Thyroid Cancer: Common In Women
Thyroid disorders are more common in women, probably due to the roles of hormones, which are different in femalesthan in males.
Thyroid nodules, Russell says, affect up to 80 percent of women, but only 5percent to 15 percent of those lumps and bumps are malignant. Bettertesting means thyroid tumors are on the rise, he notes, saying that itsprojected to become the third most common cancer.
Malignant and cancer are scary words, but Russell says that mostthyroid cancer is highly treatable, even when the cancer cells spread tonearby lymph nodes, which occurs frequently.
With thyroid cancer we talk about prognosis in terms of 20-year survivalinstead of five years, as we do with most other cancers. Its usually aslow-moving disease. Theres a 98 to 99 percent survival rate at 20 years,he says.
We treat it almost like a chronic condition where the patient getstreatment and visits her doctor regularly for follow-up.
After Surgery: Radioactive Iodine And Long
Almost all people who had surgery for papillary thyroid cancer will need to see a doctor for many years to have exams and certain blood tests to make sure the cancer has been cured, and to detect any return of the cancer as soon as possible should it return. Many people with papillary thyroid cancer will need to take radioactive iodine to help cure the cancer. We have several very important pages on these topics.
How Age Affects The Risk Of Thyroid Cancer Recurrence
Several factors determine if your thyroid cancer may return or relapse after treatment, with age being an independent risk factor. Typically, the older population is at a greater risk of experiencing a reoccurrence of thyroid cancer after an initial diagnosis. However, it is not a must that thyroid cancer will return. Other factors that increase the chances of thyroid cancer reoccurrence after diagnosis and treatment include stage, obesity, and genetics.
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Evaluation And Management Of The Solitary Thyroid Nodule
The key to the workup of the solitary thyroid nodule is to differentiate malignant from benign disease and, thus, to determine which patients require intervention and which patients may be monitored serially. History taking, physical examination, laboratory evaluation, and fine-needle aspiration biopsy are the mainstays in the evaluation of thyroid nodules. Imaging studies can be adjuncts in select cases.
A 2015 consensus statement from the American Thyroid Association on preoperative imaging for thyroid cancer surgery stated the following :
A Personal Journey Of Thyroid Cancer Treatment
The practical side of cancer treatment and life without a thyroid.
by Carly Flumer
I REMEMBER MY SURGEON TELLING ME, as we discussed surgery to treat my thyroid cancer, that I could maintain the vital functions of my thyroid and preserve my quality of life if I chose to remove only the half with the tumor in it. I was thankful to him for considering what I was looking for as an adolescent and young adult cancer patient besides a cure. However, fast forward past the surgery to when I learned I had metastases. I would go on to have the other side of my thyroid removed, then radiation treatments and a third surgery four years later when the cancer failed to respond to radiation. Now its been five years since my first diagnosis, and Im taking a little pill every day to do the work of the thyroid gland and keep me alive.
The three surgeries were outpatient, in-and-out procedures that were relatively easy to recover from. Radioactive iodine therapy wasnt as intense as much as it was annoying. The treatments made me radioactive, which meant I couldnt be within a certain distance of my family for about a week, with the distance between us slowly decreasing over time. I remember my parents leaving food outside my door for meals, flushing the toilet three times due to radiation leaving my body through my urine, and having to throw away the sheets of the makeshift bed set up for me because they were now tainted with radiation.
Tips for coping with treatment
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How Does The Doctor Know I Have Thyroid Cancer
Most thyroid cancers are found when patients see a doctor because of new neck lumps . Sometimes doctors find neck lumps during a physical exam. Yet other times thyroid cancer may be found during an ultrasound test for other health problems.
If signs are pointing to thyroid cancer, more tests will be done.
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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Different Kinds Of Thyroid Cancer
There are 4 main types of thyroid cancer. They are listed below. Your doctor can tell you more about the kind you have.
- Papillary thyroid cancer is the most common kind of thyroid cancer. It may also be called differentiated thyroid cancer. This kind tends to grow very slowly and is most often in only one lobe of the thyroid gland. Even though they grow slowly, papillary cancers often spread to the lymph nodes in the neck.
- Follicular cancer is the next most common type. Its more common in countries where people dont get enough iodine in their diet. These cancers do not tend to spread to lymph nodes, but they can spread to other parts of the body, like the lungs or bones.
- Medullary cancer is a rare type of thyroid cancer. It starts in a group of thyroid cells called C-cells. C-cells make calcitonin, a hormone that helps control the amount of calcium in the blood.
- Anaplastic cancer is a rare type of thyroid cancer. It often spreads quickly into the neck and to other parts of the body, and is very hard to treat.
Who Gets Thyroid Cancer
About 2900 people are diagnosed with thyroid cancer each year in Australia. Thyroid cancer can occur at any age. It affects almost three times as many women as men it is the seventh most common cancer affecting Australian women of all ages, and the most common cancer diagnosed in women aged 2024.
Diagnoses of thyroid cancer in Australia have increased in recent years, with almost four times as many cases estimated in 2019 as there were in 1982. Some of this increase is due to the improved quality and greater use of diagnostic scans, such as ultrasounds. This has led to the detection of smaller, often insignificant, thyroid cancers that would otherwise not have been found. Researchers are trying to work out if there are any other causes of the increased rates of thyroid cancer.
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What Is Differentiated Thyroid Cancer
Most thyroid cancers are differentiated, according to the American Cancer Society, which means that when the cells are looked at under a microscope they appear similar to normal thyroid cells. Papillary, follicular, and Hurthle cell thyroid cancer are all types of differentiated thyroid cancer. When the cancerous cells are not similar in appearance to normal thyroid tissue, the cancer is called poorly differentiated or undifferentiated. Medullary and anaplastic thyroid cancers fall into this category.
Treatment For Thyroid Cancer
Surgery to remove the thyroid and any affected lymph nodes is the preferredtreatment. Afterward, the patient will takethyroid hormonesto cover the loss of the gland and radioactive iodine to treat anyremaining cancer cells.
Traditional surgical removal of the thyroid gland, or thyroidectomy, leavesa prominent scar on the front of the neck. Russell notes that some thyroidcancer survivors are fine with their thyroidectomy scar and regard it as abadge of honor.
But plenty of patients dont want the constant reminder of cancer surgeryeach time they look in the mirror. Or they dont necessarily want a scar tobe the first thing a stranger notices. They say Its my business that Ihad a problem with my thyroid, Russell says.
Russell offers patients the option of ascarless thyroidectomy, in which the surgeon reaches the thyroid gland and removes it through themouth, so theres no cutting or scarring of the neck.
Though initially skeptical about the novel approach, Russell studied thetechnique in Thailand and saw that scarless thyroidectomy could be avaluable alternative to a traditional approach. Now Russells clinic is aleader in performing scarless thyroidectomies and trains surgeons from allover the world.
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What Are The Symptoms Of Thyroid Cancer
- A lump or swelling on the side of the neck is the most common symptom.
- Having trouble breathing.
- Having trouble swallowing.
- Having a hoarse voice.
These symptoms can also come from other conditions. If you have any of these symptoms, talk to your doctor right away. Dont wait until the symptoms get worse.
What Should People Know About Thyroid Cancer
The thyroid is a butterfly-shaped gland in the neck. It is located below the Adam’s apple and makes hormones. These hormones help control blood pressure, body temperature, the rate at which the heart beats and how fast food is converted into energy. Hormones from the thyroid gland also affect a child’s growth and development. The thyroid uses iodine, a mineral found in foods, to make some of its hormones.
There are different types of thyroid cancers depending on the type of cell that is affected. These different types of thyroid cancer vary in how successfully they can be treated the most common type grows slowly and is rarely fatal.
Each year, over 1,000 men and about 3,000 women are diagnosed with thyroid cancer in New York State. About 50 men and 70 women die from this disease in New York State each year.
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The Role Of Thyroid Hormones
The hormones T4 and T3 are known as the thyroid hormones. To make these hormones, the thyroid needs iodine, which is found in a range of foods such as seafood and iodised salt.
T4 is the main hormone made by the thyroid, but it is converted by the liver and kidneys into T3, a much more powerful hormone. Most T3 is created when the liver and kidneys convert T4 into T3, but the thyroid also makes small amounts.
To keep the body working properly, it is important that the thyroid makes the right amounts of T4 and T3. This is controlled by the pituitary gland, which is located at the base of the brain:
- If the levels of T4 and T3 drop below normal, the pituitary gland produces a hormone called thyroid-stimulating hormone . TSH prompts the thyroid to make and release more T4 and T3.
- If the levels of T4 and T3 are too high, the pituitary gland produces less TSH.
Changes in thyroid hormone levels affect your metabolism by slowing down or speeding up the bodys processes:
Underactive thyroid If you dont have enough thyroid hormones, your metabolism slows down. As a result, you may feel tired or depressed, and gain weight easily. Other symptoms may include:
- difficulty concentrating
- brittle and dry hair and skin
- sluggishness and fatigue
- in severe cases, heart problems could occur.
Overactive thyroid If you have too many thyroid hormones, your metabolism speeds up. As a result, you may:
- feel shaky and anxious
- have rapid, strong heartbeats .
The Potential Downside Of Finding More Thyroid Cancers
Like other cancers, thyroid cancer isnt one disease. There are several different types of thyroid cancer , and each type can have very different prognoses. For example, few people with anaplastic thyroid cancer, a very rare but aggressive type, will live for even a year. But almost everyone diagnosed with a small papillary thyroid cancer will be alive 5 years after diagnosis.
In fact, past autopsy studies have shown that many people die withnot froma small papillary thyroid cancer.
You can die with a cancer never knowing you had it, Dr. Davies said. If these cancers are found by chance, any intervention can potentially be overtreatmentthat is, therapy for a cancer that would have stayed the same or sometimes even gotten smaller, and never caused any symptoms.
And overtreatment not only carries the risk of side effects without any benefit to the patient, but it can also include substantial financial costs.
The most common side effect from surgery to remove part or all of the thyroid gland is a lifelong need for thyroid hormone replacement therapy, which can have its own side effects. Most people feel fine, but some might not feel as well as they did before surgery, Dr. Haymart said.
Surgery to remove thyroid cancer also has the potential to damage vocal cord functions or nearby glands that control calcium levels in the body, she explained.
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Genetic Testing For Men And Fmtc
Genetic testing is now the mainstay in the diagnosis of the FMTC syndromes. RET proto-oncogene mutations have been discovered in each of the MTC syndromes. The RET proto-oncogene is a receptor tyrosine kinase whose exact function and role in these syndromes has not been elucidated. Patients with MEN 2A have germline RET mutations resulting in substitutions of conserved cysteine residues in exons 10 and 11. All patients with MEN 2B have a germline mutation resulting in a threonine-for-methionine substitution in codon 918 of exon 16. Mutations are described in exons 13 and 14 in patients with FMTC.
Genetic screening with sensitive PCR assays for germline RET mutations is routinely performed in at-risk patients. Children of parents known to have MEN or FMTC are tested for RET mutations to guide therapy and future genetic counseling. In addition, patients presenting with sporadic MTC should undergo RET mutational analysis to rule out new spontaneous germline mutations, which should prompt the testing of offspring for similar mutations.
Biochemical Testing For Mtc
Because MTC cells produce calcitonin, elevated serum calcitonin levels are diagnostic of MTC. Although routine measurement of serum calcitonin has low yield in managing the solitary thyroid nodule because of the uncommon nature of MTCs, it is useful in the surveillance of patients with a history of MTC and in managing familial forms. Stimulating calcitonin release by using intravenous pentagastrin increases the sensitivity of the test. For pentagastrin-stimulated calcitonin evaluation, a baseline plasma calcitonin level is measured, followed by the intravenous administration of pentagastrin 0.5 mg/kg and serial measurements of calcitonin 1.5 and 5 minutes after injection. Elevated basal or stimulated calcitonin levels above the normal range for the laboratory strongly suggest MTC.
Plasma calcitonin levels are commonly increased before clinical evidence of MTC appears. Although this finding was once the mainstay in diagnosing familial forms of MTC, results of genetic testing have largely supplanted it. Plasma calcitonin testing is now used for the early detection of MTC in patients already known to be at risk for MTC because of their family history and genetic results. This level is most commonly used as a tumor marker to identify residual and metastatic disease after thyroidectomy to treat MTC.
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What Is The Follow
Periodic follow-up examinations are essential for all patients with thyroid cancer, because the thyroid cancer can returnsometimes several years after successful initial treatment. These follow-up visits include a careful history and physical examination, with particular attention to the neck area. Neck ultrasound is an important tool to view the neck and look for nodules, lumps or cancerous lymph nodes that might indicate the cancer has returned. Blood tests are also important for thyroid cancer patients. Most patients who have had a thyroidectomy for cancer require thyroid hormone replacement with levothyroxine once the thyroid is removed . The dose of levothyroxine prescribed by your doctor will in part be determined by the initial extent of your thyroid cancer. More advanced cancers usually require higher doses of levothyroxine to suppress TSH . In cases of minimal or very low risk thyroid cancer, it is typically recommended to keep TSH in the normal range. The TSH level is a good indicator of whether the levothyroxine dose is correct and should be followed periodically by your doctor.
In addition to routine blood tests, your doctor may want to check a whole-body iodine scan to determine if any thyroid cancer cells remain. These scans are only done for high risk patients and have been largely replaced by routine neck ultrasound and thyroglobulin measurements that are more accurate to detect cancer recurrence, especially when done together.
Common Symptoms Of Thyroid Cancer
Although it remains unclear what causes thyroid cancer, the condition can result from mutations of cells within the thyroid gland. These genetic changes stimulate the rapid growth of cells, leading to the accumulation of abnormal cells that form a tumor. A person with a cancerous thyroid tumor can have multiple symptoms, including:
- Difficulty swallowing
- Changes of voice, including increasing hoarseness
- A lump in the neck
- Pain in the throat and neck
- Swollen lymph node in your neck
So, be sure to check what happens when cancer spreads to the lymph nodes and when other symptoms start to show. While anyone diagnosed with thyroid cancer can live a normal life, age can affect the survival rate. For example, a patient below 45 years has an excellent prognosis than an individual over 60. Therefore, age plays a critical role in determining the survival rate of patients with thyroid cancer, where the younger population has a higher survival rate than the elderly or people over 60 years.
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What Is Thyroid Cancer
Thyroid cancer is a solid tumor cancer that usually shows up as a nodule, or mass, in the thyroid gland, which is located at the front base of your throat. It occurs when rogue cells reproduce too rapidly for the immune system to control. There are several types of thyroid cancer, but two types and follicular thyroid cancer are by far the most common, accounting for some 95 percent of cases. Between 1% and 2% of people will get thyroid cancer at some point during their lifetime. It affects three times as many women as men and is most common after age 30, though it can occur in any age group. Thyroid cancer is more likely to be aggressive in older adults.