid cancer, symptoms, diagnostic test, and treatment.
Category: Disease & Illness
Classroom: Thyroid Disease Symptoms, Problems, Treatment And Medication





Thyroid Cancer Types, Symptoms, Diagnostics, and Treatment

Common Types:

Papillary: Is responsible for approximately half of the thyroid cancers in adults. It spreads slowly and is common in young adult women.

Follicular: More rare but has a high recurrence rate, spreading to the lymph nodes via blood vessels to the bone, liver, and lungs.

Medullary: This type has a hereditary factor and is curable if detected and treated early. Left untreated it metastasizes (spreads) quickly.

Anaplastic Tumors: Spread fast and are not cured by thyroidectomy or radiation therapy.

Cancerous thyroid tumor

Symptoms of thyroid cancer:

Neck lump - in the front of the neck near the Adam's apple
Neck nodule
Painless neck lump
Neck swelling
Hoarseness
Difficulty speaking
Voice changes
Swollen neck lymph nodes
Swollen lymph nodes
Difficulty swallowing
Difficulty breathing
Throat pain
Neck pain

Diagnostic testing:

Thyroid scan
Scinti-scan shows a “cold,” nonfunctioning nodule. Other tests include
Needle biopsy,
CT scan,
Ultrasonic scan,
Chest X-ray,
Serum alkaline phosphatase, and
Serum calcitonin assay to diagnose medullary cancer

Treatment:

Total or partial thyroidectomy, with modified node dissection on the side of the primary cancer (papillary or follicular cancer)

Total thyroidectomy and radical neck excision (for medullary, giant, or spindle cell cancer)

Radiation (131I) with external radiation for inoperable cancer and after surgery instead of radical neck excision.
Thyroid suppression, with thyroid hormones to suppress TSH production. Administration of medications, such as propranolol to help increase ability to tolerate surgery and radiation

Chemotherapy for widespread metastasis is limited, but doxorubicin can be helpful.

Pre-Op Care:

The patient is informed there may be temporary voice loss or hoarseness for several days after surgery.

Post-Op Care:

The patient is to remain in a semi-Fowler's position, and pressure on the operative site is to be avoided. The head and neck is supported on sandbags and pillows.

Vital signs, such as respirations, heart rate, and temperature must be monitored regularly. The surgical dressing must be checked for bleeding. Should the patient complain that the dressing is tight, it must be loosened and the physician called right away.

Blood work to check serum calcium levels must be performed daily. Due to the removal of the parathyroid glands, the development of hypocalcemia may occur.

Complications include:

Hemorrhage and shock (elevated pulse rate and hypotension),
Tetany (carpopedal spasm, twitching, and seizures),
Thyroid storm (high fever, severe tachycardia, delirium, dehydration, and extreme irritability), and
Respiratory difficulty due to obstruction (dyspnea, crowing respirations, retraction of neck tissues

Anticipation of patient needs and emergency measures:

Tracheotomy and oxygen equipment in case of respiratory emergency.
Use of continuous steam inhalation
Administration of I.V. fluids or a soft diet may be needed, but many patients are able to eat a regular diet within 24 hours post surgery without any difficulty.

Patients may also benefit from a support group to help with issues of stress related to illness and surgery.

by Barb Hicks, RN/LMT


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