Complications | Thyroid cancer therapy

Complications

The following complications of thyroid gland surgery can be mentioned: Neighboring structures can be injured by the operation. Irritation or injury to the recurrent nerve (= nervus recurrens des N. vagus), which runs near the thyroid gland, can lead to persistent hoarseness and difficulty breathing in. Radioiodine therapy may lead to inflammation of the head and salivary glands or to stomach ulcers. If the treatment is performed very often and in high doses, the risk of developing leukemia increases by 1%.

Aftercare

Patients should have a lifelong follow-up. Aftercare consists of regular six-monthly examinations, which include a palpation of the thyroid gland and an ultrasound examination. The determination of thyroglobulin, which is produced by healthy thyroid tissue and thyroid cancer cells, is used to monitor the course of the tumor disease. If this value is measured again after radical thyroid surgery, this indicates the presence of metastases or a recurrence of the tumor. In addition, scintigraphic and X-ray controls can be performed to detect metastases and recurrence.

Prognosis and course

The papillary and follicular thyroid carcinomas have the best survival rates, with over 95% and 90% of patients surviving the next 10 years after the disease. Patients under 45 years of age have a better prognosis than older patients. The prognosis of patients with medullary thyroid carcinoma is significantly worse: only half of the patients survive another 10 years after the disease.In differentiated thyroid carcinomas, metastases occur in 20% of cases within 10 years after the thyroid tumor has developed, making aggressive repeat therapy necessary. Patients suffering from anaplastic thyroid carcinoma have the worst prognosis: life expectancy is only about half a year.

Prophylaxis

In the event of radioactive accidents, e.g. reactor accidents, the storage of radioactively contaminated iodine in the thyroid gland can be prevented by taking high doses of potassium iodide.