Overview
The thyroid gland is shaped like a butterfly and is located in the front of the neck. It makes hormones that regulate the way the body uses energy and that help the body to work normally. Thyroid cancer occurs when abnormal cells have uncontrolled growth in the thyroid gland. Though thyroid cancer is a relatively uncommon people who have suffer from it have higher probability of a favourable outcome if the cancer is found early.
The 4 different types of thyroid cancer are:
- Papillary thyroid cancer: It’s accounts for up to 80% of all thyroid cancer cases. While it tends to grow slowly, this thyroid cancer metastasizes to the nymph nodes in the neck. The chances of a favourable outcome from this type of cancer is usually high
- Follicular thyroid cancer: It makes up between 10% to 15% of all thyroid cancers. It can metastasize into your lymph nodes and is also more likely to spread into your blood vessels as well.
- Medullary cancer: It is found in about 4% of all thyroid cancer cases. It’s more likely to be found at an early stage because it produces a hormone called calcitonin, which doctors keep an eye out for in blood test results.
- Anaplastic thyroid cancer:This could be the most severe type of thyroid cancer because it’s aggressive and spreads to other parts of the body. It’s rare, and it is the hardest to treat.
Symptoms
Thyroid cancer symptoms do not usually emerge in the early stages. That’s because there are very few symptoms in the beginning.
As it grows however, the following problems may show:
- Neck, throat pain
- Lump in your neck
- Difficulty swallowing
- Vocal changes, hoarseness
- Pain in the ears
- Trouble breathing or having constant wheezing
- Frequent cough that is not related to a cold
- The lymph nodes in the neck are swollen
Causes
The following can be the causes as well as the risk factors that can lead to thyroid cancer:
- Radiation exposure: The exposure, especially during childhood, increases the risk of developing thyroid cancer. This could be due to an all-nuclear fallout that occurs after a nuclear explosion, or radiation treatment for medical conditions/diseases when radiation risks were not properly understood.
- Gender: The gender of the patient plays a big role in thyroid cancer. Around three-quarters of all patients with thyroid cancer are female.
- Some health conditions/diseases: People with the following conditions/diseases have a higher risk of developing thyroid cancer:
- Genetics: Some inherited conditions increase the risk of developing medullary thyroid cancer. Approximately one quarter of individuals, who develop medullary thyroid cancer, have an abnormal gene.
- Iodine deficiency: If there is iodine deficiency in the diet, there is a higher risk for certain types of thyroid cancer.
- Family history: Individuals with a family history of goitre (thyroid gland enlargement) have a higher risk of developing thyroid cancer.
Diagnosis
Thyroid nodules, or lumps, are very common. Most aren’t cancerous. In order to diagnose thyroid cancer one or a combination of the following tests can be conducted:
- Physical exam: The doctor conducts a physical examination of the thyroid for lumps (nodules). He may also check the neck and nearby lymph nodes for growths or swelling.
- Blood tests: The doctor may also check for abnormal levels of Thyroid-Stimulating Hormone (TSH) in the blood. Too much or too little TSH means the thyroid is not working well.
- Ultrasound: An ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside the neck. The echoes create a picture of the thyroid and nearby tissues. The picture can show thyroid nodules that are too small to be felt. Nodules that are filled with fluid are usually not cancer. Nodules that are solid may be cancer.
- Thyroid scan: In a thyroid scan, the patient is made to swallow a small amount of a radioactive substance (such as radioactive iodine), and it travels through the bloodstream. Thyroid cells that absorb the radioactive substance can be seen on a scan. Nodules that take up more of the substance than the thyroid tissue around them are called ‘hot’ nodules. Hot nodules are usually not cancer. Nodules that take up less substance than the thyroid tissue around them are called ‘cold’ nodules. Cold nodules may be cancer.
- Biopsy: A biopsy is the only sure way to diagnose thyroid cancer. A pathologist checks a sample of thyroid tissue for cancer cells, using a microscope.
A doctor may take tissue for a biopsy in one of the following two ways:
- With a thin needle: The doctor removes a sample of tissue from a thyroid nodule with a thin needle. An ultrasound device can help your doctor see where to place the needle. Most people have this type of biopsy.
- With surgery: If a diagnosis can’t be made from tissue removed with a needle, a surgeon removes a lobe, or the entire thyroid. For example, if the doctor suspects follicular thyroid cancer, the lobe that contains the nodule may be removed for diagnosis.
Treatment
There are multiple ways to treat thyroid cancer. The treatment you get will depend on the type and stage of the cancer. It also depends on the age and general health of the patient. The doctor may recommend surgery, radioactive iodine and/or radiotherapy. In most cases, especially during the early stage of the cancer, treatment is effective with a favourable outcome
Surgery: If thyroid cancer is detected at an early stage, then the doctors recommend one of the following surgical procedures:
- Thyroidectomy: The surgical removal of part or all of the thyroid gland. During this operation, the surgeon may also remove the lymph nodes in the neck and the some of the tissue around the thyroid gland.
- Lobectomy (hemithyroidectomy): The surgical removal of a lobe (one of the wings of the thyroid gland).
- Tracheostomy: Making an incision in the front of the neck and opening a direct airway through an incision in the trachea (windpipe), allowing the patient to breathe.
After surgery the patient may experience pain when swallowing and will be on a special diet of soft foods.
Thyroid Hormone Therapy: If the thyroid gland is completely or partially removed, the patient will need to take replacement hormone tablets for the rest of his/her life. The patient will need regular blood tests to make sure hormone levels are right.
Radioactive Iodine Ablation: The thyroid gland and most thyroid cancers absorb iodine. Radioactive iodine (RAI) ablation is used to destroy any thyroid tissue that’s left after a thyroidectomy.
The iodine goes to the thyroid tissue and the radiation destroys it. It may also be used for cancer that spreads to nearby lymph nodes, spreads to other parts of the body, or returns. The level of radiation in this treatment is far higher than what is used in a radioiodine scan.
The patient usually has a special diet that is low in iodine for 1 or 2 weeks before you get the treatment. If the patient is on thyroid hormone pills, they are usually stopped during this treatment.
External Radiation Therapy: Radiotherapy is usually only used for medullary or anaplastic thyroid cancers.
Chemotherapy: Chemotherapy, typically, refers to the destruction of cancer cells. It is usually only used to treat anaplastic thyroid cancer that has metastasized. However, chemotherapy may also include the use of antibiotics or other medications to treat any illness or infection.
