Papillary Thyroid Carcinoma

WHAT YOU SHOULD KNOW:

• Papillary thyroid carcinoma is also called PTC. 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 tumor grows from the follicular cells of your thyroid gland. These cells make thyroid hormones (special chemicals) that control how your body uses energy. When the cells grow and split without control or order, they often make too much tissue (tumor). You may be able to feel the tumor with your fingers and it may grow. The tumor may also be painless and you may not know it is there.
  
  
• The cause of PTC may be inherited, or the cause may be unknown. You may have neck lumps, shortness of breath, bone pain, or trouble swallowing. Blood tests, genetic screening, biopsy, and imaging tests may be done to check for PTC. 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, and radiation therapy. With treatment, your symptoms may be relieved and your PTC may be cured.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Surgery for PTC may cause injury to nearby nerves, tissues, and organs. You may have hoarseness of voice, trouble speaking, bleeding, or get an infection from surgery. Some treatments may cause nausea (upset stomach), vomiting (throwing up), or diarrhea. Even after treatment, the cancer may come back. You may need to have another surgery if the cancer returns. If PTC is left untreated, the tumor will continue to grow and your signs and symptoms may get worse. Untreated PTC may spread to other parts of your body, and you may die. Ask your caregiver if you have questions or concerns about your disease, treatment, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.

IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Medicine:

• Radioactive iodine: This medicine damages cells in your thyroid gland, decreasing the amount of thyroid hormone in your blood. This may help your body work better. After taking radioactive iodine, your thyroid gland may still make too much or not enough hormone. If this happens, you may still need to take thyroid medicine.
  
  
• Thyroid hormone: You are given this medicine to bring your thyroid hormone level back to normal.

Treatment options:

• Gene therapy: Cancer gene therapy is a procedure that puts normal or changed genes into the cells of your body. This is to replace bad or damaged genes in the treatment of genetic disorders. Ask your caregiver for more information about this treatment.
  
  
• Surgery: You may need surgery to remove your thyroid gland. Lymph nodes (bean shaped tissue that can trap cancer) may also be removed. In some cases, a part of the thyroid gland may be left in place. Surgery is done to prevent cancer cells from spreading to other body organs. Ask your caregiver for more information about thyroid surgery.
  
  
• Radiation therapy: This may include external beam radiation therapy. Radiation therapy uses x-rays or gamma rays to control bleeding, and shrink your 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. Ask your caregiver for more information about external beam radiation therapy.

Tests:

• 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. The following tests may be done after your surgery to see if all of your cancer was removed:
  
  
  • 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.
    
    
  • Magnetic resonance imaging: This test is also called MRI. During the MRI, pictures of your thyroid gland are taken. An MRI may also be used to look at your 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 if it has spread.
    
    
  • 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.
  
  

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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.

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