Team Management Assures Best Thyroid Care
Dr. Russell tells EndocrineWeb: “The most important part of managing thyroid cancer is the initial treatment.” He suggests that patients ask your doctor how often they care for patients with thyroid cancer and whether a thyroid cancer specialist is consulted. This is important to give your some reassurance that your care is being considered by someone who is well-versed in managing all types of thyroid cancer.
“One marker of quality team-based care is having the participation of a regular and dedicated thyroid tumor conference, where specialists from multiple disciplines meet and discuss challenging cases as well as anticipated outcomes,” says Dr. Russell. In this way, you can have greater confidence that your individual circumstances will be fully assessed.
The information gained from this study can be empowering and help guide the questions you may want to ask your doctor after youve been treated for thyroid cancer initially, Dr. Bernet tells EndocrineWeb. Three critical questions that you can raise, include:
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What is the stage of my cancer?
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What will the follow-up plan be?
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Does my age and stage affect the frequency of how you plan to follow me? If so, how?
It’s important to remember that there are a lot of individual differences to how people respond to treatment and to living with thyroid cancer, he says. He knows of patients that he was very worried about due to their higher stage of thyroid cancer found at diagnosis, ”and then they do phenomenally well.”
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 Early Warning Signs And Symptoms Of Thyroid Problems
Different thyroid conditions have different symptoms. However, since your thyroid has a large role in certain body systems and processes, such as heart rate, metabolism and temperature control, there are certain symptoms to look out for that could be a sign of a thyroid condition, including:
- Slow or rapid heart rate.
- Unexplained weight loss or weight gain.
- Difficulty tolerating cold or heat.
- Depression or anxiety.
- Irregular menstrual periods.
If youre experiencing any of these symptoms, talk to your healthcare provider about getting a blood test to check your thyroid function.
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What Is Thyroid Cancer
Thyroid cancer is a type of cancer that starts in the thyroid gland. It happens when cells in the thyroid grow out of control and crowd out normal cells.
Thyroid cancer cells can spread to other parts of the body such as the lungs and the bone and grow there. When cancer cells do this, its called metastasis. But the type of cancer is based on the type of cells it started from.
So even if thyroid cancer spreads to the lung , its still called thyroid cancer, not called lung cancer.
The thyroid
Ask your doctor to use this picture to show you where your cancer is.
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.
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Recovery Of Thyroid Cancer In Dogs
Depending on the course of treatment, your dog could quite possibly have many follow-up visits to the clinic for additional sessions of chemotherapy or radiation after surgery. If your pet did have surgery, he will need quiet care at home once he is released from the hospital. He will have an incision that will have to be monitored by you to ensure that there is no redness, oozing or infection. Provide a soft bed for his recuperation and make sure that your dog has plenty of water and fresh food. He may have pain medication so be sure to administer this according to your veterinarians instructions. Call the clinic immediately if you have concerns or questions about your canine companions recovery.
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Thyroid Cancer: How Age Affects Risk Of Recurrence
with Victor J. Bernet, MD, and Jonathon O. Russell, MD, FACS
So, you’ve been diagnosed with differentiated thyroid cancer and have had successful treatment. Thats great news. Yet, it would be well within reason, even expected, if you find yourself wonderingwhat is my risk of recurrenceat any point in the future?
Many factors influence the chance that you may experience a return or relapse of thyroid cancer. New data suggest that age alone appears to be an independent risk factor for predicting whether differentiated thyroid cancer, the most common kind, will reoccur,¹according to study findings published in the journal, Thyroid.
It seems that the older you are at the time of your , the greater your risk of recurrence may be. That said, its important to understand that its not definite that the thyroid cancer will return, just an increased likelihood. Other factors, such as the stage of the cancer at diagnosis, still play a roleand the stage at diagnosis may soften the effects of increasing age,¹the researchers report.
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What Are The Longer
The majority of patients with thyroid cancer can be treated successfully, but it can be fatal. Following successful treatment, patients usually have a blood test every year, and in some cases, regular scans are recommended. This is to monitor for recurrence. Around 9 in 10 of people diagnosed with thyroid cancer in England survive their disease for one year or more and 84% survive their disease for ten years or more .Most patients will be taking thyroxine tablets for life. Unless there have been any complications from surgery, patients usually return to all their previous activities.
How Is Thyroid Cancer Treated
Thyroid cancer generally has a very good outlook. The treatment will be planned taking into account which type of thyroid cancer the patient has, how far the cancer has spread, the patientâs age, general health and level of fitness. The main treatment options that may be considered include surgery and radioactive iodine therapy. A multidisciplinary team consisting of doctors and other professionals will discuss the best treatment care plan.
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What Causes Thyroid Cancer
Thyroid cancer is more common in people who have a history of exposure to high doses of radiation, have a family history of thyroid cancer, and are older than 40 years of age. However, for most people, we dont know why thyroid cancer develops.
High dose radiation exposure, especially during childhood, increases the risk of developing thyroid cancer. Radiation therapy used to treat cancers such as Hodgkins disease or breast cancer has been associated with an increased risk for developing thyroid cancer if the treatment included exposure to the head, neck or chest. Routine X-ray exposure such as dental X-rays, chest X-rays and mammograms are not associated with a high risk of thyroid cancer. As always, you should minimize radiation exposure by only having tests which are medically necessary.
Exposure to radioactivity released during nuclear disasters has also been associated with an increased risk of developing thyroid cancer, particularly in exposed children, and thyroid cancers can be seen in exposed individuals as many as 40 years after exposure.
Both Hyperthyroidism And Hypothyroidism Can Cause Hair Loss
Hyperthyroidism is defined by an overactive thyroid. This can be a result of an autoimmune disorder called Graves disease. Hypothyroidism is defined by an underactive thyroid. This can be a result of an autoimmune disorder called Hashimotoâs thyroiditis. An overactive or underactive thyroid can cause overall hair loss as the thyroid has a big role in the development and maintenance of the hair follicles. Both hypothyroidism and hyperthyroidism can cause the hair to become dry, brittle, and prone to breakage. Severe casesA sustained imbalance in either extreme can cause severe hair loss. Not having enough or having too little thyroid hormone can be a huge shock to the system. A severe thyroid disorder can cause a scalp disorder called telogen effluvium causing the hair roots to go into an abnormal growth period of ârestingâ. During this state of shock, up to 70% of scalp hair can fall out.
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What Is The Prognosis Of Thyroid Cancer
Overall, your prognosis with differentiated thyroid cancer is excellent, especially if you are younger than 55 years of age and have a small cancer. If your papillary thyroid cancer has not spread beyond the thyroid gland, patients like you rarely if ever die from thyroid cancer. If you are older than 55 years of age, or have a larger or more aggressive tumor, your prognosis remains very good, but the risk of cancer recurrence is higher. The prognosis may not be quite as good if your cancer is more advanced and cannot be completely removed with surgery or destroyed with radioactive iodine treatment. Nonetheless, even if this is your situation, you will likely be able to live a long time and feel well, despite the fact that you are living with cancer. It is important to talk to your doctor about your individual profile of cancer and expected prognosis. It will be necessary to have lifelong monitoring, even after successful treatment.
How Serious Is My Cancer
If you have thyroid cancer, the doctor will want to find out how far it has spread. This is called staging. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the spread of the cancer through the thyroid gland. It also tells if the cancer has spread to other organs of your body that are close by or far away.
Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside of the thyroid gland. Be sure to ask the doctor about the cancer stage and what it means for you.
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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will this treatment affect my ability to have children? Do I need to avoid pregnancy for a while?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too? Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Link Between Age And Repeat Thyroid Cancer Is Good News
While the connection between age and return of may be unsettling for anyone who is older when receiving a diagnosis of differentiated thyroid cancer, Dr. Bernet stresses that ”the vast majority with differentiated thyroid cancer tend to do well.”
Even in patients who are at stage 3 or 4 and over 55 year, he says, many patients can expect to live for many more decades, although for some people, he acknowledges, ”there is a higher chance of recurrence.”
What does this mean for you? If you are 55 years of age older and have one of the higher-stage cancers, be prepared for a more frequent check-up schedule. “Your doctor is going to be watching your more closely,” Dr. Bernet says.
Raising another point, says Dr. Bernet, is there are no data, as yet, about whether the patients at highest risk should have different or more intensive treatments. This is a good question for further study.
Jonathon O. Russell, MD, FACS, director of endoscopic and robotic thyroid and parathyroid surgery at Johns Hopkins Medicine in Baltimore, Maryland offers further insight regarding what these findings might mean for you he reviewed the study paper and was not involved in the study.
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How Are Thyroid Conditions Treated
There are several treatment options for thyroid conditions depending on what the conditions are and how severe they are. The three main options for treatment include:
Medication
Medications for thyroid conditions include:
- Antithyroid medications: These medications block the ability of your thyroid to make hormones. Healthcare providers may prescribe this for hyperthyroidism.
- Beta-blockers: These medications help treat symptoms of hyperthyroidism, such as rapid heartbeat, but they do not treat the thyroid condition itself.
- Radioactive iodine: This medication damages thyroid cells, eventually leading to the destruction of your thyroid gland. This is a treatment option for hyperthyroidism and thyroid cancer.
- Thyroid hormone medications: These medications are a synthetic form of thyroid hormones for the treatment of hypothyroidism. People who have a thyroidectomy or a nonfunctioning thyroid from radioactive iodine usually need to take these medications for the rest of their life.
Surgery
The most common type of surgery associated with thyroid conditions is a thyroidectomy. A thyroidectomy is the surgical removal of your entire thyroid gland. Thyroidectomy is one of the treatment options for thyroid disease and is the first-line treatment for thyroid cancer.
Another surgery option is a lobectomy, which involves removing only a part of your thyroid.
Radiation therapy and chemotherapy
Medical History And Physical Exam
If you have any signs or symptoms that suggest you might have thyroid cancer, your health care professional will want to know your complete medical history. You will be asked questions about your possible risk factors, symptoms, and any other health problems or concerns. If someone in your family has had thyroid cancer or tumors called pheochromocytomas, it is important to tell your doctor, as you might be at high risk for this disease.
Your doctor will examine you to get more information about possible signs of thyroid cancer and other health problems. During the exam, the doctor will pay special attention to the size and firmness of your thyroid and any enlarged lymph nodes in your neck.
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How Does Age Matter Once You’ve Had Thyroid Cancer
To date, the American Thyroid Association guidelines focus on three categories to calculate the risk that someone who has been treated for differentiated thyroid cancer will face recurrence. When assessing your risk of developing thyroid cancer again, the current ATA system status into low, intermediate or high risk for recurrence, taking into account the stage, whether the cancer is invasive, if neck lymph nodes are involved, as well as other factors.
This team of researchers drilled down further to look at whether age at the time of a patients diagnosis has any direct impact on the chance that thyroid cancer will come back. In particular, they looked at the association between age at diagnosis and rate of thyroid cancer recurrence and whether age has any influence on the accuracy of thyroid cancer reappearing based on the ATA diagnosis methods.¹
To study the effect of age alone on risk of cancer recurrence, this team of researchers evaluated 1,603 patients with differentiated thyroid cancer. The patients had a median age of 49 years and a disease-free survival time of 44 months, meaning the chance of avoiding relapse of thyroid cancer was about four years for those at under age 50.¹
The patients had undergone treatment at four different institutions and had undergone both thyroidectomy and radioiodine therapy. They were followed for at least one year after treatment.
Possible Health Complications Of Thyroid Cancer
With all of that said, there are some longer-term health risks associated with thyroid cancer that may become apparent later on, especially in patients who are diagnosed and treated at a young age. For instance, some possible health-related complications include:
- Heart rhythm disorders
- Heart valve disease
Some of these risks are related to the ways in which the cancer is treated. For example, in some cases the entire thyroid gland is surgically removed. This treatment may be followed by radiation therapy given in the form of radioactive iodine, as well as high-dose thyroid hormone replacement, which may cause certain side effects.
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