Papillary thyroid cancer is the most common form of thyroid cancer. Surgery is the usual treatment, often in combination with some other types of treatment. The prognosis for people with papillary thyroid cancer is very good and there is a high cure rate, especially for young people with small tumors.
The main symptom of any thyroid cancer is a lump in the center front of the neck. This does not always or even usually indicate cancer, but people who find such a lump should always see a doctor about it because treatment of thyroid cancer is easier if the tumor is caught early. Blood tests, ultrasounds, and a type of biopsy called a fine needle aspiration are used to discover if the lump is cancerous.
Surgery is the treatment of choice for the majority of people with papillary thyroid cancer. There is some controversy about whether total removal of the gland or removal of only the tumor area is the best strategy, and this also depends on patient and tumor characteristics, such as age or likelihood that the cancer has spread to other parts of the thyroid or to the lymph nodes. The surgeon in charge of a particular patient is in the best position to make a decision about the extent of surgery needed.
Radioactive iodine is often given to patients with thyroid cancer because thyroid cells are the only cells that absorb iodine. This makes thyroid cells easy to see on medical imaging. It can also be used to destroy thyroid cancer cells, particularly in patients who have had total thyroid removal but whose thyroid cancer has spread to surrounding tissues. Metastasis of papillary thyroid cancer is relatively uncommon, and if it does occur it usually affects the lymph nodes close to the thyroid and not other areas, such as the lungs or bones.
After having surgery to remove all or most of the thyroid gland, patients will usually need to take thyroid hormones for the rest of their lives. This helps to keep hormone levels in the normal range. If this medication is not taken, the body may keep trying to induce the thyroid to produce more hormones, which can lead to more thyroid tumors in any remaining thyroid tissue. Recurrence of papillary thyroid cancer is very rare, particularly in patients taking these hormones. People who only have a small part of the thyroid removed may not need to take hormones.