Will medullary thyroid cancer recur after 30 years of illness? Does high calcitonin mean cancer recurrence?

After surgery for medullary thyroid cancer, you can check whether there is any metastasis. There is a certain possibility of recurrence in the future. The specific situation depends on the effect of the surgery and the stage of the tumor. However, you don’t need to worry too much. The prognosis of thyroid cancer is very good. Just have regular checkups.

If calcitonin simply increases after surgery for medullary thyroid cancer, but no other lesions are found in imaging examinations, it does not mean that the medullary thyroid cancer has recurred. It only means that the stage of medullary thyroid cancer was relatively late at the time of surgery, and it is impossible to reduce calcitonin to the normal range through surgery. However, as long as it no longer continues to increase, the treatment effect is still quite good.

If the calcitonin level before surgery is relatively high, exceeding 1000pg/ml, and drops to over 200 after surgery, it is not considered normal in theory. However, if the calcitonin level can be maintained at over 200 after surgery, and the neck ultrasound is normal, and no distant metastases are found in the liver, lungs, or bones, then continued observation is possible. If the calcitonin value does not double within two years, it can be considered a relatively good condition, and the prognosis is relatively good.

If the calcitonin level in the first follow-up after surgery for medullary thyroid cancer is 0.2ng/ml, 7.94ng/ml three months later, and 13.5ng/ml for the third time, all of which are within the normal range, this is not called calcitonin doubling and there is no need to worry about tumor recurrence.

According to international guidelines, if calcitonin is elevated but no lesions are found in medullary thyroid cancer, no surgery is required. Therefore, in some cases, although calcitonin is elevated, the lesions cannot be detected by current imaging methods. In this case, there is no way to perform any treatment, and surgery is not possible, and only observation can be continued; if lesions are found by imaging examinations, the lesions can be treated accordingly, such as another surgery to clear the cervical lymph nodes and mediastinal lymph nodes, or to remove metastatic lesions on the liver and lungs.