Thyroid CancerYour thyroid is a butterfly-shaped gland in your neck, just above your collarbone. It makes hormones that help the body work normally. Anyone can get cancer of the thyroid gland. But certain factors may increase the risk. These include
- Being between ages 25 and 65
- Being a woman
- Being Asian
- Having a family member who has had thyroid disease
- Having radiation treatments to your head or neck
Thyroid Cancer SymptomsSome of the symptoms that may point to thyroid cancer include the
- A lump, or nodule in the neck -- especially in the front of the neck, in the area of the Adam's apple. (Note: Sometimes, the lump or nodule will be growing quickly.) (Find out how to do a Thyroid Neck Check to look for lumps or enlargement.)
- Enlargement of the neck
- Enlarged lymph nodes in the neck
- Hoarseness, difficulty speaking normally, voice changes
- Difficulty swallowing, or a choking feeling
- Difficulty breathing
- Pain in the neck or throat, including pain from the neck to the ears
- Sensitivity in the neck -- discomfort with neckties, turtlenecks, scarves, necklaces
- Persistent or chronic cough not due to allergies or illness
- Asymmetry in the thyroid (big nodule on one side, nothing on the other)
- Nodules that when manipulated give the impression that the entire thyroid is moving (this is often a sign of an aggressive cancer)
- Nodules that cause the wind pipe to go to one side of the neck, as well as cause superior vena cava syndrome
- Some particularly aggressive thyroid tumors can go to the brain and cause neurological symptoms
CausesTypes of thyroid cancer
The type of thyroid cancer determines treatment and prognosis. Types of thyroid cancer include: -
- Papillary thyroid cancer. The papillary type of thyroid cancer is the most common, making up about 80 percent of all thyroid cancer diagnoses. Papillary thyroid cancer can occur at any age, but is most commonly diagnosed in people ages 30 to 50.
- Follicular thyroid cancer. Follicular thyroid cancer also includes Hurthle cell cancer. Follicular thyroid cancer typically occurs in people older than 50.
- Medullary thyroid cancer. Medullary thyroid cancer may be associated with inherited genetic syndromes that include tumors in other glands. Most medullary thyroid cancers are sporadic, meaning they aren't associated with inherited genetic syndromes.
- Anaplastic thyroid cancer. The anaplastic type of thyroid cancer is very rare, aggressive and very difficult to treat. Anaplastic thyroid cancer typically occurs in people age 60 or older.
- Thyroid lymphoma. Thyroid lymphoma begins in the immune system cells in the thyroid. Thyroid lymphoma is very rare. It occurs most often in adults age 70 or older.
Risk factorsFactors that may increase the risk of thyroid cancer include: -
- Exposure to high levels of radiation. Examples of high levels of radiation include those that come from radiation treatment to the head and neck and from fallout from nuclear accidents or weapons testing.
- Personal or family history of goiter. Goiter is a noncancerous enlargement of the thyroid.
- Certain inherited genetic syndromes. Genetic syndromes that increase the risk of thyroid cancer include familial medullary thyroid cancer, multiple endocrine neoplasia and familial adenomatous polyposis.
Exams and TestsThe diagnosis of thyroid cancer is usually established by examination of cells obtained from a fine-needle aspiration biopsy or a surgical biopsy of a thyroid nodule.
In a fine-needle aspiration biopsy, a thin needle is inserted through the skin into the thyroid nodule and cells are withdrawn into a syringe and sent to the laboratory for analysis by a pathologist.
Blood tests are generally not useful in determining whether a particular thyroid nodule is cancerous. Most patients with thyroid cancer have normal blood levels of thyroid hormones, including a thyrotropin (TSH) level.
Thyroid Cancer TreatmentSurgery
Surgery to remove all cancer in the neck and any cancerous lymph nodes is the initial therapy for most thyroid cancers. Complications are rare when the procedure is performed by an experienced thyroid surgeon.
Radioactive Iodine using I-131 is typically used as a follow-up to surgery, or "adjuvant" treatment in papillary and follicular thyroid cancers. This treatment is usually given two to six weeks following thyroid surgery. It involves giving high doses of I-131 in a liquid or pill form. Patients undergoing this treatment must restrict their dietary intake of iodine for approximately five to14 days before the treatment and must restrict their contact with children and pregnant women for three to seven days after treatment. The goals of this treatment include destruction of any remaining thyroid tissue in the neck, a reduction in cancer recurrence rate, and improved survival.
Radiation treatment, known as external-beam radiation therapy, is used in patients with cancer that cannot be treated with surgery or is unresponsive to radioactive iodine, as well as for older patients with cancer that has distant spread. Radiation is sometimes combined with chemotherapy.
Chemotherapy is sometimes useful for progressive diseases unresponsive to radioactive iodine or radiation.
Clinical trials are studies of new cancer treatments or new ways of using existing treatments. Enrolling in a clinical trial gives you the chance to try out the latest in cancer treatment options, but clinical trials can't guarantee a cure. Ask your doctor whether you might be eligible to enroll in a clinical trial. Together you can discuss the benefits and risks of a trial and decide whether participating in a clinical trial is right for you.
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