Papillary Thyroid Carcinoma

What is papillary thyroid carcinoma?

  • 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. PTC is a differentiated type of thyroid cancer meaning the cancer cells look like normal cells. PTC may spread to other healthy organs and tissues in your body. Cancer that spreads to other body organs may be harder to control. The chances of curing PTC are better if it is found and treated early.

What causes papillary thyroid carcinoma?

PTC is most often caused by changes in your genes. Genes are little pieces of information that tell your body what to do or make. You may have been born with the genes that cause PTC. Having a close family member who has PTC increases your risk of having this condition. Your cause of PTC may be unknown. The following may increase your risk of having PTC:

  • Gender: Women are at higher risk of having PTC than men.

  • Iodine deficiency: Having too little or no iodine in your diet may cause PTC.

  • Radiation: Head or neck radiation earlier in life, increases your risk of having PTC.

  • Thyroid disease: This includes having too much thyroid hormone or an autoimmune thyroid problem (your body attacks your thyroid).

What are the signs and symptoms of papillary thyroid carcinoma?

You may have no signs or symptoms of PTC at first. Over time, you may have one or more lumps (nodules or goiters) in your neck. You may also have any of the following:

  • Difficulty swallowing.

  • Hoarse (rough) voice or trouble talking.

  • Neck pain.

  • Shortness of breath or noisy breathing.

How is papillary thyroid carcinoma diagnosed?

Your caregiver will ask you about your health history. This includes information on what signs and symptoms you have, and when they started. You may also be asked about your family's health. Your caregiver will look and feel for lumps or other signs of problems on your neck. You may also need any of the following tests:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • 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. The sample is sent to the lab for tests.

  • Genetic screening: This may be done to confirm if you or other family members have PTC. 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.

    • Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

    • 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.

How is papillary thyroid carcinoma treated?

Your treatment will be based on what stage your cancer is in. In most cases, you will need surgery to remove your whole 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. You may also need one or more of the following after your surgery:

  • 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.

  • Medicines:

    • 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 medicine: You are given this medicine to bring your thyroid hormone level back to normal.

  • 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.

When should I call my caregiver?

Call your caregiver if:

  • You have a hoarse voice.

  • You have nausea (upset stomach) or vomiting (throwing up).

  • You have new lumps on your neck.

  • You have trouble swallowing.

  • You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You suddenly have trouble breathing.

  • Your symptoms get worse or do not go away even after taking medicine.

Where can I find support and more information?

Having PTC may be a life-changing condition for you and your family. You and those close to you may feel angry, scared, or sad. These feelings are normal. Talk to your caregivers, family, or friends, about your feelings. You may also want to join a support group with other people who have PTC. Contact any of the following:

  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
  • American Thyroid Association
    6066 Leesburg Pike, Suite 550
    Falls Church , VA 22041
    Phone: 1- 703 - 998-8890
    Phone: 1- 800 - 849-7643
    Web Address: www.thyroid.org
  • National Cancer Institute
    6116 Executive Boulevard, Suite 300
    Bethesda , MD 20892-8322
    Phone: 1- 800 - 422-6237
    Web Address: http://www.cancer.gov

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. 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.

© 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.

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