Follicular Thyroid Cancer
Disease Details
Family Health Simplified
- Description
- Follicular thyroid cancer is a type of thyroid cancer that arises from the follicular cells of the thyroid gland, which are responsible for producing and storing thyroid hormones.
- Type
- Follicular thyroid cancer is a type of differentiated thyroid cancer. The type of genetic transmission associated with follicular thyroid cancer is typically sporadic, meaning it usually occurs in individuals with no family history of the disease. However, in some rare cases, it can be associated with genetic syndromes such as familial adenomatous polyposis (FAP) and Cowden syndrome, which follow an autosomal dominant pattern of inheritance.
- Signs And Symptoms
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Follicular thyroid cancer often presents with the following signs and symptoms:
1. A lump or nodule in the neck.
2. Swelling in the neck.
3. Hoarseness or voice changes.
4. Difficulty swallowing.
5. Difficulty breathing.
6. Persistent cough not related to a cold.
7. Pain in the neck or throat.
These symptoms might overlap with other thyroid conditions, so a proper medical evaluation is essential for an accurate diagnosis. - Prognosis
- The overall 5-year survival rate for follicular thyroid cancer is 91%, and the 10-year survival rate is 85%.By overall cancer staging into stages I to IV, follicular thyroid cancer has a 5-year survival rate of 100% for stages I and II, 71% for stage III, and 50% for stage IV.Compared to other variants of Follicular cell derived thyroid cancer, bone metastases are commonly associated with follicular carcinoma. In the present study a high rate of bone metastases of 34% was observed.
- Onset
- Follicular thyroid cancer typically has its onset in middle-aged adults, most commonly between the ages of 40 and 60.
- Prevalence
- The prevalence of follicular thyroid cancer (FTC) varies geographically and among different populations. FTC is less common than papillary thyroid cancer, accounting for about 10-15% of all thyroid cancer cases. It generally affects adults, with a higher incidence in women compared to men.
- Epidemiology
- Follicular thyroid cancer (FTC) is the second most common type of thyroid cancer, accounting for about 10-15% of all thyroid cancer cases. It is more prevalent in women, typically affecting those between the ages of 40 and 60. It often occurs in regions with iodine deficiency. FTC is generally less common than papillary thyroid cancer but more likely to metastasize through the bloodstream, affecting distant organs such as bones and lungs.
- Intractability
- Follicular thyroid cancer is not typically considered intractable. It is generally treated effectively with surgery (thyroidectomy), radioactive iodine treatment, and thyroid hormone suppression therapy. The prognosis is usually favorable, especially when diagnosed early. However, advanced or metastatic cases may be more challenging to treat and may require additional therapies such as external beam radiation or targeted therapy.
- Disease Severity
- Follicular thyroid cancer (FTC) is generally considered a moderately aggressive form of thyroid cancer, less aggressive than anaplastic thyroid cancer but more so than papillary thyroid cancer. Disease severity can vary based on several factors including the tumor's size, whether it has spread (metastasized) to other parts of the body, and how well it responds to treatment. Prognosis is generally favorable when detected early and treated appropriately.
- Healthcare Professionals
- Disease Ontology ID - DOID:3962
- Pathophysiology
- Follicular thyroid cancer (FTC) originates in the follicular cells of the thyroid gland, which are responsible for producing and storing thyroid hormones. The pathophysiology of FTC involves the malignant transformation of these follicular cells, leading to uncontrolled cell growth and tumor formation. Mutations in certain genes, such as RAS, PIK3CA, and PTEN, are often implicated in this process. As the tumor grows, it can invade surrounding tissues and metastasize to other parts of the body, most commonly the bones and lungs. The blood vessels within the thyroid facilitate hematogenous spread, which is characteristic of follicular thyroid cancer.
- Carrier Status
- Follicular thyroid cancer primarily arises from follicular cells of the thyroid and is not typically associated with a carrier status in the way that certain genetic conditions are. While there may be genetic mutations that increase the risk, it is generally considered sporadic rather than inherited in a straightforward manner. No known carrier status is commonly associated with this type of cancer.
- Mechanism
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Follicular thyroid cancer (FTC) is a type of thyroid cancer that arises from follicular cells in the thyroid gland, which are responsible for producing and secreting thyroid hormones. The mechanism of FTC involves the uncontrolled growth and proliferation of these follicular cells.
Molecular mechanisms:
1. **Genetic Mutations**: FTC is often associated with specific genetic alterations.
- **RAS Mutations**: Activating mutations in the RAS family of oncogenes (HRAS, KRAS, and NRAS) are common in FTC. These mutations lead to continuous activation of the MAPK and PI3K-AKT signaling pathways, promoting cell proliferation and survival.
- **PIK3CA Mutations**: Mutations in the PIK3CA gene, which encodes for a subunit of the PI3K enzyme, can also contribute to the activation of the PI3K-AKT pathway.
- **TP53 Mutations**: Although less frequent, mutations in the TP53 tumor suppressor gene can occur, leading to loss of cell cycle regulation and apoptosis.
2. **Gene Fusions**: Rearrangements involving the PAX8 and PPARγ genes can result in the PAX8-PPARγ fusion protein, which has a role in FTC development by affecting cell differentiation and growth.
3. **Loss of Tumor Suppressor Genes**: Deletion or inactivation of tumor suppressor genes such as PTEN can also contribute to FTC by enhancing PI3K-AKT pathway activity.
4. **Aberrant Signaling Pathways**: The abnormal activation of signaling pathways like the MAPK/ERK pathway and the PI3K/AKT pathway plays a critical role in FTC pathogenesis. These pathways regulate key cellular processes, including growth, differentiation, and survival.
Understanding these molecular mechanisms is crucial for developing targeted therapies and improving the management of FTC. - Treatment
- Treatment is usually surgical, followed by radioiodine.
- Compassionate Use Treatment
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Follicular thyroid cancer (FTC) may sometimes require alternative treatment approaches beyond standard therapies. Here are some considerations for compassionate use, off-label, or experimental treatments:
1. **Compassionate Use Treatments**:
- **Lenvatinib (Lenvima)** and **sorafenib (Nexavar)**: These targeted therapies are approved for differentiated thyroid cancers that include FTC, particularly when radioactive iodine treatment is ineffective.
- **Cabozantinib (Cabometyx) and Vandetanib (Caprelsa)**: These are not specifically approved for FTC but may be considered under compassionate use for patients who have not responded to other treatments.
2. **Off-Label Treatments**:
- **Pazopanib (Votrient)**: Originally approved for renal cell carcinoma and soft tissue sarcoma, it has shown efficacy in some thyroid cancers and may be used off-label for follicular thyroid cancer.
- **Everolimus (Afinitor)**: This mTOR inhibitor, approved for other cancers, may be considered off-label in certain refractory cases of FTC.
3. **Experimental Treatments**:
- **Clinical Trials**: Participation in clinical trials offering novel therapies such as new kinase inhibitors, immunotherapy agents (like pembrolizumab or nivolumab), or combination therapies may be an option.
- **Genetic and Molecular Targeted Therapies**: Research is ongoing to identify specific genetic mutations in FTC that can be targeted with new or existing drugs in a clinical trial setting.
Patients considering these treatments should consult with their healthcare provider to discuss the potential benefits and risks, as well as the availability and appropriateness of these options for their specific condition. - Lifestyle Recommendations
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For follicular thyroid cancer, here are some lifestyle recommendations to help manage your condition and overall health:
1. **Regular Monitoring**: Follow up with your healthcare provider for regular check-ups and monitoring of thyroid hormone levels.
2. **Healthy Diet**: Maintain a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Adequate iodine intake is important for thyroid function, so consider consuming iodized salt unless advised otherwise by your doctor.
3. **Physical Activity**: Engage in regular physical activity to maintain a healthy weight and improve overall wellness. This can include activities such as walking, swimming, or yoga.
4. **Stress Management**: Practice stress-relief techniques like meditation, deep-breathing exercises, or other relaxation methods to manage stress levels, which can affect your overall health.
5. **Avoid Smoking and Excessive Alcohol**: Avoid smoking and limit alcohol consumption, as these can have negative impacts on your thyroid health and overall well-being.
6. **Medication Adherence**: Take any prescribed medications, such as thyroid hormone replacement therapy, as directed by your healthcare provider.
7. **Stay Informed**: Keep yourself informed about your condition and any new developments or recommendations in the care and treatment of follicular thyroid cancer.
8. **Support System**: Lean on your support system, including family, friends, or support groups, to help you cope with the emotional aspects of your diagnosis and treatment.
Always consult with your healthcare provider before making any significant lifestyle changes. - Medication
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For follicular thyroid cancer, the most commonly used medication is radioactive iodine (I-131). This treatment helps to destroy any remaining thyroid tissue or cancer cells after surgery. Additionally, patients may receive thyroid hormone replacement therapy, typically levothyroxine, to suppress thyroid-stimulating hormone (TSH) and reduce the risk of cancer recurrence.
"Nan" might not be recognized in this context. If you need more specific information, please clarify. - Repurposable Drugs
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Repurposed drugs that have shown potential in treating follicular thyroid cancer include:
1. **Metformin**: Traditionally an anti-diabetic medication, metformin has demonstrated anti-tumor effects in various cancers, including thyroid cancer, by inhibiting cell proliferation and inducing apoptosis.
2. **Sorafenib**: Initially used for liver and kidney cancers, sorafenib is a multi-kinase inhibitor that targets pathways involved in tumor growth and angiogenesis, and it has been repurposed for advanced thyroid cancers.
3. **Lenvatinib**: Primarily approved for renal cell carcinoma and hepatocellular carcinoma, lenvatinib also targets multiple receptor tyrosine kinases involved in tumor proliferation and has been effective in treating radioactive iodine-refractory thyroid cancer.
Research is ongoing to identify and validate other potential drugs that could be repurposed for the treatment of follicular thyroid cancer. - Metabolites
- There are no specific metabolites uniquely associated with follicular thyroid cancer (FTC). However, the disease may be studied using various metabolites that are generally involved in thyroid function and cancer processes, such as thyroglobulin, thyroid hormones (T3 and T4), and certain glycolytic and lipid metabolism-related metabolites. Metabolomic profiling might be used in research settings to identify metabolic changes associated with FTC, but no definitive metabolites are currently used for standard diagnosis or treatment.
- Nutraceuticals
- For follicular thyroid cancer (FTC), there is limited scientific evidence supporting the effectiveness of nutraceuticals in its treatment and management. While some dietary supplements and natural compounds may have general health benefits, they should not replace standard therapies such as surgery, radioactive iodine treatment, and thyroid hormone therapy. Always consult healthcare providers before considering any nutraceuticals for FTC.
- Peptides
- For follicular thyroid cancer, peptides and nanoparticles (nan) are avenues being explored in research for diagnostic and therapeutic purposes. Peptides can be used as therapeutic agents or as targeted delivery systems for drugs, ensuring they specifically interact with cancer cells. Nanoparticles can serve as carriers for drugs, enhancing delivery and reducing side effects. They can also be used for imaging, improving the detection and monitoring of cancer.