Thyroid cancer is a disease that you get when abnormal cells begin to grow in your thyroid gland The thyroid gland is shaped like a butterfly and is located in the front of your neck. It makes hormones that regulate the way your body uses energy and that help your body work normally. Thyroid cancer is an uncommon type of cancer. Most people who have it do very well, because the cancer is usually found early and the treatments work well.
The main risk factors for thyroid cancer
- Benign thyroid disease
- Radiation
- Family history of thyroid cancer
- A bowel condition called FAP
- Being very overweight (obese)
- Producing too much growth hormone (acromegaly)
- Diabetes
Symptoms
Thyroid cancer can cause several symptoms:
- You may get a lump or swelling in your neck. This is the most common symptom.
- You may have pain in your neck and sometimes in your ears.
- You may have trouble swallowing.
- You may have trouble breathing or have constant wheezing.
- Your voice may be hoarse.
- You may have a frequent cough that is not related to a cold.
Some people may not have any symptoms. Their doctors may find a lump or nodule in the neck during a routine physical exam.
Diagnosis of thyroid cancer
Doctors use many tests to diagnose cancer and find out if it has spread to another part of the body, called metastasis. Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer.
If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread.
Your doctor may consider these factors when choosing a diagnostic test:
• Age and medical condition
• Type of cancer suspected
• Signs and symptoms
• Previous test results
• In order to diagnose thyroid cancer, your doctor will ask about your medical history and do a physical exam.
• Your doctor may check your vocal cords using a thin tube-like instrument that has a light (laryngoscope).
• Your doctor may order a CT scan or an ultrasound to get a better look at your thyroid. If your doctor thinks that the lump or nodule could be cancerous, he or she may do a fine needle biopsy of the thyroid gland.
• You may also have blood tests to check the levels of your thyroid-stimulating hormone (TSH), serum calcitonin, or carcinoembryonic antigen (CEA).
• Other tests may be done before, during, or after your treatment for thyroid cancer.
• Serum thyroglobulin level tests check for remaining cancer.
• Radioactive iodine scans help your doctor find out whether thyroid cancer has spread beyond the thyroid gland.
• Thyroid ultrasound is a safe and simple way to find out whether a thyroid nodule is solid or fluid-filled (cystic). It can also detect multiple thyroid nodules and abnormal lymph nodes in the neck.
In some cases, an MRI, a chest X-ray, a CT scan, or a PET scan may be done.
If you have medullary thyroid cancer (MTC), a CT scan of the chest and belly and a bone scan may also be need
Treatment Overview
The goal of treatment for thyroid cancer is to get rid of the cancer cells in your body. How this is done depends on your age, the type of thyroid cancer you have, the stage of your cancer, and your general health.
Most people have surgery to remove part or all of the thyroid gland. Sometimes a suspicious lump or nodule has to be surgically removed before you will know if you have cancer or not.
After surgery, you may need treatment with radioactive iodine to destroy any remaining thyroid tissue. When you no longer have all or part of your thyroid gland, you will probably need to take thyroid hormone medicines for the rest of your life. These medicines replace necessary hormones that are normally made by the thyroid gland and prevent you from having hypothyroidism-too little thyroid hormone.
Your treatment for thyroid cancer may include:
- Surgery to remove the part of the thyroid gland that contains cancer. Removing one part (lobe) is called a lobectomy. Removing both lobes is called a total thyroidectomy. Removing all but a very small part of the thyroid is called a near-total thyroidectomy. Lymph nodes may also be removed during surgery.
- Radioactive iodine, which is used after surgery to destroy any remaining thyroid tissue. After you have your thyroid surgically removed, you may have to wait several weeks before having radioactive iodine treatment to destroy any remaining thyroid tissue. During the waiting period, you may have symptoms of hypothyroidism such as fatigue, weakness, weight gain, depression, memory problems, or constipation.
- Thyroid-stimulating hormone (TSH) suppression therapy. TSH suppression therapy reduces the TSH in your body, which may help prevent the growth of any remaining cancer cells.
- If thyroid cancer is advanced when it is diagnosed, initial treatment may also include chemotherapy or radiation therapy.
Ongoing treatment
After treatment for thyroid cancer, you may need to take thyroid hormone medicine for the rest of your life to replace the hormones that your body no longer makes. You will also need follow-up visits with your doctor every 6 to 12 months. In addition to scheduling regular visits, be sure to call your doctor if you notice another lump in your neck or if you have trouble breathing or swallowing.
At your follow-up visits, your doctor may order a blood test to measure your thyroid-stimulating hormone (TSH) level. This test helps your doctor know if you are taking the right amount of thyroid hormone medicine. Your doctor may order other tests, such as a radioiodine scan, X-rays, or a CT scan.
Can thyroid cancer be prevented?
Most people with thyroid cancer have no known risk factors, so it is not possible to prevent most cases of this disease.
Radiation exposure, especially in childhood, is a known risk factor for thyroid cancer. Because of this, doctors no longer use radiation to treat less serious diseases. Imaging tests such as x-rays and CT scans also expose children to radiation, but at much lower doses, so it’s not clear how much they might raise the risk of thyroid cancer (or other cancers). If there is an increased risk it is likely to be small, but to be safe, children should not have these tests unless they are absolutely needed. When they are needed, they should be done using the lowest dose of radiation that still provides a clear picture.
Blood tests can be done to look for the gene mutations found in familial medullary thyroid cancer (MTC). Because of this, most of the familial cases of MTC can be prevented or treated early by removing the thyroid gland. Once the disease is discovered in a family, the rest of the family members can be tested for the mutated gene.
If you have a family history of MTC, it is important that you see a doctor who is familiar with the latest advances in genetic counseling and genetic testing for this disease. Removing the thyroid gland in children who carry the abnormal gene will probably prevent a cancer that might otherwise be fatal
