Medullary thyroid cancer: symptoms, causes and treatment

Medullary thyroid cancer: symptoms, causes and treatment

Medullary thyroid cancer (MTC) is a rare type of cancer that forms in the thyroid. It differs from other forms of thyroid cancer because it starts in different cells, called parafollicular C cells.

The thyroid is a small gland present at the front of the neck, which plays an important role in the production of hormones that regulate the body. Thyroid cancer occurs when atypical cells in the thyroid begin to grow out of control. According to American Cancer Society (ACS)The types of thyroid cancer vary depending on the cells in which the cancer grows.

Evidence suggests that CMT is the rarest type of thyroid cancer, representing 3–4% of all thyroid cancers and affecting approximately 1,000 people in the United States each year.

In this article, we will provide an overview of medullary thyroid cancer, including symptoms, treatment, and outlook.

the thyroid gland is a butterfly-shaped gland at the front of the neck that produces thyroid hormones, which help regulate the body’s metabolic rate. The thyroid gland contains two main types cells: follicular cells and C cells, also called parafollicular cells.

Follicular cells are responsible for producing thyroid hormones, while parafollicular cells produce the hormone calcitonin. This hormone helps control how the body uses calcium. TCM differs other types of thyroid cancer because it develops in parafollicular cells. Some people may also refer to MTC as medullary thyroid carcinoma.

There are two types of CMT: sporadic and familial. Sporadic is the most common type, usually occurring in older people and affecting only one thyroid lobe. Familial CMT is hereditary and usually develops during childhood or early adulthood. People with this type may have cancer in both thyroid lobes and may also have a higher risk of other types of tumors.

The name refers to the location of parafollicular C cells, which are present in the thyroid marrow. CMT is also often harder to detect and treat than other thyroid cancers.

MTC tends to grow slowly. As such, a person may show no symptoms during the early stages of the disease. When symptoms develop, they usually present as a mass or nodule in the neck, corresponding to the mass of cells that develop in the thyroid. If the nodule is large enough, it can also cause difficulty breathing or swallowing and a hoarse voice.

Less common symptoms May include:

  • a red or blushing face
  • weightloss
  • loose stools or diarrhea

As with many cancers, doctors stage CMT with four steps ranging from 1 to 4. The stage classification of cancer depends on different factors, such as the size of the tumor and whether it has spread to lymph nodes or distant organs.

Although age is a staging factor for other types of thyroid cancer, it plays no role in the staging of CMT.

Stage 1 is the earliest stage where the tumor is the smallest and has not yet spread. The severity increases with each stage until stage 4, by which time the cancer can be any size and may have grown and spread to nearby structures and distant sites.

MTC is the result of alterations in the parafollicular cells. However, since most cases are sporadic, the exact cause is unknown.

For the 25% of TCM cases that run in families, evidence indicates that these people carry a change in the RET uncomfortable. This gene is present on chromosome 10 and plays a role in cell signaling. Scientists have linked changes in this gene to several sporadic cancers, such as MTC.

The changes in the RET gene causes a condition known as multiple endocrine neoplasia type 2, or MEN2. The evidence indicates that there is two types of MEN2: MEN2A and MEN2B.

Usually, people with TCM have a lump in the neck. The initial diagnosis will usually start with a doctor checking this mass. They can then use imaging examssuch as ultrasound, computed tomography or MRI, to scan the thyroid.

If a doctor suspects thyroid cancer, they will probably do a fine needle aspiration biopsy of the nodule. This involves removing a small amount of tissue from the nodule using a very fine needle. A pathologist will then examine the sample and see if any cancerous cells are present.

A doctor may also want to perform other tests to confirm the diagnosis and provide more information to help with treatment plans. This may include blood tests to check calcitonin, calcium, and carcinoembryonic antigen (CEA) levels.

The main treatment for CMT is surgery, known as thyroidectomy. This involves the total removal of the thyroid gland and will require a person to take thyroid hormone replacement medications for life.

In addition to surgery, people may also need other types of treatment, especially if the tumor has spread to sites outside the thyroid or outside the neck. These treatments may also be an option if a person is not fit for surgery. These options May include:

  • external radiation
  • chemotherapy
  • targeted therapies

The best management approach depends on the stage of the cancer at the time of diagnosis. If the cancer has spread, treatment often involves an aggressive approach with multiple strategies and a combination of chemotherapy drugs.

According to ACSmost forms of thyroid cancer are not preventable, as they usually occur sporadically.

However, if a person knows they have a family history of TCM, they may wish to test for certain genetic changes that may indicate a risk for this disease. If a person is at high risk, a doctor may do a thyroidectomy to to prevent cancer to develop.

Evidence indicates that MTC can reproduce even years after an initial diagnosis. Usually, routine monitoring and follow-up checks continue for years after a diagnosis.

Many tests are available that can identify recurrent or metastatic disease. Part of the follow-up checks will likely include blood tests that measure calcitonin levels. After surgery to remove the thyroid, calcitonin levels are usually undetectable. If the levels increase, it could indicate a respawn.

The outlook or prognosis for people with TCM varies. Factors, like staging at diagnosis, response to treatment, and general health all play a role in recovery and prognosis.

Although the prognosis for CMT is generally not as favorable as that of other thyroid cancers, early detection and treatment can give optimal results. Additionally, routine monitoring of biomarkers, such as calcitonin or ACE, during the first year after surgery can be a useful predictor of survival rates.

MTC occurs less often than other forms of thyroid cancer, so data on survival rates may not be completely accurate. Although there is currently no cure, people can live with CMT for many years, and research continues into treatment options that may improve survival rates. According to research 2017the 10-year MTC survival rates are:

  • 95% with cancer localized only in the thyroid gland
  • 75% with regional disease without spread to distant organs
  • 20% with distant spread to organs, such as the liver or lungs

If a person has a neck lump with no known cause, they should contact a doctor. People should also be aware of potential symptoms of CMT, such as difficulty breathing or swallowing.

Additionally, if people have a known family history of CMT, they should consider seeing a healthcare professional. A doctor may recommend genetic testing to determine if they have the genetic changes that could lead to CMT.

MTC is a rare form of thyroid cancer that develops in parafollicular C cells. Although early-stage MTC may cause no symptoms, a person may notice a lump in the neck near the thyroid gland. Researchers are unsure of the exact cause of the disease, as many cases occur sporadically. However, about a quarter of MTC cases have a genetic link.

Treatment options usually include surgery to remove the thyroid. Additional treatments may include chemotherapy, radiation therapy, and targeted therapies. The prognosis largely depends on the stage of the disease at diagnosis and how people respond to treatment.