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Thyroid Cancer

A butterfly-shaped gland located in the neck, the thyroid plays an important role in a person’s well-being. Like the pituitary gland, it is part of the endocrine system, which regulates specific body functions. The thyroid generates hormones that control the body’s heart rate, blood pressure, temperature and metabolism. Thyroid cancer develops when cells of the thyroid grow uncontrollably. Fortunately, most thyroid tumors are benign (non-cancerous).

Cancer of the thyroid is uncommon, accounting for about 1 percent of all cancers diagnosed. However, it has become the 8th most commonly diagnosed cancer in women. Fortunately for those with the disease, there’s hope. Early detection, accurate diagnosis, precise treatment and scheduled follow-up can result in a healthy future.

Types of thyroid cancer include:

  • Papillary thyroid cancer
  • Follicular thyroid cancer
  • Medullary thyroid cancer
  • Anaplastic thyroid cancer

Symptoms

In the early stages of thyroid cancer, no symptoms are present. As the cancer develops, symptoms may include:

  • Lump in the front of the neck
  • Voice changes or hoarseness
  • Swollen lymph nodes
  • Trouble breathing or swallowing
  • Recurring or constant pain in the throat and/or neck

The above symptoms are often due to benign, non-cancerous conditions such as goiter or infection. However, due to their possible severity, it is recommended that anyone with these symptoms see a doctor to be diagnosed as soon as possible.

Diagnosis

To better understand the symptoms that may suggest thyroid cancer, your doctor may ask a series of questions regarding personal and family medical history.

One or more of the following tests may also be performed:
Physical exam: Your doctor feels your thyroid for lumps (nodules). Your doctor also checks your neck and nearby lymph nodes for growths or swelling.

Blood tests

Your doctor may check for abnormal levels of thyroid-stimulating hormone (TSH) in the blood. Too much or too little TSH means the thyroid is not working well.

Ultrasound
Thyroid scan
Biopsy

Biopsy is the only sure way to diagnose thyroid cancer.

Staging

Staging of thyroid cancer consists of analyzing the size of the nodule, whether the cancer has spread, and if so, to what other parts of the body. Thyroid cancer spreads most often to the lymph nodes, lungs, and bones. When cancer spreads from its original place to another part of the body, the new tumor has the same kind of cancer cells and the same name as the original cancer. Doctors call the new tumor "distant" or metastatic disease.

Staging may involve one or more of these tests:

  • Ultrasound
  • CT scan
  • MRI
  • Chest X-ray

Treatment

People with thyroid cancer have many treatment options. Treatment usually begins within a few weeks after the diagnosis, but you will have time to talk with your doctor about treatment choices and get a second opinion.

The choice of treatment depends on:

  • Type of thyroid cancer (papillary, follicular, medullary, or anaplastic)
  • Size of the nodule
  • Patient’s age
  • Stage of cancer

Radioactive Iodine

Depending on the type and stage of thyroid cancer, most patients receive at least one dose of radioactive iodine after surgery. This involves a low-iodine diet and some other preparation before treatment, as well as strict radiation-isolations precautions after treatment. Side effects are usually mild and transient. Patients can, however, get quite tired due to lack of thyroid hormone, but this will improve once thyroid hormones supplementation resumes. Patients need close follow-up by their endocrinologist for regular blood checks.

Radiation Therapy

External beam radiation can also be used for thyroid cancer. Aggressive thyroid cancers are often treated with radiation sometimes combined with chemotherapy. External radiation has less of a role in well-differentiated thyroid cancers, but can be used in select cases with good control of tumor.

Surgery

Most people with thyroid cancer have surgery. The surgeon may remove all or part of the thyroid. The following are possible types of surgeries to treat thyroid cancer:

Total thyroidectomy: Complete removal of the entire thyroid through an incision in the neck.

Lobectomy: Some people with follicular or papillary thyroid cancer may have only part of the thyroid removed. The surgeon removes one lobe and the isthmus.

Some people who have a lobectomy later have a second surgery to remove the rest of the thyroid.