Design Setting And Participants
This nationwide population-based case-control study was conducted from April 27, 2018, to November 8, 2018, using the Taiwanese National Health Insurance Research Database. Participants were adults either with a new diagnosis of primary colorectal cancer without a history of cancer, or without cancer. Cases and controls were matched 1:1 by age, sex, and index date. Diagnosis of hyperthyroidism or hypothyroidism prior to the diagnosis of colorectal cancer was then determined.
Prevalence Of Thyroid Diseases In Patients With Colon Cancer And Benign Colon Polyps
1Ataturk Training and Research Hospital, Ankara, Turkey 2Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
Aim: In this study, we aimed to evaluate thyroid functions, thyroid antibody positivity, thyroid ultrasonography findings and prevalence of thyroid cancer in patients with colon cancer and benign colon polyps. Also, we aimed to compare prevalence of thyroid diseases in two groups.
Materials and methods: Fifty-seven patients with colon cancer and 50 patients with colon polyps were included in the study. All patients were evaluated with thyroid US and thyroid fine needle aspiration biopsy was performed in indicated nodules.
Results: There were 57 patients with colon cancer and 50 patients with colon polyps. There was no difference in terms of age and sex distribution between groups . Ultrasonographically, nodular and multinodular goiter was observed in 30 patients with colon cancer and 29 patients with polyp. FNAB was performed in 23 patients in cancer groups and 14 patients in polyp group. Cytology was reported as malignant in one patient with cancer and in one patient with polyp. In these two patients and in another colon cancer patient with suspicious FNAB result, thyroid cancer was confirmed histopathologically. Presence of thyroid disease defined as thyroid dysfunction or positive antithyroid antibody or presence of nodule or thyroiditis in US was found in 44 patients with cancer and 44 patients with polyp .
How Does Obesity Affect Cancer Survivors
Most of the evidence about obesity in cancer survivors comes from people who were diagnosed with breast, prostate, or colorectal cancer. Research indicates that obesity may worsen several aspects of cancer survivorship, including quality of life, cancer recurrence, cancer progression, prognosis , and risk of certain second primary cancers .
For example, obesity is associated with increased risks of treatment-related lymphedema in breast cancer survivors and of incontinence in prostate cancer survivors treated with radical prostatectomy . In a large clinical trial of patients with stage II and stage III rectal cancer, those with a higher baseline BMI had an increased risk of local recurrence . Death from multiple myeloma is 50% more likely for people with the highest levels of obesity compared with people at healthy weight .
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How Does Exposure To Radiation Increase The Risk Of Thyroid Cancer
The effects of radiation exposure depend on the amount of radiation and the age at which a person is exposed: the higher the dose of radiation and the younger the age of exposure, the greater the risk of getting thyroid cancer. Exposure during childhood raises the greatest risk.
Most exposure to radiation comes from medical treatments or from the environment .
The amount of radiation in routine medical tests like mammograms, x-rays and CT scans is low and not thought to significantly raise the risk of getting thyroid cancer. Still, lead aprons may be used to cover the neck as a precaution, and radiation tests should only be used on children when absolutely necessary.
How Does A Family History Of Thyroid Cancer Increase The Risk Of Thyroid Cancer
Some cases of thyroid cancer are associated with a positive family historymeaning that someone in the patients family also had the disease.
Papillary thyroid cancer can be genetically linked and may also be associated with inherited forms of colon cancer, breast cancer, and goiters. Most cases of papillary thyroid cancer are not genetic in nature, though.
Some people with medullary thyroid cancer have a genetic disorder called Multiple Endocrine Neoplasia type 2 that puts them at risk for tumors in other parts of the body as well .
People with medullary thyroid cancer, as well as their families, should consider getting tested for the genetic mutations associated with MEN 2.
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Genetic Characterization And Evaluation Of The Variant Of Interest In The Kindred
Across the FNMTC cohort who underwent sequencing , we identified in total 2931 variants across all eight MMR genes . A heterozygous missense variant ) was detected in Chr2:47476481 within the MSH2 gene exclusively in one kindred exhibiting manifestations of both FNTMC and HNPCC-associated tumors. In this Caucasian family, the sequencing was performed in one member affected by FNMTC, HPNCC-associated tumors and melanoma , one member affected solely by HNPCC-associated tumor , and one member with FNMTC only , as well as seven unaffected family members . This varianta missense mutation was present in this family in three affected adults , and in two unaffected children under the age of 18 and was presenting as G/G homozygous in non-affected adults from this family and across the rest of the cohort . The presence of this variant was confirmed by targeted sequencing performed on the probands sample using multiple cancer panels across 103 genes at a CLIA-certified genetics laboratory. We did not find any other genetic alterations in the kindred.
Synchronous Primary Sigmoid Colon Cancer And Primary Thyroid Cancer Followed By A Malignant Tumor Of The Kidney: Case Report Of Multiple Primary Cancer And Review Of The Literature
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The colonoscopy results were satisfactory, with norecurrence noted . Tofurther investigate the characteristics of the liver and kidneytumors, PET-CT examination was conducted, the results of whichindicated that: i) The tumor in the right anterior lobe of theliver may have been a metastatic lesion ii) combined with the CT scanresults, it was supposed that the tumor of the right kidney anusperineum may have been malignant iii) 1.5 years after radicalsurgery for left lobe thyroid cancer, no recurrence was observed iv) a small node in theleft anterior-inferior abdominal exhibited high absorbance of FDG,possibly indicating metastasis or a responsive modification.
This study was supported by the Natural SciencesFoundation of Shandong Province .
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Is Weight Loss After A Cancer Diagnosis Beneficial For People With Overweight Or Obesity
Most studies of this question have focused on breast cancer. Several randomized clinical trials in breast cancer survivors have reported weight loss interventions that resulted in both weight loss and beneficial changes in biomarkers that have been linked to the association between obesity and prognosis .
However, there is little evidence about whether weight loss reduces the risk of breast cancer recurrence or death . The NCI-sponsored Breast Cancer WEight Loss Study, an ongoing randomized phase III trial, is examining whether participating in a weight loss program after breast cancer diagnosis affects invasive disease-free survival and recurrence in overweight and obese women .
Does Losing Weight Lower The Risk Of Cancer
Most of the data about whether losing weight reduces cancer risk comes from cohort and casecontrol studies. Observational studies of obesity and cancer risk should be interpreted with caution because they cannot definitively establish that obesity causes cancer and people who lose weight may differ in other ways from people who do not.
Some of these studies have found decreased risks of breast, endometrial, colon, and prostate cancers among people with obesity who had lost weight. For example, in one large prospective study of postmenopausal women, intentional loss of more than 5% of body weight was associated with lower risk of obesity-related cancers, especially endometrial cancer . However, unintentional weight loss was not associated with cancer risk in this study.
A follow-up study of weight and breast cancer in the Womens Health Initiative found that, for women who were already overweight or obese at the beginning of the study, weight change was not associated with breast cancer risk during follow-up. However, in a study that pooled data from 10 cohorts, sustained weight loss was associated with lower breast cancer risk among women 50 years and older .
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Dont Ignore A Hoarse Voice
Allergies, respiratory infections, and sore throats can cause temporary hoarseness not associated with cancer. But if you have hoarseness thats not going away, its important not to ignore it.
To learn more about thyroid cancer or other thyroid disorders, book an appointment over the phone with the team at Desert West Surgery today.
What Research Is Being Done On Obesity And Cancer
Many studies are exploring mechanisms that link obesity and cancer . One research area involves understanding the role of the microbes that live in the human gastrointestinal tract in both type 2 diabetes and obesity. Both diseases are associated with dysbiosis, an imbalance in the community of these microbes. For example, the gut microbiomes of people with obesity differ from and are less diverse than those of people of healthy weight. Imbalances in the gut microbiota are associated with inflammation, altered metabolism, and genotoxicity, which may in turn be related to cancer.
Researchers are also studying how obesity alters the tumor microenvironment, which may play a role in cancer progression. For example, studies in mouse models show that obesity creates a competition for lipids between tumor cells and T cells that makes the T cells less effective at fighting the cancer .
Another area of investigation is the role of insulin receptor signaling in cancer. Many cancer cells express elevated levels of IR-A, a form of the insulin receptor that has a high affinity for insulin and related growth factors. Researchers are investigating how these factors contribute to metabolic disease and cancer and whether they may be useful targets for therapeutic interventions to prevent obesity-related cancers.
Garvey WT, Mechanick JI. Proposal for a scientifically correct and medically actionable disease classification system for obesity. Obesity 2020 28:484492.
Clinical Analysis Of Fnmtc Cohort
Forty-three FNMTC families encompassing 383 family members that met the inclusion criteria for FNMTC , mean age 43.5 years, were selected for the study. A total of 168 members were sequenced, encompassing 54 FNMTC affected and 114 unaffected members from the cohort . Total affected by TC members per family ranged between 2 and 9 patients. FNMTC was more prevalent in women and characterized by a median tumor size of 1.0 cm, multifocal growth in 44%, and gross extrathyroidal extension in 11.3% . Central neck lymph node metastases were found in 40.3% of patients at presentation, 12.9% presented with lateral neck lymph node metastases, and none had distant metastases. Papillary thyroid cancer presented as the predominant cancer type in the cohort . Because there are reports on more aggressive behavior of familial micro-PTC , we analyzed the clinical features of micro-PTC in our study. Within the studied FNMTC cohort, 24 patients presented with micro-PTC. Ten of 24 patients with micro-PTC presented with multifocal disease, three patients had central neck lymph node metastases, and one patient presented with lateral neck lymph node metastases. There was no microscopic or gross extra-thyroid or extra-nodal extension of micro PTC in the FNMTC cohort. A typical, less aggressive behavior of micro-PTC in our cohort, could have been due to implementing an active screening strategy.
Table 1 Clinical characteristics of the study participants affected by thyroid cancer.
The Link Between Hoarseness And Thyroid Cancer
Thyroid cancer may not be as well known as some other types of cancer, like lung cancer, breast cancer, or colorectal cancer, but its just as serious. More than 43,000 Americans are diagnosed with thyroid cancer yearly, and about 2,200 people will die from the disease.
Like other types of cancer, thyroid cancer benefits from early diagnosis and early treatment. The best way to get treatment: learn to recognize the symptoms of thyroid cancer, including one of the most common signs changes in your voice.
At Desert West Surgery, our team has extensive experience in state-of-the-art treatment for thyroid cancer, helping patients at our three Las Vegas, Nevada, locations receive the most appropriate treatment as early as possible. Heres how thyroid cancer and other thyroid problems can affect your voice.
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Prevalence Of Mets In The Study Group
The presence of Mets was similar in the colorectal polyp and control groups . A total of 39 subjects with colon polyps were Mets. Out of these 24 had documented thyroid nodules . A total of 66 subjects with colon polyps were Mets. Out of these, 31 had thyroid nodules. The comparison did not reach statistical significance . The sex distribution was detected to be similar in Mets and Mets subjects with colorectal polyps. However, the age group was higher in Mets subjects with colorectal polyps compared to Mets subjects with colorectal polyps .
Out of the total 173 subjects, 79 were demonstrated to have thyroid nodules. Out of these, 44 had a uninodular goiter, and 35 had a multinodular goiter. The prevalence of Mets was higher in subjects with a documented thyroid nodule compared to subjects without a thyroid nodule. This analysis did not reach statistical significance . The prevalence of Mets did not differ between subjects with uninodular and multinodular goiter .
Expert Review And References
- International Agency for Research on Cancer . Volume 75: Ionizing Radiation Part 1: X- and Gamma -Radiation, and Neutrons. 2000: .
- International Agency for Research on Cancer . Volume 96: Alcohol Consumption and Ethyl Carbamate. 2010: .
- International Agency for Research on Cancer . Volume 100D: Radiation: a review of human carcinogens. 2011: .
- Kitahara CM, Schneider AB, Brenner AV. Thyroid cancer. Thun MJ . Schottenfeld and Fraumeni Cancer Epidemiology and Prevention. 4th ed. New York, NY: Oxford University Press 2018: 44:839-860.
- Kotwal A, Davidge-Pitts CJ, Thompson GB. Thyroid tumors. DeVita VT Jr, Lawrence TS, Rosenberg SA . DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia: Wolters Kluwer 2019: 81:1326-1337.
- Ron E, Schneider AB. Thyroid cancer. Schottenfeld D, Fraumeni JF Jr . Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press 2006: 50:975-994.
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Immunohistochemical Staining Of Available Tumor Tissue
IHC was performed on FFPE tissue taken from representative sections of the available TC samples to evaluate the expression of the MMR proteins MLH1, MSH2, MSH6, PMS2 as per the manufacturers protocol and performed on Ventana Benchmark Ultra Auto stainers. Proficient mismatch repair or deficient mismatch repair status was assessed by two independent pathologists based on H& E and IHC staining pattern. H& E and immunohistochemical images were taken using a Leica Camera.
Exposure To Ionizing Radiation Exposure To Ionizing Radiation Is The Strongest Risk Factor For Thyroid Cancer The Risk Of Developing Thyroid Cancer Is Related To Your Age When You Were Exposed The Younger You Are When Exposed To Radiation The Greater The Risk Of Developing Thyroid Cancer
People, especially children, who receive radiation therapy to the head and neck have a higher risk of developing thyroid cancer. When thyroid cancer develops, it usually occurs 20 to 40 years after the radiation exposure. The risk of developing thyroid cancer after radiation therapy depends on the type of radiation used and the dose. The benefit of treating a cancer usually outweighs the risk of developing thyroid cancer later in life.
People who received low-dose radiation as children to treat non-cancerous conditions like fungal infections of the scalp, acne or enlarged tonsils have an increased risk of developing thyroid cancer.
Nuclear accidents and weapons
People who are exposed to ionizing radiation from nuclear accidents or weapons have a greater risk of developing thyroid cancer, especially if they were children when they were exposed to the radiation.
Diagnostic imaging tests
Diagnostic imaging tests, such as x-rays and CT scans, use ionizing radiation to make images. There is some evidence that having diagnostic imaging tests may increase the risk for thyroid cancer. The risk of cancer from imaging tests must be weighed against their benefits. Modern imaging equipment delivers the lowest amount of radiation possible.
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Signs And Symptoms Of Thyroid Cancer
Thyroid cancer most often begins as a lump or nodule on or in the thyroid gland. In general, the symptoms will relate to the presence of this lump or nodule:
- A lump in the neck, sometimes growing quickly
- Swelling in the neck
- Pain in the front of the neck, sometimes going up to the ears
- Hoarseness or other voice changes that do not go away
- Trouble swallowing
- Trouble breathing
- A constant cough that is not due to a cold
It’s important to note that nearly all thyroid cancers have little to no symptoms and lab tests for thyroid cancer often come back negative . The best screening method — and the best course of action should you display any of the above symptoms — is to have your doctor check your neck on a regular basis.
Continue to learn about thyroid cancer
Starting The Diagnostic Process
Not everyone follows the same diagnostic process. Some people may be helped through the process by their family doctor, while others may be helped by a specialist or a Diagnostic Assessment Program .
In many cases, a family doctor is the first contact point in the process of diagnosing cancer and is the one to refer a patient to a specialist or DAP.
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