How To Cope With Thyroid Cancer
Being diagnosed with any cancer is a big shock youre likely to feel upset, frightened and confused. It can be very difficult coping with a cancer diagnosis so give yourself time to adjust. Be sure to talk to your family and friends about how youre feeling, as well as to the healthcare professionals treating you.
What Are Thyroid Nodules
Tumours in the thyroid are also called thyroid nodules and these are formed due abnormal overgrowth of cells in the thyroid gland. These are very common with at least half of the people having one nodule by the age of 60 years. 95% of the thyroid nodules are benign though and and only 5% are cancerous in nature.The thyroid glands basically contains two types of cells and the tumours begin in one of these two types:
How Is Anaplastic Thyroid Cancer Treated
Anaplastic thyroid cancer is difficult to treat because it is very aggressive and can spread rapidly within the neck and metastasize to distant parts of the body. It is less predictable than other thyroid cancers however, one thing that all long-term survivors have in common is the sense of urgency in diagnosis and treatment.
It is important to work with a doctor or team of doctors who have experience with anaplastic thyroid cancer. You must be your best advocate. Take a family member or friend to appointments if possible. Take notes. Ask questions. If you are unable to travel to a major medical/ cancer facility with experience, many of the larger, more experienced institutions are happy to advise your local doctors on the best treatment options. Do not be afraid to ask your local doctors to collaborate with experts at more experienced centers on your treatment plan given the rarity of this diagnosis. It is also important to understand the risks and benefits involved with various treatment options.
Anaplastic thyroid cancer does not respond to radioactive iodine therapy or Thyroid Stimulating Hormone suppression, which are commonly used in patients with other forms of differentiated thyroid cancer.
Treatment of anaplastic thyroid cancer, is best done through a multidisciplinary team , and typically consists of combining surgery with external beam radiation and chemotherapy.
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What Will Happen After Treatment
Most people do very well after treatment, but you may need follow-up care for the rest of your life. This is because most thyroid cancers grow slowly and can come back even 10 to 20 years after treatment. Your cancer care team will tell you what tests you need and how often they should be done.
Be sure to go to all of these follow-up visits. You will have exams, blood tests, and maybe other tests to see if the cancer has come back. At first, your visits may be every 3 to 6 months. Then, the longer youre cancer-free, the less often the visits are needed.
Sometimes treatments may not cure your cancer. You many need to keep getting treatment and care. From time to time tests will be done to see how your treatment is working.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life.
The Most Common And Rare Forms
Understanding a thyroid cancer diagnosis can be confusing. There are many different types of thyroid cancer, with varying survival rates and multiple names.
Whether papillary or follicular thyroid cancer, hereditary or sporadic medullary thyroid cancer, or undifferentiated anaplastic thyroid cancers, these growths start in the thyroid.
The thyroid is a small organ in the front of the throat, near the base of the neck. It is butterfly shaped, with two lobes. It helps the body regulate essential functions, including metabolism, blood pressure, heart rate, and temperature by releasing proteins called hormones that act on other parts of the body.
Several types of cancer and benign growths can develop in the thyroidsome more dangerous than others. Thyroid cancers are growths of abnormal cells in the thyroid that have the potential to spread and take over other tissues and organs in the body. Thankfully most are successfully treatedmore than 900,000 people live with thyroid cancer in the United States.
This article will outline the various types of thyroid cancer and highlight their differences.
Terry Vine / Getty Images
The thyroid gland contains two types of cells, which perform different functions, as follows:
- Follicular cells make hormones that regulate metabolism, blood pressure, and heart rate.
- C cells make a hormone that helps the body use calcium.
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How Can I Prevent Thyroid Cancer
Many people develop thyroid cancer for no known reason, so prevention isnt really possible. But if you know youre at risk for thyroid cancer, you may be able to take these steps:
- Preventive surgery: Genetic tests can determine if you carry an altered gene that increases your risk for medullary thyroid cancer or multiple endocrine neoplasia. If you have the faulty gene, you may opt to have preventive surgery to remove your thyroid gland before cancer develops.
- Potassium iodide: If you were exposed to radiation during a nuclear disaster, such as the 2011 incident at Fukushima, Japan, taking potassium iodide within 24 hours of exposure can lower your risk of eventually getting thyroid cancer. Potassium iodide blocks the thyroid gland from absorbing too much radioiodine. As a result, the gland stays healthy.
Types Of Thyroid Cancer
There are 5 main types of thyroid cancer:
In addition, other types of cancer may start in or around the thyroid gland. For lymphoma in the thyroid, read Cancer.Nets Guide to Non-Hodgkin Lymphoma. For more information on sarcoma in the thyroid, read the Cancer.Net Guide to Sarcoma. For information on a tumor in the nearby parathyroid gland, read Cancer.Nets Guide to Parathyroid Cancer.
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How Is Thyroid Cancer Diagnosed
If you have an enlarged thyroid nodule or other signs of thyroid cancer, your healthcare provider may order one or more of these tests:
- Blood tests: A thyroid blood test checks hormone levels and gauges whether your thyroid is functioning properly.
- Biopsy: During a fine-needle aspiration biopsy, your healthcare provider removes cells from your thyroid to test for cancer cells. A sentinel node biopsy can determine if cancer cells have spread to lymph nodes. Your provider may use ultrasound technology to guide these biopsy procedures.
- Radioiodine scan: This test can detect thyroid cancer and determine if cancer has spread. You swallow a pill containing a safe amount of radioactive iodine . Over a few hours, the thyroid gland absorbs the iodine. Your healthcare provider uses a special device to measure the amount of radiation in the gland. Areas with less radioactivity need more testing to confirm the presence of cancer.
- Imaging scans:Magnetic resonance imaging , computed tomography and positron emission tomography scans can detect thyroid cancer and cancer spread.
What Are The Symptoms Of Thyroid Cancer
You or your healthcare provider might feel a lump or growth in your neck called a thyroid nodule. Dont panic if you have a thyroid nodule. Most nodules are benign . Only about three out of 20 thyroid nodules turn out to be cancerous .
Other signs of thyroid cancer include:
- Difficulty breathing or swallowing.
- Swollen lymph nodes in the neck.
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Papillary Cancer And Its Variants
Most cancers are treated with removal of the thyroid gland , although small tumors that have not spread outside the thyroid gland may be treated by just removing the side of the thyroid containing the tumor . If lymph nodes are enlarged or show signs of cancer spread, they will be removed as well.
In addition, recent studies have suggested that people with micro-papillary cancers may safely choose to be watched closely with routine ultrasounds rather than have immediate surgery.
Even if the lymph nodes arent enlarged, some doctors recommend central compartment neck dissection along with removal of the thyroid. Although this operation has not been shown to improve cancer survival, it might lower the risk of cancer coming back in the neck area. Because removing the lymph nodes allows them to be checked for cancer, this surgery also makes it easier to accurately stage the cancer. If cancer has spread to other neck lymph nodes, a modified radical neck dissection is often done.
Treatment after surgery depends on the stage of the cancer:
People who have had a thyroidectomy will need to take daily thyroid hormone pills. If RAI treatment is planned, the start of thyroid hormone therapy may be delayed until the treatment is finished .
Outlook For Thyroid Cancer
Around 9 in every 10 people are alive 5 years after a diagnosis of thyroid cancer. Many of these are cured and will have a normal lifespan.
But the outlook varies depending on the type of thyroid cancer and how early it was diagnosed. At present the outlook is:
- more than 9 in 10 people with papillary carcinoma live at least 5 years after diagnosis
- more than 9 in 10 people with follicular carcinoma live at least 5 years after diagnosis
- more than 7 in 10 men, and around 9 in 10 women with medullary thyroid carcinoma live at least 5 years after diagnosis
- around 1 in 10 people with anaplastic thyroid carcinoma live at least 5 years after diagnosis
Up to 1 in 4 people treated for thyroid cancer are later diagnosed with cancer in another part of the body, such as the lungs or bones, but cancer can often be treated again if this happens.
Page last reviewed: 28 August 2019 Next review due: 28 August 2022
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Evidence Of No Benefit Associated With Screening
Screening for thyroid cancer is primarily accomplished by neck palpation or ultrasound imaging. In the absence of formal screening, asymptomatic thyroid cancers are most commonly detected incidentally on cross-sectional imaging performed for other medical conditions or on surgical specimens of benign diseases such as goiter.
The efficacy of thyroid cancer screening has never been evaluated in a randomized controlled trial . No RCTs of intermediate endpoints have been conducted. No population-based screening programs for thyroid cancer exist in the United States, the United Kingdom, or Europe, although neck palpation screening results in incidental detection of asymptomatic cancers. Over time, U.S. and U.K. thyroid cancer incidence rates have increased, but thyroid cancer mortality has remained constant or decreased slightly. That pattern is consistent with the detection of cancers that are not destined to cause symptoms or result in death .
Much of what is known about the impact of thyroid cancer screening comes from South Koreas experience. Investigators examined thyroid cancer trends in South Korea using the following three data sources:
- The 2010 Korea Community Health Survey.
- The Korea Cancer Registry.
- Mortality data from Statistics Korea.
References
Surgery For Thyroid Cancer
Most patients with thyroid cancer have some type of surgery. Surgery is done to take out the tumor and all or part of the thyroid gland. Sometimes lymph nodes are taken out from the neck, too.
Side effects of surgery
Any type of surgery can have risks and side effects. Be sure to ask the doctor what you can expect. Possible side effects of thyroid surgery include:
- Bleeding or a blood clot in the neck
- Damage to the parathyroid glands
- Short or long term problems with your voice
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How Does Thyroid Cancer Affect Pregnancy
Thyroid cancer is the second most common cancer diagnosed in pregnant women . Approximately 10% of thyroid cancers develop during pregnancy or within the first year after childbirth. Experts believe fluctuating hormone levels during pregnancy may trigger the cancer.
If you receive a thyroid cancer diagnosis during pregnancy, your healthcare provider can discuss treatment options. Depending on the cancer type and severity, your provider may recommend delaying treatment until after you deliver your baby. If treatment cant wait, most women can safely undergo surgery to remove the cancerous gland. You shouldnt have radioactive diagnostic tests or treatments when youre pregnant or breastfeeding.
Signs And Symptoms Of Thyroid Cancer
Thyroid cancer develops slowly and, for this reason, it often doesnt cause any symptoms. Here are the signs to look for:
- a lump in the front of your neck but around 19 out of 20 thyroid lumps are not cancer, so only 1 out of every 20 is likely to be
- the lump feels firm, gets bigger over time and doesnt move around under the skin when you touch it
- your thyroid gland is made up of two halves, called lobes, which are joined together by a thinner bridge of tissue called the isthmus. Thyroid cancer is usually found in just one lobe, so you may only feel a lump on one side of the space between your collar bones
- it can sometimes be found in both thyroid lobes
Occasionally, if its large enough to press on your windpipe , thyroid cancer can cause one or more of these symptoms:
- pain in your neck, ear or jaw
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What Are The Complications Of Thyroid Cancer
Most thyroid cancers respond well to treatment and arent life-threatening.
After thyroid surgery or treatments, your body still needs thyroid hormones to function. Youll need thyroid replacement hormone therapy for life. Synthetic thyroid hormones, such as levothyroxine , take over for the thyroid hormones that your body no longer naturally produces.
What Kind Of Treatment Will I Need
There are many ways to treat thyroid cancer but surgery is the main treatment. The treatment plan thats best for you will depend on:
- The stage of the cancer
- The chance that a type of treatment will cure the cancer or help in some way
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
Depending on the type and stage of your thyroid cancer, you may need more than 1 type of treatment.
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What To Do If You Notice Signs Of Thyroid Cancer
If you experience signs of thyroid cancer, its important to consult with your doctor to get an accurate diagnosis.
First, your doctor may conduct a physical examination, manually palpating your neck and throat to check for abnormal growths or areas of swelling, including the thyroid and lymph nodes. Your doctor may also gather your personal and family medical history, ask about your symptoms and risk factors, including any inherited genetic mutations.
A blood test called a tumor marker test may be recommended to check for high levels of certain hormones, such as:
- Triiodothyronine
- Thyroid-stimulating hormone
If cancer is suspected, one or more of the following diagnostic tests may be ordered:
Ultrasound. An ultrasound over the neck region may be done to locate any nodules that are present on your thyroid and determine whether theyre made up of solid or liquid material.
Chest X-ray: This basic imaging test may be done if your doctor suspects the cancer has metastasized to your lungs.
Magnetic resonance imaging scan: Using magnets, an MRI scan creates highly detailed images of the thyroid and surrounding areas.
Computed tomography scan or positron emission tomography scan: A CT scan uses contrast dye that helps your doctor pinpoint the size and location of your cancer, and whether it has metastasized to surrounding tissues. A PET scan is similar but uses an injection of radioactive sugar instead of contrast dye .
Expert cancer care
Ctca Approach To Helping You Maintain Your Quality Of Life
At CTCA, each thyroid patients multidisciplinary care team is typically led by an otolaryngology-trained oncologist and coordinated by a registered oncology nurse, who helps track the various appointments, follows up on tests and answers questions that come up along the way. Your team may also include a radiation oncologist, surgeon and pathologistall working together, under one roof, to coordinate and deliver your care plan.
Many common treatments for thyroid cancer, including surgery and radiation therapy, can cause side effects, such as pain, malnutrition and neuropathy, that may impact your quality of life. We understand that supporting your quality of life is critical to your recovery. Thats why each CTCA patients personalized treatment plan includes a range of supportive care services designed to help manage side effects, reduce the risk of treatment delays and help the patient get back to life.
Patients with thyroid cancer who have had most or all of their thyroid gland removed by surgery, for example, may need to take daily hormone supplements in order to maintain their bodies normal metabolism. If you need to take thyroid hormone therapy, your care team at CTCA will work with you to find the right dosage and help you manage potential side effects.
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What Is Different About Medullary Thyroid Cancer
Except for medullary thyroid cancer, the other common types of other thyroid cancers arise from a thyroid follicular cell . Medullary thyroid cancer arises from a different cell type within the thyroid gland . These c-cells are neuroendocrine cells that are very different from thyroid follicular cells in that they do not concentrate iodine and they do not make thyroid hormones.
Unlike the other thyroid cancers, medullary thyroid cancer may be part of a hereditary syndrome in which each first degree relative of an affected patient has a 50% chance of developing medullary thyroid cancer. The genetic mutation for hereditary thyroid cancer is now well know and its detection is possible with a commercially available blood test . Of all the patients with medullary thyroid cancer, only 25% have a genetic syndrome that can be passed through a family. The other 75% have sporadic medullary thyroid cancer that affects only that patient and is not hereditary.
Unlike papillary and follicular thyroid cancers with make thyroglobulin, medullary thyroid cancer makes tumors markers known as calcitonin and CEA . In addition, the cells that give rise to medullary thyroid cancer are not sensitive to TSH, so thyroid hormone suppressive therapy is not needed. Rather, in medullary thyroid cancer the thyroid hormone levels are adjusted to achieve a TSH in the normal reference range.