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THYROID CANCER TREATMENT IN TURKEY

1. What is important to know about thyroid cancer treatment?

  • The disease responds well to treatment. According to the statistics of the American Society of Clinical Oncology, 98-99% of patients with the initial stages of the disease and 56% with the late ones survive the milestone of 5 years. Therefore, it is important to start treatment immediately for thyroid cancer.

  • The main methods of treatment are surgery and radioiodine therapy. Chemotherapy, targeted and external beam therapy are prescribed by doctors only in the later stages, with severe forms of the disease and relapses.

2. Where to treat thyroid cancer: choosing a clinic and making an appointment for a consultation

1. Choosing a clinic for the diagnosis and treatment of thyroid cancer

Leave a request on our website and the coordinating doctor will contact you. He will help with the selection of a medical center  and will guide you on prices.

2. Obtaining an individual treatment program and organizing a consultation at the medical center

Send the available test results to the coordinating physician. He will send them to the hospital of your choice and receive a preliminary diagnostic and treatment program based on your medical records.

 

The average response time from the hospital is up to 5 working days (this is the workload of the medical center).

 

If the program and cost suit you, the coordinating doctor will arrange a consultation at the clinic.

3. Tickets and accommodation

If necessary, Medikal & Estetik Group helps with booking tickets and accommodation.

Find out more about this with the coordinating physician.

4. Interpreter and transfer airport - clinic - airport

Medical centers provide transfers and translators. Whether these services are included in the cost of treatment, check with the coordinating physician of Medikal & Estetik Group.

 

5. Payment for treatment

You pay for the completed procedures to the cashier of the medical center. Medikal & Estetik Group services patients do not pay.

6. Is it possible to consult a Turkish doctor remotely?

Yes, you can get a second opinion. Find out more about this  here .

3. What does the diagnosis of the disease include?

  • Physical examination and health history  : Examining the body to check for general signs of health, including checking for signs of illness, such as bumps (nodules) or swelling in the neck, voice box, and lymph nodes, and anything else that seems unusual. ... There will also be a history of the patient's health habits, as well as past illnesses and treatments.

  • Laryngoscopy  : A procedure in which a doctor checks the larynx (voice box) using a speculum or laryngoscope. A laryngoscope is a thin, tube-shaped instrument with an illumination and a viewing lens. A tumor in the thyroid gland can press on the vocal cords. A laryngoscopy is done to see if the vocal cords are moving normally.

  • Blood hormone research  : A procedure in which a blood sample is tested to measure the amount of certain hormones released into the blood by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness in the organ or tissue that produces it. The blood can be tested for abnormal thyroid-stimulating hormone (TSH) levels. TSH is produced by the pituitary gland in the brain. It stimulates the production of thyroid hormone and controls the growth rate of thyroid follicular cells. Blood can also be tested for high levels of the hormone calcitonin and antithyroid antibodies.

  • Studies of the chemical composition of blood  : A procedure in which a blood sample is tested to measure the amount of certain substances, such as calcium, released into the blood by organs and tissues of the body. An unusual (more or less than usual) amount of a substance may be a sign of illness.

  • Ultrasound examination: A procedure in which high energy sound waves (ultrasound) are reflected off the internal tissues or organs of the neck and create an echo. The echo forms a picture of body tissue called a sonogram. The picture can be printed to view later. This procedure can show the size of the thyroid nodule and determine if the cyst is solid or fluid-filled. Ultrasound can be used to perform fine needle aspiration biopsy.

  • CT scan   : A procedure in which a series of detailed pictures of the interior of the body, such as the neck, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. The dye can be injected into a vein or swallowed to make organs and tissues more visible. This procedure is also called computed tomography, computed tomography, or computed axial tomography.

  • Fine needle aspiration biopsy of the thyroid gland  : Removal of thyroid tissue with a fine needle. The needle is inserted through the skin into the thyroid gland. Several tissue samples are taken from different parts of the thyroid gland. A pathologist examines tissue samples under a microscope for cancer cells. Because thyroid cancer is difficult to diagnose, patients should ask for biopsy samples to be checked by a pathologist experienced in diagnosing thyroid cancer.

  • Surgical biopsy  : Removing a thyroid nodule or one lobe of the thyroid gland during surgery so the pathologist can examine cells and tissues under a microscope to check for signs of cancer. Because thyroid cancer is difficult to diagnose, patients should ask for biopsy samples to be checked by a pathologist experienced in diagnosing thyroid cancer.

 

4. Methods of treatment for thyroid cancer

1. Operation (thyroidectomy)

For thyroid cancer, doctors perform a thyroidectomy - removal of most or all of the organ.

If the pathology has spread to the lymph nodes, the doctor excises them along with the gland.

Doctors perform the removal of the tumor by the following methods:

  • open - through an incision up to 8 cm in the neck;

  • endoscopic - through an incision up to 2 cm;

  • robotic - through a 2 cm incision in the armpit using the Da Vinci robotic surgeon;

  • without incisions in the neck - through the mouth or armpit.

 

2. Radioiodine therapy

Doctors treat thyroid cancer with radioactive iodine after surgery. The substance acts on the remaining abnormal cells and prevents relapse.

The patient takes an oral radioiodine capsule. After the procedure, he emits radiation that can harm others, so the patient is hospitalized in an individual ward for 3-7 days.

 

3. Hormone therapy

Doctors prescribe medications to:

  • maintain the required level of hormones after removal of the gland;

  • stop the spread of the remaining malignant cells.

 

4. External beam therapy

The procedure is indicated for the postoperative treatment of medullary and anaplastic thyroid cancer. Doctors act on a tumor using an apparatus that delivers a radiation beam to the neoplasm with millimeter precision and practically does not harm healthy tissues.

 

5. Chemotherapy

Chemotherapy is prescribed by oncologists for anaplastic cancer and the ineffectiveness of previous treatment for other forms of the disease.

Patients take chemotherapy drugs orally or through a drip.

 

6. Targeted therapy

The technique stops the division of malignant cells. Doctors resort to it if a laboratory study of a tumor has revealed a genetic mutation in it.

Targeted therapy is indicated for patients with medullary, anaplastic thyroid cancer. It is also prescribed for follicular and papillary cancers if previous treatment has not worked.

7. Immunotherapy

A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infections, and other diseases. Some types of immunotherapy target only certain cells of the immune system. Others affect the immune system as a whole. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG), and some monoclonal antibodies.

5. How long does thyroid cancer treatment take?

  1. Surgery for thyroid cancer takes 2-4 hours

  2. Postoperative hospitalization - 2-7 days.

  3. Doctors prescribe radioiodine therapy 4-6 weeks after the intervention.

  4. The patient takes the substance and remains in the hospital for 3-7 days.

  5. After 2-4 months, he undergoes an ultrasound scan. If necessary, doctors prescribe the procedure again.

  6. The approximate duration of external beam radiation therapy is 3 weeks.

 

6. How is recovery from thyroid cancer treatment going?

 

1. Possible side effects

Temporary hoarseness and loss of voice may occur after surgery.

Treatment of thyroid cancer with radioactive iodine can provoke:

  • dry eyes and mouth;

  • painful sensitivity, swelling of the neck and salivary glands;

  • nausea and vomiting;

  • failure of taste perception;

  • violation of the menstrual cycle in women;

  • decreased sperm motility in men.

 

2. Rehabilitation

After removing most of the gland or the entire organ, the patient needs to take medications throughout his life that maintain the necessary level of hormones.

After radioiodine therapy, doctors recommend periodically chewing lemon and chewing gum for 2 days. This will increase salivation and reduce the effects of radiation on the salivary glands.

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Рак щетовидной железы

7. Types of thyroid cancer

Thyroid cancer  can be described as:

  • Differentiated thyroid cancer, which includes well-differentiated tumors, poorly differentiated tumors, and undifferentiated tumors;

  • Medullary thyroid cancer.

Well-differentiated tumors (papillary thyroid cancer and follicular thyroid cancer) are treatable and usually cured.

Poorly differentiated and undifferentiated tumors (anaplastic thyroid cancer) are less common. These tumors grow and spread quickly and are less likely to heal. Patients with anaplastic thyroid cancer should undergo molecular testing for a mutation in the BRAF gene.

Medullary thyroid cancer is a neuroendocrine tumor that develops in the C cells of the thyroid gland. C cells produce a hormone (calcitonin) that helps maintain normal blood calcium levels.

8. Risk factors for thyroid cancer

Anything that increases the risk of a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer. Talk to your doctor if you think you are at risk.

Risk factors for thyroid cancer include the following:

9. Medullary thyroid cancer

 

Medullary thyroid cancer is sometimes caused by a change in a gene that is passed from parent to child.

These genes in cells carry hereditary information from parent to child. A certain change in the RET gene that is passed from parent to child (inherited) can cause medullary thyroid cancer.

There is a genetic test that is used to check for an altered gene. First, the patient is tested to see if he has an altered gene. If the patient has it, other family members may also be tested to see if they are at increased risk for medullary thyroid cancer. Family members, including young children who have the altered gene, may have a thyroidectomy (surgery to remove the thyroid gland). This can reduce the likelihood of developing medullary thyroid cancer.

10. Signs of thyroid cancer

Thyroid cancer may not cause early signs or symptoms. This is sometimes found during a routine physical examination. Signs or symptoms may appear as the tumor grows. Other conditions can cause the same signs or symptoms. Check with your doctor if you have any of the following:

  • Lump (nodule) on the neck.

  • Labored breathing.

  • Swallowing problems.

  • Pain when swallowing.

  • Hoarseness.

11. Factors affecting the prognosis of recovery . Treatment options

V  forecast  and the treatment option depends on the following conditions:

  • The age of the patient at the time of diagnosis.

  • A type of thyroid cancer.

  • Stage  cancer.

  • Whether the cancer has been completely removed by surgery.

  • The patient has multiple endocrine neoplasia type 2B (MEN 2B).

  • The general health of the patient.

  • Has cancer just been diagnosed or  relapsed  (returned).

1. Treatment of papillary and follicular thyroid cancer of I, II and III stages (localized / regional)

Treatment for papillary and follicular thyroid cancer in stage I (younger than 55 years old; 55 years and older), stage II (younger than 55 years old; 55 years and older), and stage III may include the following:

  • Operation (thyroidectomy or lobectomy).

  • Radioactive iodine therapy.

  • Hormone therapy to prevent the body from making thyroid-stimulating hormone (TSH).

  • External beam therapy.

2. Treatment of papillary and follicular thyroid cancer (metastatic) stage IV

When cancer has spread to other parts of the body, such as the lungs and bones, treatment usually does not cure the cancer, but it can relieve symptoms and improve quality of life. Treatment for stage IV papillary and follicular thyroid cancer may include the following:

1. For tumors consuming iodine

  • Total thyroidectomy.

  • Radioactive iodine therapy.

  • Hormone therapy to prevent the body from making thyroid-stimulating hormone (TSH).

 

2. For tumors that do not absorb iodine

  • Total thyroidectomy.

  • Hormone therapy to prevent the body from making thyroid-stimulating hormone (TSH).

  • Targeted therapy with a tyrosine kinase inhibitor (sorafenib or lenvatinib).

  • Surgery to remove cancer from areas where it has spread.

  • External beam radiation therapy.

  • Clinical trial for chemotherapy.

  • Clinical trials of targeted therapy.

  • Clinical trials of immunotherapy.

3. Treatment of recurrent papillary and follicular thyroid cancer

Treatment for recurrent papillary and follicular thyroid cancer may include the following:

  • Surgery to remove a tumor with or without radioactive iodine therapy.

  • Radioactive iodine therapy, where cancer can only be detected by a scan of the thyroid gland and cannot be detected during a physical examination.

  • Targeted therapy with a tyrosine kinase inhibitor (sorafenib, lenvatinib, selpercatinib, larotrectinib, or entrectinib).

  • External beam radiation therapy or intraoperative radiation therapy as palliative therapy to relieve symptoms and improve quality of life.

  • Chemotherapy.

  • Clinical study on targeted therapy.

  • Clinical trials of immunotherapy.

4. Treatment of medullary thyroid cancer

Localized medullary thyroid cancer is found in the thyroid gland only and can spread to nearby muscles in the neck. Locally advanced and metastatic thyroid cancer has spread to other parts of the neck or other parts of the body.

Treatment for localized medullary thyroid cancer may include the following:

  • A total thyroidectomy if the cancer has not spread to other parts of the body. Lymph nodes near the cancer are also removed.

  • External beam radiation therapy for patients who have recurrent cancers in the thyroid gland.

5. Treatment for locally advanced / metastatic medullary thyroid cancer may include the following:

  • Targeted therapy with a tyrosine kinase inhibitor (Vandetanib, cabozantinib, or selpercatinib) for cancer that has spread to other parts of the body.

  • Chemotherapy as palliative therapy to relieve symptoms and improve the quality of life of patients in whom cancer has spread to other parts of the body.

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Radioactive iodine therapy is not used to treat medullary thyroid cancer.

6. Treatment of anaplastic thyroid cancer

Treatment for anaplastic thyroid cancer may include the following:

  • Total thyroidectomy as a palliative therapy to relieve symptoms and improve the quality of life of patients with cancer in or near the thyroid gland.

  • Tracheostomy as a palliative therapy to relieve symptoms and improve quality of life.

  • External beam therapy.

  • Chemotherapy.

  • Targeted therapy with protein kinase inhibitors (dabrafenib and trametinib) for patients with a specific mutation in the BRAF gene.

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COST OF TREATMENT AND DIAGNOSIS OF THYROID CANCER IN TURKEY

  • Biopsy for Thyroid Cancer from $ 450

  • CT (computed tomography) for thyroid cancer from $ 50

  • PET-CT for Thyroid cancer from $ 500

  • Chemotherapy for breast cancer from $ 1200

  • Radiation therapy for rectal cancer on request

  • Radioiodine therapy for thyroid cancer from $ 3000

  • Subtotal thyroidectomy for thyroid cancer from $ 6000

  • Thyroid resection for Thyroid cancer from $ 4000

  • Thyroidectomy for Thyroid Cancer from $ 6000

  • Diagnostics + Radioiodine therapy from $ 3720

  • Thyroid cancer from $ 7080

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