• Thyroid Cancer

    Thyroid Cancer There are four main types of cancers that occur in the thyroid gland. The type of cancer is the most important factor affecting prognosis. The two most common types, papillary and follicular, if treated appropriately, have excellent prognoses, depending on the stage of the cancer when first detected. The remaining two types of thyroid cancers, medullary and anagplastic are more likely to result in poorer outcomes. 
     

    Risk Factors

    These factors increase your risk of developing thyroid cancer. Tell your doctor if you have any of these risk factors:

    • History of radiation to the head, neck or chest, especially in infancy or childhood
    • Family history of thyroid cancer
    • Female
    • Age 30 and over
    • Exposure to radioactive fallout (seen in patients exposed to radiation from nuclear accidents in Europe or as a result of being near nuclear testing during childhood)

    Symptoms

    If you have any of these symptoms do not assume it is due to thyroid cancer. These symptoms may be caused by other conditions. Tell your doctor if you have any of these symptoms:

    • A lump in the neck
    • Neck pain, sometimes going up to the ears
    • Hoarseness
    • Difficulty swallowing
    • Difficulty breathing
    • Enlarged lymph glands in the neck

    Diagnosis

    The doctor will ask about your symptoms and medical history, and perform a physical exam. This may include a careful examination of your neck to look for lumps or abnormalities.

    Tests:

    • Fine needle aspiration-removal of fluid and cells from a thyroid nodule with the use of a very thin needle
    • This test can be done in the doctor's office and may or may not require a local anesthetic.
    • Blood test
    • Thyroid scan-X-rays taken after radioactive iodine is injected into the blood
    • The iodine is absorbed by the thyroid gland. This causes it to light up and be more visible on X-ray.
    • Ultrasound-a test that uses sound waves to examine thyroid nodules
    • Surgical biopsy-removal of a sample of thyroid tissue to test for cancer cells

    Treatment

    Once thyroid cancer is found, staging tests (possibly including CT/MRI scans and PET scans) are done to find out if the cancer has spread. Treatment depends on the stage of the cancer.

    Surgery

    Thyroid surgery may include removal of one lobe for biopsy to determine if a nodule within the thyroid lobe is cancerous. The specimen (thyroid lobe) may be examined by a pathologist while you are still under the general anesthetic. While not 100 percent accurate, the pathologist may return with a diagnosis of cancer. At that point the surgeon may remove the opposite lobe of the thyroid gland, this is called a total thyroidectomy.  

    Radioactive Iodine Therapy

    This uses large doses of radioactive iodine to destroy any remaining thyroid tissue and thyroid cancer without affecting the rest of the body. This treatment is used to destroy thyroid tissue not removed by surgery and to treat thyroid cancer that has spread to lymph nodes and other parts of the body.

    External Radiation Therapy

    This is the use of radiation to kill cancer cells and shrink tumors. Radiation is directed at the tumor from a source outside the body. It is rarely used for thyroid cancer.

    Chemotherapy

    This is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, or through a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy to treat thyroid cancer is still investigational. Chemotherapy has not been shown to effectively control or kill thyroid cancer.

    Prevention

    Because the exact cause of thyroid cancer is unknown, finding it early and treating it is the best way to prevent dying from the disease:

    • Aged 20-39, have a thyroid exam every three years
    • Aged 40 or older, have a thyroid exam every year

    Exposure to radiation is a major risk factor for thyroid cancer, therefore:

    • Avoid unnecessary exposure to radiation
    • If you have been exposed to radiation of the head, neck or chest, particularly as a child, have frequent checks for thyroid cancer
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