Treatment And Clinical Trials
When youve been diagnosed with thyroid cancer, you want a team of expert cancer specialists on your side. Scripps MD Anderson multidisciplinary oncology teams fight thyroid cancer using the latest evidence-based treatments and therapies, including minimally invasive surgery and targeted radiation therapy.
Our approach to treating thyroid cancer
Your Scripps MD Anderson cancer care team includes professionals from every area of oncology, including endocrinologists, surgeons, radiation oncologists and nurses who specialize in cancer care.
In addition, our nurse navigators can help coordinate your care and ensure you have support and guidance throughout your treatment and recovery. Learn more about how Scripps MD Anderson puts you at the center of care.
Thyroid cancer treatment options at Scripps MD Anderson
Your Scripps MD Anderson cancer care team will customize your treatment plan based on several factors, including:
- The stage of your cancer
- Whether your cancer has spread
- Your age and overall health
Thyroid cancer surgery
Surgery is the most common treatment for thyroid cancer. Depending on the stage of the cancer and how far it may have spread, Scripps MD Anderson physicians may use several surgical procedures to treat thyroid cancer. These include:
Chemotherapy drugs may be used in combination with radiation therapy to treat anaplastic thyroid cancer. Its usually not effective for other types of thyroid cancer.
Thyroid hormone therapy
How To Talk To Your Doctor About Thyroid Cancer
Receiving a thyroid cancer diagnosis may come as a surprise. Our doctors take time to answer your questions so you feel confident about the next steps in your care.
Feel free to ask us about:
- Further testing, if necessary, to confirm a diagnosis or check treatment progress
- Cancer stage, which tells us how serious the cancer is and if it is likely to spread
- Treatment options, which often includes surgery followed by hormone therapy
- Potential treatment side effects and care options that help you get relief
Our personalized approach to care means you often have choices about your treatment plan. We explain options in ways that are easier to understand. You are welcome to bring loved ones with you to appointments for support.
Common Thyroid Cancer Symptoms To Look For
The thyroid is a butterfly-shaped gland in your lower neck. It produces hormones that help regulate your metabolism, temperature and energy levels.
Thyroid cancer develops when cells within the thyroid mutate and grow abnormally. Thyroid cancer symptoms can be subtle early on and sometimes are blamed on an infection or a seasonal allergy. Thyroid cancer is highly treatable using a variety of methods.
What are some common thyroid cancer symptoms?
Thyroid cancer symptoms can vary among patients. The most common symptom is a painless lump in the neck.
The lump often develops either in the thyroid gland, located at the base of the neck just above the breastbone, or on the sides of the neck, says endocrinologist Steven Waguespack, M.D. The neck mass can represent the primary tumor and/or an enlarged lymph node thats been replaced with cancer.
Other thyroid cancer symptoms can include:
- rapid growth of a neck mass
- hoarseness of the voice
- increase in bowel movements or diarrhea several times a day
What are common risk factors for thyroid cancer?
The most common risk factor for thyroid cancer is prior exposure of the thyroid to radiation, such as from radiation therapy given for cancer treatment, or internal radiation exposure that results from nuclear fallout. However, most people who develop thyroid cancer wont have any known risk factors.
What are the different types of thyroid cancers?
The four major subtypes of thyroid cancer, in order from most to least common, are:
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About The Patient First Program For Head And Neck Diseases And Cancer: Putting Patients First
The program is simple: working in consultation with physicians, a dedicated patient coordinator performs a preoperative assessment to identify if patients have a complex medical history, malnutrition, chronic infections, or bleeding disorders. They also seek to understand any potential social barriers to discharge including physical limitations, lack of family support, or the assistance needed with specialized care, such as tracheostomy or feeding tube management. By identifying these patients early in the process, preoperative intervention can be introduced to limit the risk of perioperative complications, delays in hospital discharge, and hospital readmissions.
Our patient coordinators and experts review with patients all aspects of their treatment plan, once solidified, explaining the process in detail. The team addresses all types of surgical and nonsurgical treatment approaches. These include: thyroidectomy , salivary gland surgery, transoral robotic surgery , open resection with microvascular reconstructive surgery, and medical/radiation oncology.
Anaplastic Thyroid Cancer In Patients Of All Ages
Anaplastic thyroid cancer grows quickly and usually has spread within the neck when it is found. Anaplastic thyroid cancer is considered stage IV thyroid cancer. Stage IV anaplastic thyroid cancer is divided into stages IVA, IVB, and IVC.
In stage IVA, cancer is found in the thyroid only and the tumor may be any size.
In stage IVB, one of the following is found:
- cancer is found in the thyroid and the tumor may be any size cancer has spread to nearby lymph nodes or
- the tumor is any size and cancer has spread from the thyroid to nearby muscles in the neck and may have spread to nearby lymph nodes or
- the tumor is any size and cancer has spread from the thyroid to soft tissue under the skin, the esophagus, the trachea, the larynx, the recurrent laryngeal nerve , or tissue in front of the spine, or has surrounded the carotid artery or the blood vessels in the area between the lungs cancer may have spread to lymph nodes.
In stage IVC, the tumor is any size and cancer has spread to other parts of the body, such as the lungs or bones. Cancer may have spread to lymph nodes.
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Thyroid Cancer Symptoms Diagnosis And Stages
According to the American Cancer Society, thyroid cancers are being detected earlier than in the past, in part due to improved diagnostic techniques, and can be treated successfully.
Learn more about thyroid cancer symptoms, diagnostic testing and stages below. As with most cancers, the earlier thyroid cancer is found, the greater the likelihood of successful treatment.
If you have symptoms of thyroid cancer, your doctor may recommend diagnostic testing. Scripps MD Anderson physicians use blood, lab and imaging tests to diagnose thyroid cancer.
A blood sample is collected and checked for abnormal levels of hormones and other substances that can indicate a problem with the thyroid. Blood tests cannot confirm thyroid cancer, but they can let your doctor know if your thyroid is functioning as it should be. If not, other tests may be needed.
If other diagnostic tests suggest you have thyroid cancer, your doctor may order a biopsy to confirm the diagnosis. Generally, there are two ways to perform a thyroid biopsy:
- Fine-needle aspiration biopsy uses a thin needle inserted through the skin to remove tissue samples from different parts of the thyroid. The samples are examined for cancer cells under a microscope.
- Surgical biopsy is when thyroid tissue is surgically removed for examination.
Computed tomography scan
Magnetic resonance imaging
Positron emission tomography scan
Thyroid cancer stages
What Causes Thyroid Nodules And How Common Are They
We do not know what causes most thyroid nodules but they are extremely common. By age 60, about one-half of all people have a thyroid nodule that can be found either through examination or with imaging. Fortunately, over 90% of such nodules are benign. Hashimotos thyroiditis, which is the most common cause of hypothyroidism , is associated with an increased risk of thyroid nodules. Iodine deficiency, which is very uncommon in the United States, is also known to cause thyroid nodules.
Content Analysis For Risk And Benefit Information
A sentence-by-sentence evaluation of each material was completed to assess for the presence and absence of the following content: benefits of and cautions about thyroid nodule evaluation and fine-needle thyroid nodule biopsy and risks, benefits, and long-term effects of thyroidectomy. Table 1 outlines the concepts identified iteratively through close reading of the documents to categorize the data related to benefits, risks, and long-term effects for each topic. Initial coding was done by one author with audit and checking for agreement by . Disagreements were resolved by consensus and, when necessary, discussion with the senior author’s research team.
How Do I Participate
Individuals participating in the study will be asked to complete questionnaires about their medical and family histories. Optional registry activities include:
- Signing a release for medical records
- Donating a sample of blood, saliva, and/or tumor tissue to be used for research
- Sharing information about the registry with family members
- Being re-contacted periodically to update medical and family history information, and to be notified of other research opportunities
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What Are The Symptoms And Types Of Thyroid Cancer
Thyroid cancer typically does not cause any signs or symptoms early in the disease. As thyroid cancer grows symptoms may vary from patient to patient, but the main thyroid cancer symptoms include:
- A lump or nodule that can be felt through the skin on the neck
- Problems swallowing
- Pain in the front of the neck or throat
- A cough that does not go away
- Breathing problems, especially the feeling like breathing though a straw
- Cough with blood
- Changes to the voice, including increasing hoarseness
- Swollen lymph nodes in the neck
These symptoms may be associated with other health conditions and do not always relate back to thyroid cancer. If you have any of these symptoms and find that they worsen or dont go away over time, schedule an appointment with your doctor right away for a proper diagnosis.
Thyroid cancer can be diagnosed in three types: medullary, anaplastic and differentiated.
Papillary And Follicular Thyroid Cancer In Patients 55 Years And Older
Stage I: In stage I papillary and follicular thyroid cancer, cancer is found in the thyroid only and the tumor is 4 centimeters or smaller.Stage II: In stage II papillary and follicular thyroid cancer, one of the following is found:
- cancer is found in the thyroid and the tumor is 4 centimeters or smaller cancer has spread to nearby lymph nodes or
- cancer is found in the thyroid, the tumor is larger than 4 centimeters, and cancer may have spread to nearby lymph nodes or
- the tumor is any size and cancer has spread from the thyroid to nearby muscles in the neck and may have spread to nearby lymph nodes.
Stage III: In stage III papillary and follicular thyroid cancer, the tumor is any size and cancer has spread from the thyroid to soft tissue under the skin, the esophagus, the trachea, the larynx, or the recurrent laryngeal nerve . Cancer may have spread to lymph nodes.
Stage IV: Stage IV papillary and follicular thyroid cancer is divided into stages IVA and IVB.
In stage IVA, the tumor is any size and cancer has spread to tissue in front of the spine or has surrounded the carotid artery or the blood vessels in the area between the lungs. Cancer may have spread to lymph nodes.
In stage IVB, the tumor is any size and cancer has spread to other parts of the body, such as the lungs or bones. Cancer may have spread to lymph nodes.
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Support Groups Services And Resources
Scripps offers a comprehensive lineup of support groups, support services and resources to help you along every step of your cancer journey.
Thyroid cancer support groups, workshops and events
Support services for cancer patients
We are here for you not only as your oncologists, but as a robust multidisciplinary team of experts who understands that your cancer journey is about much more than your medical treatment. Specifically, Scripps MD Anderson offers a variety of patient support services to ensure your physical, psychological and emotional well-being as well as resources for dealing with the logistical and financial aspects of cancer care. Our services and resources include:
What Are The Different Types Of Thyroid Cancer
Thyroid cancer is categorized based on the type of thyroid cells where the cancer begins and how the cancer cells appear under a microscope.
There are two kinds of cells found in the thyroid.
Follicular cells are the most common. They produce thyroid hormone, which is important for growth, mental function and helping the body create energy. Most thyroid cancers develop from follicular cells.
Parafollicular cells, also known as C cells, produce a small amount of the hormone calcitonin, which helps control calcium metabolism. Most parafollicular cells are in the upper third of each lobe. Medullary thyroid cancer is the only thyroid cancer that develops from parafollicular cells.
Thyroid cancers can also be categorized based on the appearance of their cells. Cancer cells that look most like normal, healthy cells are called well differentiated. Patients with well differentiated thyroid cancers are most likely to be disease-free at the end of treatment. Poorly differentiated and undifferentiated cancer cells look less and less like healthy cells. These forms of thyroid cancer are usually harder to treat and the outlook for these patients is worse.
Doctors believe most thyroid cancers start as well differentiated. As the cancer grows, its cells can develop additional mutations, changing it into a less differentiated, harder-to-treat type of thyroid cancer.
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What You Need To Know About Thyroid Cancer
- Your thyroid is a gland in the neck that produces hormones, chemical messengers that control body functions. Thyroid hormones control your heart rate, digestion and bone strength.
- This type of cancer starts as a thyroid nodule, an abnormal, noncancerous growth. Find out more about thyroid nodules.
- Having a family history of certain thyroid cancers may raise your risk of a future thyroid cancer diagnosis. Learn more about rare and familial endocrine tumors.
- Younger patients with thyroid cancer receive additional support and specialized inpatient care through our adolescent and young adult cancer program.
How Is A Thyroid Nodule Evaluated And Diagnosed
Once the nodule is discovered, your doctor will try to determine whether the rest of your thyroid is healthy or whether the entire thyroid gland has been affected by a more general condition such as hyperthyroidism or hypothyroidism. Your physician will feel the thyroid to see whether the entire gland is enlarged and whether a single or multiple nodules are present. The initial laboratory tests may include measurement of thyroid hormone and thyroid-stimulating hormone in your blood to determine whether your thyroid is functioning normally.
Since its usually not possible to determine whether a thyroid nodule is cancerous by physical examination and blood tests alone, the evaluation of the thyroid nodules often includes specialized tests such as thyroid ultrasonography and fine needle biopsy.
The report of a thyroid fine needle biopsy will usually indicate one of the following findings:
- This result is obtained in up to 80% of biopsies. The risk of overlooking a cancer when the biopsy is benign is generally less than 3 in 100 tests or 3%. This is even lower when the biopsy is reviewed by an experienced pathologist at a major medical center. Generally, benign thyroid nodules do not need to be removed unless they are causing symptoms like choking or difficulty swallowing. Follow up ultrasound exams are important. Occasionally, another biopsy may be required in the future, especially if the nodule grows over time.
NUCLEAR THYROID SCANS:
Advanced Treatment For Thyroid Cancer In San Diego
Scripps MD Anderson Cancer Center provides the most advanced thyroid cancer diagnostic and treatment services with expertise, compassion and a personal team that works together to ensure you receive the best possible care. Our oncologists use the most sophisticated treatments, such as single-site robotic surgery and the newest radiation therapy technologies.
Our multidisciplinary, collaborative board of cancer specialists reviews complex care plans to ensure patients receive the best possible care from diagnosis to recovery in San Diego.
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Follicular Cell Thyroid Cancers
From well differentiated to undifferentiated, the types of thyroid cancer from follicular cells are:
Papillary thyroid cancer: This is typically the least aggressive type of thyroid cancer. It accounts for about 80% of thyroid cancer diagnoses. While papillary thyroid cancer usually occurs in only one lobe of the thyroid gland, it appears in both lobes in 10%-20% of cases. Papillary thyroid cancer is most common in women of childbearing age. Its treatment is successful in most patients.
Follicular thyroid cancer: This accounts for about 10% of thyroid cancers. Though it can be more aggressive than papillary thyroid cancer, follicular thyroid cancer usually grows slowly. Treatment for follicular thyroid cancer is similar to papillary thyroid cancer and is successful for most patients.
Both papillary and follicular thyroid cancer are considered well differentiated cancers. Well differentiated thyroid cancer tends to stay contained within the thyroid gland. When it does spread outside the thyroid, the most common locations of spread, or metastasis, are lymph nodes, lungs, bones and the liver.
HÃ¼rthle cell thyroid cancer: Also called oxyphilic cell carcinoma, HÃ¼rthle cell carcinoma was considered a type of follicular thyroid cancer until recently. Most patients diagnosed with HÃ¼rthle cell carcinoma do well, but the outlook may change based on the extent of disease at the time of diagnosis.
Patient Benefits With Tors
In addition to enhancing the surgeons visibility, mobility, and accuracy during the procedure, transoral robotic surgery offers patients significant benefits, including:
- Less post-operative discomfort
- Shorter hospital stay
- No visible scarring, as there is no external incision
- Speedier recovery
- Faster return to speaking and swallowing
- Reduction of possible complications
- Reduction of the need for chemotherapy or radiation, particularly for early stage cancers
- Cost efficiency
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