Follicular thyroid cancer is the second most common of all thyroid cancers. It comprises about 15% of all thy thyroid cancer cases. Considered more aggressive than the more common papillary thyroid cancer, it affects an older age bracket and is less common in children. Like papillary cancer, it is often discovered as a painless lump in the neck. Like most thyroid tumors, it occurs more after the age of 40. The peak onset ages is from 40 to 60. Females are more likely to develop this cancer than males by 3 to 1 ratio for reasons still unknown to science.
It can be difficult to diagnose someone with follicular thyroid cancer without performing surgery. A lump in the neck can be a hundred thousand things. Even if the doctor is sure it is thyroid cancer, it is difficult to distinguish follicular from papillary. A fine-needle aspiration biopsy can not distinguish follicular adenoma from follicular cancer. A course-needle aspiration, on the other hand, cannot distinguish it from non-toxic nodular goiter 60% of the time.
Radiation exposure is rarely associated with follicular thyroid cancer. The spread of cancer cells to lymph nodes is uncommon. But invasion into arteries, veins and other vascular structures within the gland is common. Lungs or bone infiltration is very uncommon although it is more common than with papillary cancer.
Surgery can completely cure follicular thyroid cancer. Still, controversy about the treatment for follicular thyroid cancer is also a hot item in the medical world, much like for papillary cancer. There are debates regarding how much of the thyroid gland should be removed. Is it necessary to remove the entire thyroid or just a lobe or a part of it? Is it lobectomy or total thyroidectomy? Removing both lobes of the gland is sometimes associated with increased complications so some experts suggest to remove just the affected lobe. However, if the entire thyroid is affected, thyroidectomy is compulsory.
After the surgery, the patient is also required to undergo hormone treatment to replace the natural hormones that the thyroid produce.