Medullary Thyroid Carcinoma

WHAT YOU SHOULD KNOW:

  • Medullary thyroid carcinoma is also called MTC. It is a kind of tumor (abnormal growth) found in your thyroid gland. The thyroid gland is a small, butterfly-shaped organ in the front area of your neck. The abnormal growth comes from a part of the thyroid gland called parafollicular cells, or C-cells. These cells make the hormone (special body chemical) calcitonin that controls the amount of calcium in your blood. When the abnormal cells grow and split, they make too much tissue called a tumor. The cause of MTC may be inherited (passed on by a parent), or the cause may be unknown. Certain thyroid conditions and having radiation treatment earlier in life may increase your risk of having MTC.

  • Neck lumps, shortness of breath, bone pain, or trouble swallowing are common signs and symptoms of MTC. You may also have diarrhea (loose bowel movements), a hoarse (rough) voice, or flushed (red) skin. Blood and urine tests, biopsy, genetic screening, and imaging tests may be done to check for MTC. Imaging tests include computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, thyroid scan, and ultrasound. You may be treated with surgery, medicines, or radiation therapy. The chances of curing MTC are better when it is found and treated early.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Surgery for MTC may cause injury to nearby nerves, tissues, and organs. You may also bleed too much or get an infection from surgery. Some treatments may cause nausea (upset stomach), vomiting (throwing up), diarrhea, or hair loss. Even after treatment, the cancer may come back and spread to other parts of your body. You may need to have another surgery if the cancer comes back. If MTC is left untreated, the tumor will continue to grow and your signs and symptoms will worsen. With MTC, you may die. Ask your caregiver if you have questions or concerns about your disease, treatment, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Tests:

  • Blood and urine tests: These tests may be done to see how your body is doing. They can help your caregivers learn more about your health condition. You may need to have blood and urine tests done more than once.

  • Fine-needle biopsy: This is a procedure where a very small piece of your thyroid gland is taken for tests. Your caregiver may use medicine to numb the front part of your neck. A small needle is used to get the tissue sample from your thyroid gland. After the sample is collected, a bandage may cover the biopsy area. The sample is sent to the lab for tests.

  • Genetic screening: This may be done to confirm if you or other family members have MTC. This will also give your caregiver more information on how to treat your condition.

  • Imaging tests: Certain tests use a special dye to help pictures show up better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

    • Computed tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your neck and chest. It may be used to look at your tissues, bones, muscles, and blood vessels. Before taking the pictures, you may be given dye through an IV in your vein.

    • MRI: This test is also called magnetic resonance imaging. During the MRI, pictures of your thyroid gland are taken. An MRI may be used to look at the organs, muscles, joints, bones, or blood vessels. You will need to lie still during the test. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.

    • Positron emission tomography scan: This test is also called a PET scan. A PET scan shows how much blood and oxygen is flowing to your neck area. It may also show other parts of the body with cancer.

    • Thyroid scan: This test shows caregivers how well your thyroid is working. Radioactive dye is put into your IV or is given to you to drink. The working part of the thyroid gland absorbs (soaks up) the dye. Two to 48 hours later, caregivers put a machine called a scintillator over your neck. The machine takes pictures showing the areas of your thyroid that absorbed the dye.

    • Ultrasound: This is a test using sound waves to look inside your neck. Pictures of your thyroid gland show up on a TV-like screen.

Treatment options:

  • Surgery: You will need surgery to remove your thyroid gland. With this surgery, lymph nodes (bean shaped tissue that can trap cancer) may also be removed. Ask your caregiver for more information about this surgery.

  • Other possible treatments: The following treatments may be used after you have surgery to remove your thyroid gland:

    • Chemotherapy:

      • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.

      • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.

    • Radiation therapy: This may include external beam radiation therapy. Radiation therapy uses x-rays or gamma rays to control bleeding, and shrink the tumor. It keeps cancer cells from splitting into new cells, which is one way cancer spreads. Lymph nodes with cancer are also treated with radiation. It may be given after surgery to kill the cancer cells that were not removed. This treatment may be given along with chemotherapy. Ask your caregiver for more information about external beam radiation therapy.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Medullary Thyroid Carcinoma (Inpatient Care)

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