Condition Overview
Metastatic thyroid cancer occurs when thyroid cancer cells spread from the thyroid gland to other parts of the body. The most common sites of metastasis include the lymph nodes, lungs, bones, and, less frequently, the liver and brain. Metastatic thyroid cancer can develop from any type of thyroid cancer, including papillary, follicular, medullary, and anaplastic thyroid cancer, but it is most commonly associated with aggressive forms.
Patients with metastatic thyroid cancer may present with various symptoms depending on the location of the metastases. Common symptoms include persistent pain, swelling in the neck, difficulty breathing or swallowing, cough, and unexplained weight loss. In cases where the cancer has spread to the bones, patients may experience bone pain and fractures.
Diagnosis involves a combination of imaging studies, such as ultrasound, CT scan, MRI, and PET scan, to detect the presence and extent of metastases. Biopsy of the metastatic lesions may be performed to confirm the diagnosis. Blood tests, including thyroglobulin levels, can also be used to monitor the disease.
It can be very concerning to learn that you have metastatic thyroid cancer. A surgeon who does too much or too little surgery can significantly alter your long term prognosis and need for more treatment. Please find a very experienced surgeon if you have metastatic thyroid cancer.
Treatment Options
- Total Thyroidectomy
- Description: Total thyroidectomy involves the complete removal of the thyroid gland and is often the initial step in managing metastatic thyroid cancer. This procedure aims to eliminate the primary source of cancer and reduce the risk of further metastasis.
- Indications: Diagnosed metastatic thyroid cancer, large primary tumors, or extensive local disease.
- Radiofrequency Ablation (RFA)
- Description: RFA is a minimally invasive procedure that uses heat generated by radiofrequency energy to destroy cancerous tissue. It is primarily used to target metastatic lesions in the liver, bones, and other organs where surgical resection may not be feasible, but it can also be used for recurrent cancers in patients who are poor surgical candidates. It is not generally the recommended treatment for patients who have other treatment options because it is rarely definitive and can make future treatment more challenging.
- Indications: Metastatic lesions in non-surgical candidates, palliation of symptoms, localized metastatic disease.
- Central Neck Dissection (CND)
- Description: CND is a surgical procedure that involves the removal of lymph nodes and other tissues in the central compartment of the neck. It is often performed in conjunction with thyroidectomy to address lymph node metastases, but does increase the risk of permanent hypoparathyroidism.
- Indications: Lymph node metastases in the central neck, recurrent or persistent metastatic disease.
- Systemic Therapy
- Description: Systemic therapy can b a term that is sometimes used to include treatments such as radioactive iodine (RAI) therapy, targeted therapy, and chemotherapy. RAI therapy is commonly used for certain types of thyroid cancer that absorb iodine, while targeted therapy and chemotherapy may be used for more aggressive or resistant forms.
- Indications: Metastatic thyroid cancer unresponsive to surgery or RAI, widespread metastatic disease, specific genetic mutations.
Management of metastatic thyroid cancer requires a comprehensive approach involving a multidisciplinary team, including endocrinologists, oncologists, surgeons, and radiologists. The goal is to control the spread of the disease, alleviate symptoms, and improve the patient's quality of life. Regular monitoring and individualized treatment plans are essential for achieving the best possible outcomes. Having an experienced team such as that at the Russell Center ensures that you will have access to the widest range of options for your metastatic thyroid cancer.
