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Thyroid Cancer

  • Overview Symptoms Causes Diagnosis Treatment
Overview

Thyroid cancer is the cancer of the Thyroid gland. This disease occurs when abnormal cells begin to grow in the thyroid gland. The thyroid gland is shaped like a butterfly and is located in the front of the neck. It makes hormones that regulate the way the body uses energy and that help the body to work normally. Thyroid cancer is a relatively uncommon type of cancer. Most people who have it do very well, because the cancer is usually found early and the treatments work well. After it is treated, thyroid cancer may come back, sometimes many years after treatment.

Symptoms

Thyroid cancer can cause several symptoms:

  • A lump or swelling in the neck
  • Pain in your neck and sometimes, in the ears
  • Trouble swallowing
  • Trouble breathing or having constant wheezing
  • Voice may become hoarse
  • Frequent cough that is not related to a cold
  • Hoarseness, or problems speaking in a normal voice
  • The lymph nodes in the neck are swollen
Causes

The following can be the causes as well as the risk factors that can lead to thyroid cancer:

  • Radiation exposure: The exposure, especially during childhood, increases the risk of developing thyroid cancer. This could be due to an all-nuclear fallout that occurs after a nuclear explosion, or radiation treatment for medical conditions/diseases when radiation risks were not properly understood.
  • Gender: The gender of the patient plays a big role in thyroid cancer. Around three-quarters of all patients with thyroid cancer are female.
  • Some health conditions/diseases: People with the following conditions/diseases have a higher risk of developing thyroid cancer: Hashimoto's thyroiditis, Cowden's syndrome, thyroid adenoma and familial adenomatous polyposis.
  • Genetics: Some inherited conditions increase the risk of developing medullary thyroid cancer. Approximately one quarter of individuals, who develop medullary thyroid cancer, have an abnormal gene.
  • Family history: Individuals with a family history of goiter (thyroid gland enlargement) have a higher risk of developing thyroid cancer.
Diagnosis

In order to diagnose thyroid cancer one of the following tests can be conducted:

  • Physical exam: The doctor conducts a physical examination of the thyroid for lumps (nodules). He may also check the neck and nearby lymph nodes for growths or swelling.
  • Blood tests: The doctor may also 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: An ultrasound device uses sound waves that can't be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside the neck. The echoes create a picture of the thyroid and nearby tissues. The picture can show thyroid nodules that are too small to be felt. Nodules that are filled with fluid are usually not cancer. Nodules that are solid may be cancer.
  • Thyroid scan: In a thyroid scan, the patient is made to swallow a small amount of a radioactive substance (such as radioactive iodine), and it travels through the bloodstream. Thyroid cells that absorb the radioactive substance can be seen on a scan. Nodules that take up more of the substance than the thyroid tissue around them are called 'hot' nodules. Hot nodules are usually not cancer. Nodules that take up less substance than the thyroid tissue around them are called 'cold' nodules. Cold nodules may be cancer.
  • Biopsy: A biopsy is the only sure way to diagnose thyroid cancer. A pathologist checks a sample of thyroid tissue for cancer cells, using a microscope.

A doctor may take tissue for a biopsy in one of the following two ways:

  • With a thin needle: The doctor removes a sample of tissue from a thyroid nodule with a thin needle. An ultrasound device can help your doctor see where to place the needle. Most people have this type of biopsy.
  • With surgery: If a diagnosis can't be made from tissue removed with a needle, a surgeon removes a lobe, or the entire thyroid. For example, if the doctor suspects follicular thyroid cancer, the lobe that contains the nodule may be removed for diagnosis.
Treatment

The doctor may recommend surgery, radioactive iodine and/or radiotherapy. In most cases, especially during the early stage of the cancer, treatment is effective and thyroid cancer is cured.

Surgery: If thyroid cancer is detected at an early stage, then the doctors recommend one of the following surgical procedures:

  • Thyroidectomy: The surgical removal of part or all of the thyroid gland. During this operation, the surgeon may also remove the lymph nodes in the neck.
  • Lobectomy (hemithyroidectomy): The surgical removal of a lobe (one of the wings of the thyroid gland).
  • Tracheostomy: Making an incision in the front of the neck and opening a direct airway through an incision in the trachea (windpipe), allowing the patient to breathe.

After surgery the patient may experience pain when swallowing and will be on a special diet of soft foods.

Thyroid hormone therapy: If the thyroid gland is completely or partially removed, the patient will need to take replacement hormone tablets for the rest of his/her life. The patient will need regular blood tests to make sure hormone levels are right.

Radioactive iodine: After surgery the patient may receive a course of radioactive iodine therapy, which is aimed at preventing thyroid cancer recurrence. After treatment, patients will be on a low-iodine diet. Pregnant women should not receive radioactive iodine treatment.

External radiation therapy: Radiotherapy is usually only used for medullary or anaplastic thyroid cancers.

Chemotherapy: Chemotherapy, typically, refers to the destruction of cancer cells. It is usually only used to treat anaplastic thyroid cancer that has metastasized. However, chemotherapy may also include the use of antibiotics or other medications to treat any illness or infection.