Papillary Thyroid Cancer: Causes, Treatment, Symptoms and Diagnosis | Dr Subramanian Kannan

Dr Subramanian Kannan, Consultant Endocrinology at Narayana Health City, Bommasandra, Bengaluru. On World Thyroid Day, Dr Kannan discusses thyroid cancer, specifically papillary thyroid cancer, which is increasingly diagnosed worldwide.
Thyroid cancer occurs when abnormal cells grow in the thyroid gland. These cancers can remain in the thyroid or spread to lymph nodes, lungs, and bones. Papillary thyroid cancer, the most common type, is generally slow-growing.
When diagnosed with papillary thyroid cancer, the first step is a detailed neck ultrasound to map the lymph nodes. This preoperative lymph node mapping is crucial for determining if the cancer has spread beyond the thyroid. If confined to the thyroid, surgery involves removing the thyroid gland and checking the central compartment for lymph nodes. A lateral neck dissection is performed if lymph nodes are found on either side of the thyroid.
The pathology report is reviewed post-surgery, and an iodine whole-body scan is conducted to check for distant spread. This scan requires a few weeks without thyroid medication. Along with the scan, thyroglobulin and antithyroglobulin antibodies are tested to assess residual disease and guide radioactive iodine therapy.
Surveillance follow-up includes periodic neck ultrasounds and serum thyroglobulin level checks. While chemotherapy and radiotherapy are rarely needed, they may be considered if traditional treatments are ineffective.
In summary, managing papillary thyroid cancer involves careful preoperative neck ultrasound, thorough surgery, and post-surgical iodine scans and marker tests.
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