How Is Thyroid Cancer Treated
Treatment usually involves surgery to remove all or part of the thyroid gland. This is performed under general anesthesia with a small incision in the lower neck in most cases. Some select patients with cancer may qualify for trans-oral endoscopic removal. In appropriate cases, lymph nodes are also removed from the neck.
The decision about how much thyroid should be removed is based on several factors that you should discuss with your doctor, including the size of the nodule, your age and gender, and the type of cancer. Most thyroidectomies are accomplished without affecting surrounding structures and function, either as an outpatient visit or with an overnight stay.
After surgery, thyroid hormone may be prescribed to keep the bodyâs functions in balance. In select cases, additional treatments such as radioactive iodine may be given at an interval after surgery. Standard radiotherapy and chemotherapy are infrequently used. Innovative approaches involving immunotherapy, a treatment that uses the bodyâs immune system to identify and fight the cancer cells, and targeted chemotherapy, which uses medicines to turn off the cancer cellsâ ability to grow and spread, may be recommended in some cases.
Thyroid Hormone Replacement Therapy
Thyroid hormone replacement therapy is often prescribed after thyroid surgery to replace the hormones that are no longer being produced by your thyroid tissue. Depending on how much of your thyroid was taken out, you may have to take the medication most commonly levothyroxine for the rest of your life.
Thyroid hormone replacement can also help prevent the growth or recurrence of thyroid cancer. It does this by lowering your circulating level of the hormone TSH, which is secreted by your brains pituitary gland and tells your thyroid to make more thyroid hormone. High TSH levels can stimulate the growth of thyroid cancer cells. Higher doses of replacement thyroid hormone tell your body to make less TSH, slowing the growth of any thyroid cancer cells and lowering the odds of your cancer coming back.
It can take a few adjustments to find the correct dosage of thyroid hormone replacement. During this time, you may need to see the doctor every 6 to 8 weeks for a blood draw to determine if your levels are optimal.
Can You Detect Thyroid Cancer Early
Many cases can be detected at the early thyroid cancer stages. The usual scenario is many thyroid cancer patients know the condition when they visit their doctor for a checkup for nodules and lumps in the neck.
Others know they have thyroid cancer after doing the routine physical examination or if they undergo an ultrasound or a CT scan.
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How Common Is Thyroid Cancer
Thyroid cancer is a rare form of cancer, accounting for less than 1% of all cancer cases in the UK.
It’s most common in people aged 35 to 39 years and in those aged 70 years or over.
Women are 2 to 3 times more likely to develop thyroid cancer than men. It’s unclear why this is, but it may be a result of the hormonal changes associated with the female reproductive system.
How To Prevent Thyroid Cancer
Because doctors are not sure as to why cancerous thyroid develops in the first place, there is no definite way you can avoid thyroid cancer. But, you can be mindful if your family background has an inherited gene mutation that can increase the risk of the condition and another thyroid disease.
If this is the case, you may want to check with your doctor as to what you should do about it.
For those who live near a nuclear power plant, you may have to secure a medication that can inhibit the radiation effects of the power plant on your thyroid. You can also contact your local emergency management department for some government medical assistance regarding this matter.
Feeling pain is your bodys simplest way of telling you theres something wrong, and its just one of the several symptoms of thyroid cancer you should watch out for. Your swollen lymph node and thyroid lump may be putting pressure on the other organs along your neck and causing you discomfort and other thyroid problems.
These signs may be small pains and disturbances, but early detection of thyroid cancer may help in a faster and more successful recovery.
Do you know someone who is diagnosed with thyroid cancer? What are the signs and symptoms they are experiencing? Let us know in the comments section below!
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What Else Could It Be
A lump in your thyroid could be caused by an infection or a goiter, which is an abnormal growth of the thyroid gland. It might not be cancerous at all. Lumps in the thyroid usually arenât.
But itâs possible to have thyroid cancer without any symptoms at all.
Your doctor will examine your thyroid during routine physical exams. If you have any symptoms between checkups, such as a new nodule on the gland or a rapidly growing one, you should make an appointment to have your thyroid gland checked. Your doctor will do several tests to diagnose the source of the problem and decide on the best treatment.
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Are There Any Complications Of Thyroid Cancer
Despite having treatment, thyroid cancer can come back with active blood vessels, even if you had the organ removed. This happens when cancer spreads to other parts of the body or when there are microscopic cancerous cells left after surgery.
The recurrence can be treated, though. Your doctor may perform periodic blood tests or recommend thyroid scans to see signs of the conditions recurrence.
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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.
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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Surgery For Thyroid Cancer
Most patients with thyroid cancer have some type of surgery. Surgery is done to take out the tumor and all or part of the thyroid gland. Sometimes lymph nodes are taken out from the neck, too.
Side effects of surgery
Any type of surgery can have risks and side effects. Be sure to ask the doctor what you can expect. Possible side effects of thyroid surgery include:
- Bleeding or a blood clot in the neck
- Damage to the parathyroid glands
- Short or long term problems with your voice
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What Causes Thyroid Cancer
In most cases, the cause of thyroid cancer is unknown. However, certain things can increase your chances of developing the condition.
Risk factors for thyroid cancer include:
- having a benign thyroid condition
- having a family history of thyroid cancer
- having a bowel condition known as familial adenomatous polyposis
- acromegaly a rare condition where the body produces too much growth hormone
- having a previous benign breast condition
- weight and height
Read more about the causes of thyroid cancer
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Thyroid Cancer Symptom #: Change In Your Voice
An individual who presents with a symptom of thyroid cancer which is a change in voice is a later sign of thyroid cancer and an unfavorable one. Sometimes, this change in voice can be very subtle and may only be noticed by the person who is being effected. Any change in voice should be a call to action and an appropriate evaluation for a thyroid cancer undertaken. If a person has hoarseness or loss in voice, this is truly one of an urgent matter for expert evaluation and likely surgery for the thyroid cancer. In adults, although vocal cord paralysis may be caused by other issues, hoarseness caused by a paralyzed vocal cord must be considered thyroid cancer until proven otherwise.
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:
- Triiodothyronine
- 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.
Chest X-ray: This basic imaging test may be done if your doctor suspects the cancer has metastasized to your lungs.
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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What Is Differentiated Thyroid Cancer
Most thyroid cancers are differentiated, according to the American Cancer Society, which means that when the cells are looked at under a microscope they appear similar to normal thyroid cells. Papillary, follicular, and Hurthle cell thyroid cancer are all types of differentiated thyroid cancer. When the cancerous cells are not similar in appearance to normal thyroid tissue, the cancer is called poorly differentiated or undifferentiated. Medullary and anaplastic thyroid cancers fall into this category.
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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Other Signs And Symptoms
Other, more rare or unusual signs of medullary thyroid cancer that you should be aware of include:
- Severe diarrhea. This is a very rare symptom sometimes found in people with advanced medullary thyroid cancer. The tumor produces high levels of calcitonin, a hormone that may cause severe diarrhea.
- Cushing syndrome. In rare cases, adrenal tumors can cause Cushing syndrome, a condition that arises when a tumor secretes hormones that the thyroid wouldnt normal create. Cushing syndrome associated with medullary thyroid cancer is uncommon. The syndrome is more commonly caused by the pituitary gland overproducing adrenocorticotropic hormone , or by taking oral corticosteroid medication.
- Facial flushing. A red face, neck, or chest paired with warm or burning sensations can be a sign of many conditions. Tumors or other abnormal growths can overproduce hormones, triggering flushing. The symptom can also be a response to certain drugs, foods, alcohol, or menopause.
- Bone pain. People with medullary thyroid cancer may have bone pain if the cancer has spread to form bone lesions.
- Lethargy. Many people with advanced cancer may feel physically, emotionally, or mentally tired. The causes of fatigue during cancer are complex and not well understood.
- Weight loss. Unusual weight loss is a symptom of advanced medullary thyroid cancer that has spread beyond the thyroid into other organs.
Last medically reviewed on August 12, 2019
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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What Are The Risk Factors For Thyroid Cancer
The following are factors that can increase your risk of developing the condition:
- Inherited genetic syndromes There are certain inherited genetic syndromes that you might want to check, such as endocrine neoplasia and familial medullary thyroid cancer.
- High radiation exposure You might want to avoid exposing yourself to frequent radiation treatments.
After A Diagnosis Of Thyroid Cancer
After a diagnosis of thyroid cancer you may feel disbelief, uncertainty, fear and anxiety. There is no right or wrong way to feel and experiencing a range of emotions is normal. While the most common types of thyroid cancers have a very good long-term prognosis, you may still feel shocked and confused. It may help to talk to family and friends about how you are feeling.
Ask your specialist to explain treatment options and any potential side effects and financial concerns. Take as much time as you can so that you can make well-informed decisions.
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Types Of Thyroid Cancer
There are 4 main types of thyroid cancer:
- papillary carcinoma the most common type, accounting for about 8 in 10 cases it usually affects people under 40, particularly women
- follicular carcinoma accounts for up to 1 in 10 cases and tends to affect middle-aged adults, particularly women
- medullary thyroid carcinoma accounts for less than 1 in 10 cases unlike the other types, it can run in families
- anaplastic thyroid carcinoma the rarest and most serious type, accounting for around 1 in 50 cases it usually affects people over the age of 60
Papillary and follicular carcinomas are sometimes known as differentiated thyroid cancers. They tend to be easier to treat than the other types.
What To Do About Symptoms Of Thyroid Cancer
If you have one or more of these thyroid cancer symptoms, you should seek expert evaluation by a thyroid cancer expert. This may be a thyroid cancer surgeon or an endocrinologist who has expertise in the evaluation and management of individuals with thyroid cancer. The evaluation of a person with thyroid cancer symptoms includes:
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Thyroid Cancer Causes And Risk Factors
Its not clear exactly what causes thyroid cancer to develop. However, there are a number of known potential risk factors, some of which can be modified and others that cant. According to the National Cancer Institute, risk factors for developing thyroid cancer include:
Other research led by Dr. Harari is looking at whether certain environmental exposures, including to pesticides and flame retardants, have a link to thyroid cancer.
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?
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