Thyroid cancer is a type of cancer that develops in the thyroid cells. The thyroid is a gland shaped like a butterfly and it is found on the lower part of the neck. The gland produces different hormones that regulate various bodily functions. It is not a common type of cancer in the United States although the rates are gradually increasing*. The majority of thyroid cancer can be cured with the right treatment.
Signs and Symptoms
The common symptoms of thyroid cancer include:
- A lump in the neck or swelling in the neck area.
- Pain in the neck which sometimes reaches the ears.
- Difficulty of discomfort when swallowing.
- Difficulty breathing or wheezing.
- Hoarseness of voice which is not connected to cough or cold.
In some cases, there are no symptoms but the doctor finds a lump in the neck during a regular physical examination.
Causes and Risk Factors
The exact cause of thyroid cancer is still unknown but like other cancers, there are changes in the DNA of cells in the thyroid. The DNA changes may be due to aging or those that are inherited.
Factors that increase* risk of thyroid cancer:
- Sex – Thyroid cancer is more common in women.
- Radiation Exposure – This includes weapons testing and plant accidents which involve high levels of radiation.
- Specific Genetic Syndromes That Are Inherited – There are genetic syndromes that can increase* the risk of thyroid cancer including multiple endocrine neoplasia and familial medullary thyroid cancer.
Types of Thyroid Cancer
The treatment and prognosis depends on the particular type of thyroid cancer.
- Papillary Thyroid Cancer – This is the most common type of thyroid cancer. It starts from the follicular cells where thyroid hormones are produced and stored. It often affects people from 30 to 35 years of age but can occur at any age.
- Follicular Thyroid Cancer – It also begins in the follicular cells but typically affects people older than 50.
- Medullary Thyroid Cancer – It begins in the C cells that are responsible for the production of the hormone calcitonin. There are genetic syndromes that increase* the risk of this type of thyroid cancer.
- Anaplastic Thyroid Cancer – This is a rare and rapidly growing type of thyroid cancer. It typically affects individuals 60 years of age or older.
- Thyroid Lymphoma – This is also a rare form of thyroid cancer that starts in the immune system cells. It grows very quickly and usually occurs in older adults.
Tests and Diagnosis
To diagnose thyroid cancer, the doctor needs a thorough medical history then a physical examination will be conducted. The vocal cords will be checked using a laryngoscope and a CT scan or ultrasound may be ordered to get a better look at the thyroid. If there are nodules or lumps and the doctor suspects they are cancerous, a fine needle biopsy of the thyroid gland will be conducted.
The other tests for diagnosing thyroid cancer are:
- Blood Tests – The levels of thyroid-stimulating hormone (TSH), carcinoembryonic antigen (CEA) and serum calcitonin are checked.
- Serum Thyroglobulin Level Test – This is to check for remaining cancer.
- Radioactive Iodine Scans – This is to check if the cancer has spread outside the thyroid gland.
- MRI, PET scan and Chest X-Ray – These are sometimes performed to get a clearer picture of the cancer.
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Treatments and Medications
Again, the treatment for thyroid cancer depends on the type and stage, overall health and preferences of the patient.
- Surgery – A part or the entire thyroid can be removed through surgery. In some cases, lymph nodes in the back may also be removed if the cancer has reached them. Surgery comes with a risk of bleeding and infection and the parathyroid glands can also incur damage during the procedure.
- Thyroid Hormone Therapy – After the thyroid or a portion has been removed, the thyroid hormone medication levothyroxine needs to be taken for life. This is to supply the body with the missing hormones and suppress* the production of TSH.
- Radioactive Iodine – Large doses of a particular form of radioactive iodine is used to destroy microscopic areas affected by thyroid cancer. It can also be used for treating recurring thyroid cancer or if the cancer has spread to other areas.
- External Radiation Therapy – High-energy beams are used to target precise areas of the body to destroy cancerous cells. It may be done before or after surgery if radioactive iodine treatment is not effective.
- Chemotherapy – Drugs are used to kill cancer cells. The chemicals are administered to the vein where it travels throughout the body to kill growing cells which includes cancer cells. This is not commonly used for thyroid cancer.
- Alcohol Ablation – Alcohol is injected to small thyroid cancers for targeting cancers that are in inaccessible areas.
- Targeted Drug Therapy – Medications are used to attack the vulnerabilities in cancer cells. The targeted drugs include cabozantinib, sorafenib and vandetanib. This option is used in people in advanced stages of thyroid cancer.
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Precaution and Self Care
Getting diagnosed with thyroid cancer is frightening but there are many ways to cope. Learn all you can about thyroid cancer so you can make the best decisions for your care. You can also connect with others suffering from the same disease or talk to thyroid cancer survivors. Focus on what you can control in regards to your health and keep your body fit and strong which will help you get through thyroid cancer treatment.