Can You Beat Stage 4 Thyroid Cancer
Stage IV thyroid cancer is difficult to treat, and the prognosis is not as good. Sometimes, only palliative care may be possible if cancer has spread to the brain. A complete cure may not be possible once cancer reaches stage IV. Most types of thyroid cancer have a 100% cure rate in the early stages .
Tests That May Be Done
Blood tests: Blood tests alone cant tell if a thyroid lump is cancer. But they can help show if the thyroid is working the way it should.
Ultrasound: For this test, a small wand is moved over the skin in front of your neck. It gives off sound waves and picks up the echoes as they bounce off the thyroid gland. The echoes are made into a picture on a computer screen. How a lump looks on ultrasound can sometimes help tell if its cancer, but ultrasound cant tell for sure.
Radioiodine scan: For this test, a low dose of radioactive iodine is swallowed or put into a vein. Over time, the iodine is absorbed by the thyroid gland. A special camera is then used to see the radioactivity. Nodules that have less iodine than the rest of the thyroid can sometimes be cancer.
CT or CAT scan: Its a special kind of x-ray that takes detailed pictures of the thyroid and can show if the cancer has spread.
MRI scan: This test uses radio waves and strong magnets instead of x-rays to take pictures. MRI scans can be used to look for cancer in the thyroid, or cancer that has spread.
PET scan: In this test, you are given a special type of sugar that can be seen inside your body with a camera. If there is cancer, this sugar shows up as hot spots where the cancer is found. This test can be very useful if your thyroid cancer is one that doesnt take up radioactive iodine.
If the diagnosis is not clear after an FNA biopsy, you might need another kind of biopsy to get more cells to test.
Thyroid Cancer Survival Rate
Most thyroid cancers are very curable. In fact, the most common types of thyroid cancer papillary and follicular cancers have a more than 98% cure rate if theyre caught and treated at an early stage. The earlier you are diagnosed, the less likely it is that your cancer will have spread beyond the thyroid and the easier it is to treat.
Medullary thyroid cancer has a worse prognosis and is likely to include lymph node involvement. Once cancer has entered the lymph nodes it spreads readily through the lymphatic system, meaning your cancer will require more extensive and possibly more aggressive treatment.
The least common type of thyroid cancer, anaplastic thyroid cancer, has a very poor prognosis. The best results occur when localized anaplastic thyroid cancer is diagnosed early and completely removed via a thyroidectomy, as its very aggressive. Unfortunately, this cancer tends to be found after it has already spread.
Because most people dont die from thyroid cancer, its sometimes called a good cancer to get even by some physicians. Almost everyone I take care of has heard that, Dr. Lieb says. But I take issue with it. Physicians can feel very bad telling people they have cancer, and rather than saying your prognosis is good, some downplay the diagnosis. But there isnt a good cancer.
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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.
Magnetic Resonance Imaging Scan
MRI scans use magnets instead of radiation to create detailed cross-sectional images of your body. MRI can be used to look for cancer in the thyroid, or cancer that has spread to nearby or distant parts of the body. But ultrasound is usually the first choice for looking at the thyroid. MRI can provide very detailed images of soft tissues such as the thyroid gland. MRI scans are also very helpful in looking at the brain and spinal cord.
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What Happens After A Thyroid Cancer Diagnosis
The disparity by sex in the prevalence of small papillary thyroid cancers found during life and after death suggests that many women are receiving treatment for small tumors that might never have caused symptoms, Dr. Davies explained.
The factors that lead more women to get a diagnosis of small papillary thyroid cancer are numerous and complex, she said. Women tend to be more likely than men to seek medical care overall. Theyre more likely to encounter health issues that may have hormonal causes, such as difficulties with pregnancy.
Thyroid ultrasound is widely used to evaluate medical problems that may involve the thyroid. But its not intended to be used to screen people who dont have symptoms for thyroid cancer, Dr. Davies explained. However, she added, it often gets ordered along with other tests to speed the process of diagnosing a potential thyroid issue.
That can lead to finding things that were unrelated to someones symptoms. And that can also distract from discovering the real cause of the problem someone came to the clinic for, said Dr. Davies.
The biggest challenge, said Dr. Haymart, is that its currently impossible to predict which tumors found by chance will pose a threat to health.
How do you determine which cancers might be indolent and just sit there for the rest of the patients life, and which ones might be aggressive and potentially cause harm? she asked. Thats very difficult to tease out.
Lab Tests Of Biopsy Samples
In some cases, doctors might use molecular tests to look for specific gene changes in the cancer cells. This might be done for different reasons:
- If FNA biopsy results arent clear, the doctor might order lab tests on the samples to see if there are changes in the BRAF or RET/PTC genes. Finding one of these changes makes thyroid cancer much more likely.
- For some types of thyroid cancer, molecular tests might be done to see if the cancer cells have changes in certain genes , which could mean that certain targeted drugs might be helpful in treating the cancer.
These tests can be done on tissue taken during a biopsy or surgery for thyroid cancer. If the biopsy sample is too small and all the molecular tests cant be done, the testing may also be done on blood that is taken from a vein, just like a regular blood draw.
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When To Get Medical Advice
See a GP if you have symptoms of thyroid cancer. The symptoms may be caused by less serious conditions, such as an enlarged thyroid , so it’s important to get them checked.
A GP will examine your neck and can organise a blood test to check how well your thyroid is working.
If they think you could have cancer or they’re not sure what’s causing your symptoms, you’ll be referred to a hospital specialist for more tests.
Find out more about how thyroid cancer is diagnosed.
Second Way To Check For Thyroid Cancer Wellness Visit With Your Primary Care Physician
The second best way to check for thyroid cancer is to stay up to date with your medical visits. This may mean an annual check-up with your primary care physician or your OB/GYN. Both types of physicians will take a complete history and do a thorough physical exam as part of the thyroid cancer screening process. When your physician is taking your history, you will be asked many questions about recent signs and symptoms. Through these questions, certain symptoms may be noted that could be related to a thyroid cancer. If certain symptoms like a change in voice, difficulty swallowing, or a sense of a lump in your throat are mentioned, then a proper thyroid ultrasound would then be ordered.
During your physical exam portion of a thyroid cancer screening, your neck would also be felt to detect any lumps or irregularities. While your doctor is feeling your neck, he/she may feel a growth in your thyroid or an enlarged lymph node. These findings could be indicative of a thyroid cancer and would also prompt a dedicated thyroid ultrasound.
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Where Does Thyroid Cancer Spread First
Most patients with thyroid cancer have the cancer contained in the thyroid at the time of diagnosis. About 30% will have metastatic cancer, with most having spread of the cancer to the lymph nodes in the neck and only 1-4% having spread of the cancer outside of the neck to other organs such as the lungs and bone.
Who Is Most Likely To Get Thyroid Cancer
Thyroid cancer is more common in women than in men, and more so during their reproductive years. The highest number of women diagnosed with thyroid cancer are between the ages of 44 and 49 years. Men are more likely to develop thyroid cancer at an older age. For example between the ages of 80 to 84 years.
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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.
Diagnosis Of Thyroid Cancer
Usually, diagnosing thyroid cancer begins when a routine test suggests a problem with the thyroid. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for cancer or other health problems.
The process of diagnosis may seem long and frustrating. Its normal to worry, but try to remember that other health conditions can cause similar symptoms as thyroid cancer. Its important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of thyroid cancer.
The following tests are commonly used to rule out or diagnose thyroid cancer. Many of the same tests used to diagnose cancer are used to find out the stage, which is how far the cancer has progressed. Your doctor may also order other tests to check your general health and to help plan your treatment.
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Symptoms Of Thyroid Cancer
Thyroid cancer usually develops slowly, without many obvious symptoms. However, some people experience one or more of the following:
- a painless lump in the neck
- trouble swallowing
- difficulty breathing
- changes to the voice
- swollen lymph glands in the neck .
Although a painless lump in the neck is a typical sign of thyroid cancer, thyroid lumps are common and turn out to be benign in 90% of adults. Having an underactive or overactive thyroid is not typically a sign of thyroid cancer.
Not everyone with these symptoms has thyroid cancer. If you have any of these symptoms or are worried, always see your doctor.
What Is The Prognosis For People Who Have Thyroid Cancer
Eight out of 10 people who have thyroid cancer develop the papillary type. Papillary thyroid cancer has a five-year survival rate of almost 100% when the cancer is in the gland . Even when the cancer spreads , the survival rate is close to 80%. This rate means that, on average, youre about 80% as likely to live for at least five years after diagnosis as someone who doesnt have metastatic papillary thyroid cancer.
Five-year survival rates for other thyroid cancer types include:
- Follicular: Close to 100% for localized around 63% for metastasized.
- Medullary: Close to 100% for localized around 40% for metastasized.
- Anaplastic: Close to 31% for localized 4% for metastasized.
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What Are The Types Of Thyroid Cancer
Thyroid cancer is classified based on the type of cells from which the cancer grows. Thyroid cancer types include:
- Papillary: Up to 80% of all thyroid cancers are papillary. This cancer type grows slowly. Although papillary thyroid cancer often spreads to lymph nodes in the neck, the disease responds very well to treatment. Papillary thyroid cancer is highly curable and rarely fatal.
- Follicular: Follicular thyroid cancer accounts for up to 15% of thyroid cancer diagnoses. This cancer is more likely to spread to bones and organs, like the lungs. Metastatic cancer can be more challenging to treat.
- Medullary: About 2% of thyroid cancers are medullary. A quarter of people with medullary thyroid cancer have a family history of the disease. A faulty gene may be to blame.
- Anaplastic: This aggressive thyroid cancer is the hardest type to treat. It can grow quickly and often spreads into surrounding tissue and other parts of the body. This rare cancer type accounts for about 2% of thyroid cancer diagnoses.
What Does The Research Say
Researchers looked at 37 peer-reviewed studies containing data on the relationship between breast and thyroid cancers.
They noted in a 2016 paper that a woman whos had breast cancer is 1.55 times more likely to develop a second cancer of the thyroid than a woman without a history of breast cancer.
A woman with thyroid cancer is 1.18 times more likely to develop breast cancer than a woman without a history of thyroid cancer.
Researchers are unsure about the connection between breast and thyroid cancers. Some research has indicated the risk of developing a second cancer increases after radioactive iodine is used to treat thyroid cancer.
Iodine is generally considered safe, but it could trigger a second cancer in a small number of people. Radiation used to treat certain forms of breast cancer may increase the risk of developing thyroid cancer.
Certain genetic mutations like a germline mutation could link the two forms of cancer. Lifestyle factors like exposure to radiation, poor diet, and lack of exercise, could also increase the risk of both cancers.
Some researchers also noted the possibility of a surveillance bias, which means a person with cancer is more likely to follow up with screening after treatment. This improves detection of a secondary cancer.
They also analyzed the results by dividing the data into groups based on the time between the diagnosis of the first and the second cancer.
Both breast and thyroid cancers have unique screening guidelines.
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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.
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.
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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:
- 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.
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 .
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