How Do You Treat Thyroid Cancer
There are a few different treatments for thyroid cancer. Which one you are offered will depend on the type of thyroid cancer you have and what stage it is at.
The first step is usually surgery, with all or part of your thyroid removed, along with any nearby glands that show signs of cancer.
Radiotherapy and in particular a treatment called radioiodine is also used to kill cancerous cells. If you have radioiodine treatment, youll need to go into hospital for a few days. Youll be given an injection of radioactive iodine and will then stay in a special, lead-lined room until youre no longer radioactive.
Chemotherapy is also sometimes used for advanced thyroid cancers or if cancer comes back after being treated.
You might be given hormone therapy after your treatment to replace the hormones that the thyroid would normally make.
Side Effects Of Thyroid Surgery
The risks of thyroid surgery include:
Damage to the laryngeal nerve. It can be stunned, or one vocal cord wont move the same way as the other, Dr. Harari explains. About 5% of people temporarily experience this complication, and 1% have permanent damage. There are procedures to regain vocal strength, and an ENT specialist can assist the patient in these efforts.
Hypoparathyroidism, or, as sometimes surgeons decide to remove one or more of the parathyroid glands four tiny glands that regulate the bodys calcium levels and are located near the back of the thyroid. People whose thyroid surgery involves a central neck incision have a 10% risk of parathyroid complications.
Vagus nerve issues. Lateral neck incisions can risk impacting the vagus nerve, Dr. Harari says. This can have effects on the voice as well as the shoulder or tongue.
Loss of thyroid function. After surgery, you will probably need to take pills for the rest of your life to replace lost thyroid hormones. If your parathyroid glands are also removed, you may also need to take calcium and vitamin D.
Dietary & Nutritional Factors
Dietary and nutritional factors have been implicated as risk factors for differentiated thyroid cancer of follicular cell origin. Iodine deficiency is a well-established risk factor for developing follicular thyroid cancer, and iodine supplementation has been implemented in most regions with endemic goiter . By contrast, iodine excess has been associated with an increased risk of papillary thyroid cancer. Chronic iodine deficiency may have a protective effect in females , but there are no equivalent studies looking at male gender. In the San Francisco Bay Area Thyroid Cancer study group, a protective effect of dietary iodine and phytoestrogens was found in women, but the study did not have any male subjects . The role of fish and cruciferous vegetables on thyroid cancers have been debated. However, there are no studies that show a gender difference in the effects of fish and cruciferous vegetables in thyroid cancer . The wide range of food items investigated combined with the variable pattern of consumption in different epidemiologic groups, which have different malignancy rates, lends itself to much speculation. These same variables also make it extremely difficult to compare the data on nutritional factors and come to a clear consensus. There is no strong evidence for dietary factors having a role in the gender disparity seen in thyroid cancer.
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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.
How Do I Know If I Have Thyroid Cancer What Are The Common Symptoms
Thyroid cancer generally doesnt produce any symptoms. Most people dont realize they have it because a benign or cancerous growth isnt going to make your thyroid function any less or more than usual.
Sometimes, if your thyroid cancer has grown to a larger size, you could feel a lump in your neck, but most thyroid cancer is not discovered until imaging tests are ordered for unrelated reasons or a clinician feels something on their exam.
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What Are The Treatment Options For Thyroid Cancer
Thyroid cancer is a surgical disease, so almost all patients will have some form of surgery . The extent of surgery will depend on the type and stage of your thyroid cancer, but the majority of patients go home the same day of surgery . A tiny incision is made in your neck and most patients heal very well with minimal residual scar by 6 months.
More advanced thyroid cancers will also be treated with radioactive iodine pills after surgery, which work by targeting the thyroid tissue in your body and emitting radiation very slowly to kill thyroid cells.
You can learn more about our treatment options here: Treatment Options
Reducing Your Risk And Other Possible Causes
You might have heard of other possible causes of cancer. Stories about potential causes are often in the media and it isnt always clear which ideas are supported by evidence.
We havent included them here, either because there is no evidence about them or it is less clear.
A pooled analysis of thyroid cancer incidence following radiotherapy for childhood cancer LHS Veiga and others
Cancer. Principles and practice of oncology VT De Vita, S Hellman and SA RosenbergLippincott, Williams and Wilkins, 2018
The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015KF Brown and othersBritish Journal of Cancer, 2018. 118, Pages 1130-1141
Family History of Cancer and Risk of Sporadic Differentiated Thyroid Carcinoma
L Xu and others
Papillary thyroid cancer: Clinical features and prognosis
R Tuttle and others
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Can Thyroid Cancer Be Prevented
Most thyroid cancer cannot be prevented.
One rare type of thyroid cancer, called medullary thyroid cancer , runs in families. A genetic test can tell you if you have a greater chance of getting MTC. If this test shows that you have an increased risk, you can have your thyroid gland removed to reduce your risk for thyroid cancer later in life.
What Is Someones Lifetime Risk Of Developing Thyroid Cancer
The lifetime risk of being diagnosed with a clinically relevant thyroid cancer is small, but has been increasing steadily over the years, tripling over the past three decades. It is more commonly seen in younger adults than older ones. Luckily, the majority of thyroid cancer is very treatable and survivors live long, healthy, productive lives.
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Will I Be Cared For Mainly By One Provider Or Will There Be Multiple Ones
Thyroid cancer care is a team sport. Dr. Lieb says you can expect to be cared for by many people during your cancer treatment, including your primary care physician, your endocrinologist, and your surgeon. There will also be pathologists and social workers. Depending on the type of thyroid cancer, you may also see a nuclear medicine team, vascular surgeon, voice specialist, and imaging professionals.
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.
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The Most Common Cancers In Young Adults
The types of cancers seen in young adults are not unique to this age group, but the most common types in this age range are largely different from those in children or older adults.
Some of the most common cancers in young adults are:
- Colorectal cancer
- Brain and spinal cord tumors
Even within this age group, some of these cancers become more or less common as people age. For example, lymphomas are more common before age 25, whereas breast, cervical, and colorectal cancers become more common after age 25.
Many other types of cancer can occur in young adults as well.
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.
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Why Have Thyroid Cancer Diagnoses Spiked For Us Women
Since the 1990s, a boom in the use of thyroid ultrasound has led to thyroid cancer diagnoses more than tripling.
Thyroid cancer is diagnosed more often in women than men. And over the past few decades, this sex-based gap has grownsubstantially.
A new study, however, indicates that this disparity isnt what it seems on the surface. A large contributor appears to be that women are more likely to be diagnosed with small thyroid cancers that would have been unlikely to cause problems during their lifetime, researchers reported August 30 in JAMA Internal Medicine.
Women were more than four times as likely as men to be diagnosed with a small papillary thyroid cancer during their lives, the study found. Such cancers are rarely fatal. In contrast, diagnoses of aggressive and often deadly types of thyroid cancer were nearly equal in men and women. There was also no real difference between sexes in small papillary thyroid cancers found on autopsy, which werent detected during life.
The study wasnt designed to pinpoint the cause of this imbalance. But women are more likely than men to undergo tests for other medical reasons that can detect these small cancers that otherwise would have probably not been found. And as clinicians, were primed to think about thyroid problems more often in women, said Louise Davies, M.D., M.S., of the Department of Veterans Affairs, who led the new research.
How Do I Choose A Thyroid Surgeon
A high-volume surgeon is best. Whether you opt for a general, endocrine, or head and neck surgeon, you want to choose a provider who does a lot of these surgeries every year, says Dr. Lieb. Dr. Chen says a good volume to shoot for is 100 per year or more.
You can find directories of qualified surgeons at the American Association of Endocrine Surgeons or the American Academy of Otolaryngology Head and Neck Surgery.
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Thyroid Cancer In Women
Thyroid cancer is the most common cancer in women 15 to 30 years of age. Though lumps in the thyroid are common, only 5 to 10 percent of lumps are cancer. Women’s expert Dr. Kirtly Parker Jones talks about the risk factors for thyroid cancerthe majority of which women can’t changebut also discusses why thyroid cancer is one of the most curable kinds of cancers.
Millions of women have thyroid problems, the most common being under or overactive thyroid. The majority of people in the United States with thyroid problems are women. We’re not sure why that’s the case except that most thyroid problems are due to autoimmune disease, antibodies that we make against part of the thyroid gland. All autoimmune diseases are more common in women.
Over and underactive thyroid symptoms are vague. The symptoms are feeling cold or slightly depressed. For underactive thyroid, feeling hot, your heart pounding and anxious, maybe weight loss are common for overactive thyroid. Sometimes the thyroid is slightly enlarged with over or underactive thyroid problems, but thyroid cancer presents as a lump. Sometimes the lump is noticed by the patient, but sometimes it presents with hoarseness of voice or difficulty swallowing, and sometimes the lump is detected by a clinician during a physical exam.
How Is Thyroid Cancer Managed Or Treated
Treatments for thyroid cancer depend on the tumor size and whether the cancer has spread. Treatments include:
- Surgery: Surgery is the most common treatment for thyroid cancer. Depending on the tumorâs size and location, a surgeon may remove part of your thyroid gland or all of the gland . The surgeon also removes any nearby lymph nodes where cancer cells have spread.
- Radioiodine therapy: With radioiodine therapy, you swallow a pill or liquid containing a higher dose of radioactive iodine than whatâs used in a diagnostic radioiodine scan. The radioiodine shrinks and destroys the diseased thyroid gland along with cancer cells. This treatment is very safe. Your thyroid gland absorbs almost all of the radioiodine and the rest of your body has minimal radiation exposure.
- Radiation therapy: Radiation kills cancer cells and stops them from growing. External radiation therapy uses a machine to deliver strong beams of energy directly to the tumor site. Internal radiation therapy involves placing radioactive seeds in or around the tumor.
- Chemotherapy: Intravenous or oral chemotherapy drugs kill cancer cells and stops cancer growth. Very few people diagnosed with thyroid cancer will ever need chemotherapy.
- Hormone therapy: This treatment blocks the release of hormones that can cause cancer to spread or come back.
What are the complications of thyroid cancer?
How does thyroid cancer affect pregnancy?
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What Are The Warning Signs Of Thyroid Cancer
You or your healthcare provider might feel a lump or growth in your neck called a thyroid nodule. Donât panic if you have a thyroid nodule. Most nodules are benign . Only about 3 out of 20 thyroid nodules turn out to be cancerous .
Other thyroid cancer symptoms include:
- Difficulty breathing or swallowing.
- Swollen lymph nodes in your neck.
What are the signs that thyroid cancer has spread?
If you have thyroid cancer that has spread to other areas of your body, you may experience symptoms such as:
- Exposure to radioactive fallout from nuclear weapons or a power plant accident.
What Causes Thyroid Cancer
Experts don’t know what causes thyroid cancer. But like other cancers, changes in the DNA of your cells seem to play a role. These DNA changes may include changes that are inherited as well as those that happen as you get older.
People who have been exposed to a lot of radiation have a greater chance of getting thyroid cancer.
A dental X-ray now and then will not increase your chance of getting thyroid cancer. But past radiation treatment of your head, neck, or chest can put you at risk of getting thyroid cancer.
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Non Cancerous Thyroid Disease
Some non cancerous conditions of the thyroid increase your risk of thyroid cancer. These include:
- an enlarged thyroid
- a condition where the immune system attacks the thyroid gland
Its important to remember that although having a lump or nodule increases the risk, thyroid cancer is rare. Thyroid lumps are common. But only about 5 out of 100 thyroid lumps are cancer.
Why Is The Thyroid Important For Our Bodies
The thyroid is part of the Endocrine system of your body. Its role is to produce, store and release hormones to your bloodstream to be carried out to your bodys cells. It helps regulate your metabolism, temperature, how fast or slow your brain, liver, heart, and other organs work. Essentially, it is the gland that allows you to have energy and overall well-being.
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Thyroid Cancer On The Rise Among Young Women
The prevalence of thyroid cancer is on the rise and is increasingly more common in young women. The fifth most common cancer in women, and 12th overall among both men and women, it is also one of the most treatable, with a five-year survival rate of 98.1 percent.
While thyroid nodules occur in up to 50 percent of people by age 60, only about 5 to 10 percent end up being cancer, and most are papillary cancer, which is usually slow-growing and very curable, says Whitney Goldner, MD, Nebraska Medicine endocrinologist.
Most people with thyroid cancer do not have symptoms, however, sometimes a painless nodule in the neck, or a swollen or enlarged lymph node may be one of your first signs. Other possible symptoms include a hoarse voice, pressure in the neck, or difficulty swallowing. Any of these symptoms warrant a visit to your doctor to be evaluated, says Dr. Goldner.
Because many nodules cannot be felt, diagnostic tests will generally include an ultrasound of the neck and thyroid and a blood test to evaluate the function of your thyroid. The majority of thyroid cancers are typically found incidentally either during a neck exam or imaging of the neck for unrelated reasons due to the lack of symptoms, notes Dr. Goldner.
Got a Suspicious Bump? Get it Checked!
Some patients may be candidates for a minimally invasive surgical technique called roboticassisted thyroid surgery.