Hurthle cell cancer is a type of malignant tumor that affects the thyroid, the butterfly-shaped gland in the neck. This gland is responsible for the secretion of hormones responsible for the regulation of the body's metabolism and other functions. Several types of cancer can affect the thyroid gland, but Hurthle cell cancer is the most aggressive variation. Many patients with Hurthle cell cancer will not experience symptoms prior to diagnosis. When symptoms do manifest, they include neck or throat pain, breathlessness, difficulty swallowing, voice changes, and a lump in the neck.
Usually, Hurthle cell cancer is diagnosed using imaging tests, and the testing of a thyroid tissue sample called a biopsy. When Hurthle cell cancer spreads, it most commonly affects the lungs, lymphatic system, and bones. Hurthle cell cancer survival rates drop by over a fourth once it has metastasized beyond the thyroid, so early detection and aggressive treatment are crucial when considering treatment options.
A thyroidectomy is a surgical procedure used to extract all or part of the thyroid gland that has become detrimental to an individual's health. Most Hurthle cell cancer patients will have a full thyroidectomy to completely remove the tumor, and to stop the spread of cancer. During this surgical procedure, the surgeon will extract the whole thyroid gland but preserve the small thyroid tissue edges around the parathyroid glands. If there is a suspicion Hurthle cell cancer has metastasized to the surrounding lymph nodes, they may also be removed.
In addition, Hurthle cell cancer may have spread into nearby regions such as the nerve of the voice box, trachea, esophagus, and voice box. Should any of these structures be affected by Hurthle cell cancer, they will be removed as well during the thyroidectomy. While this surgical procedure remains the most effective option for treating Hurthle cell cancer, it leaves the patient with no thyroid gland left to produce essential hormones. This lack of a thyroid gland requires the patient to take hormones for the rest of their life. This replacement hormone is very similar to the hormone the thyroid gland naturally produces, and it performs all the same functions.
Radiation therapy is a type of treatment that involves the use of high-energy beams to decrease the size of early-stage cancer, inhibit cancer from coming back, or for symptom control once cancer has metastasized. The energy types that may be used in radiation therapy include x-rays, electron beams, gamma rays, and protons. Radiation beams are able to destroy or severely damage cancerous cells. During radiation therapy, a machine located outside of the body applies a carefully targeted beam of energy onto the affected area of the body.
Radiation therapy is used in patients with Hurthle cell cancer that does not respond well to other treatments, such as radioiodine therapy. Radiation therapy is also used to treat cancers and tumors that have metastasized beyond the thyroid gland. It is also commonly utilized to reduce the likelihood of cancerous cells returning to the neck after tumor excision surgery has been performed. Radiation therapy is given for several weeks, and it is administered at a frequency of five days a week.
Targeted Drug Therapy
Targeted drug therapy is a treatment used in several types of cancer that work by blocking particular genes or proteins that allow tumors to spread and grow. Even though most cases of Hurthle cell cancer can be effectively treated with the use of surgery and radioactive iodine therapy, some cases may not respond well to those treatment options. Targeted drug therapy utilizes medications to target specific proteins, genes, or the environment that allows cancerous cells to survive and grow. Different types of cancers and tumors have different targets best identified through tests that can be performed on the cancerous cells.
Two main kinds of targeted drug therapy can be used in the treatment of Hurthle cell cancer. Small molecule medicines have the ability to penetrate through the membrane of cancer cells because of their small size, and they destroy the cell from the inside out. Monoclonal antibodies are targeted drugs that attack specific targets on or around the cancerous cells. Targeted drug therapy is usually only used for patients with Hurthle cell cancer that cannot be effectively treated by other methods.
Radioactive Iodine Therapy
Radioactive iodine therapy or radioiodine therapy is a thyroid cancer treatment that works by utilizing the interaction between thyroid cells and an element called iodine. The thyroid gland has a unique property of being able to absorb almost all of the iodine inside of the body. The thyroid cells will collect iodine even if they are not still located in the thyroid. These thyroid cells may be leftover from tumor excision surgery, or they may be cancerous thyroid cells that have spread to other parts of the body.
Radioiodine therapy uses a radioactive form of iodine or RAI that can be swallowed in a capsule. When the capsule dissolves, the radioactive iodine will be delivered to all thyroid cells in the body including the cancerous one. The RAI will then destroy all of the cells that it has been absorbed by with high doses of radiation. The doses of radiation used in this type of therapy are much higher than the doses used in other forms of radiation. Aside from thyroid removal surgery, radioactive iodine therapy is the most common treatment method used in Hurthle cell cancer patients. It is greatly favored due to its minimal effects on the rest of the body.
Chemotherapy is a cancer treatment that uses drugs to kill cancerous cells throughout the body. This treatment is utilized in cases of Hurthle cell cancer where the cancerous cells have spread throughout the body. The reason for chemotherapy use in such cases is because it has a systemic effect, or it affects the whole body rather than just a specific area. Chemotherapy works to kill cells n the process of the cell cycle. The cell cycle is a process all cells go through to form new cells. Cancerous cells have the property of abnormal and rapid replication using the cell cycle.
Chemotherapy, however, targets all cells within the body in any stage of the cell replication process. This mechanism ensures most cancerous cells throughout the body are destroyed, but the effects of chemotherapy are also applied to healthy cells within the process of replication. It is the damage inflicted to healthy cells around the body that gives chemotherapy its reputation of being a harsh therapy. Chemotherapy is often used in patients with Hurthle cell cancer who do not respond to other treatments, cannot undergo surgery, or as a precautionary measure following tumor excision surgery.