Thyroid cancer is an uncommon malignant disease involving abnormal cells that grow in the thyroid gland residing in the front of the neck. The butterfly -shaped gland produces hormones to regulate how the body utilizes energy to ensure it works normally. Most individuals who developed thyroid cancer can live fairly normal lives if the condition is found early and treated well. However, thyroid cancer can recur, often many years after the final treatment.
Thyroid cancer develops when abnormal cells start the growing gland that might produce a noticeable lump in the neck. Usually, the cancer can be controlled the before it has metastasized to other areas of the body. The doctor used many methods to identify, diagnose, and stage the disease to ensure the patient receives the best treatment.
Many individuals with thyroid cancer never display any symptoms. The condition is often diagnosed by a doctor during a routine exam or unintentionally detected from an image scan or x-ray taken for other reasons. There are four major kinds of thyroid cancer that include:
The survival rate of thyroid cancer patients and the prognosis (outlook) of their disease is highly dependent on numerous factors including the patient's age, the location and size of the thyroid tumors, and whether it has spread (metastasized) to other areas of the body.
Who Is at Risk for Thyroid Cancer?
Medical science has yet to determine the exact cause of thyroid cancer. However, it appears abnormalities in a cell's DNA likely plays a role, as does inheriting the disease from parents and grandparents.
While anyone can develop thyroid cancer, there are specific risk factors that increase the potential of acquiring the condition. While having one or more of the risk factors can increase the risk, it is not definite that the individual will. The most common thyroid cancer risk factors involve:
- Age – Older individuals tend to develop the condition more than the younger generation
- Gender – Females tend to develop thyroid cancer more than males.
- Radiation Exposure – Individuals who have been exposed to elevated levels of radiation, including an atomic bomb blast or nuclear power accident, have an increased risk of developing thyroid cancer.
- Ethnicity – Asian-Americans tend to develop thyroid cancer more than all other races in the United States.
- Genetic Predisposition – Individuals with a family history of multiple endocrine neoplasias, familiar medullary thyroid carcinoma, and other conditions related to the thyroid have an increased chance of developing the disease.
- Family or Personal History – Thyroid Cancer and Thyroid disease tend to run in families.
- Inherited Medical Problems – People who inherit the milliard polyposis or Gardner's syndrome are more likely to develop thyroid cancer compared to those without the inherited condition.
- Recurring Radiation Treatments – Individuals who have a history of receiving radiation therapy for the chest, neck, or head during childhood have an increased risk of developing thyroid cancer.
Only medullary thyroid cancer is inherited through generations. This is because a specific gene is passed down to children that increase the risk of developing medullary thyroid cancer.
While many individuals with thyroid cancer never display symptoms during its initial stage, the most common detectable thyroid cancer symptoms involve:
- A swelling or lumps appearing in the neck
- Difficulty in swallowing
- Dear pain
- Constant wheezing
- Difficulty in breathing
- Continuous coughing unrelated to a cold or flu
Experiencing one or more of the symptoms listed above should prompt the individual to seek medical attention to a avoid an infection.
Diagnosing Thyroid Cancer
There is not a simple screening test to determine if the individual is at risk of developing thyroid cancer. Instead, a diagnostician or doctor will perform a comprehensive physical exam and look for any noticeable changes in the thyroid. In addition, the physician will obtain a family/personal medical history and ask about certain risk factors associated with the disease. This could include a family history of thyroid problems or exposure to radiation. Other common tests used to diagnose and validate thyroid cancer involve:
- Blood Tests – A serum blood test can determine how well the thyroid gland is functioning. The doctor will usually perform a thyroid hormone level test and a medullary-type specific test.
- Imaging Tests – The doctor may recommend the patient undergo a PET (positron emission tomography) scan or CT (computerized tomography) scan, or ultrasound. These scans provide highly detailed visual imagery that assists the doctor in making an accurate diagnosis.
- Biopsy – Removing a small piece of thyroid tissue using needle aspiration can help the doctor in determining whether the patient is suffering from cancer of the thyroid. The doctor will usually perform an ultrasound to guide the aspirating needle into the thyroid nodule before removing a sample of tissue that can be examined in a laboratory setting.
- Genetic Tests – Some forms of the disease are caused by genetic changes that lead to medullary thyroid cancer.
After the diagnostic tests have been completed, the physician will review the results to determine if the patient is suffering from thyroid cancer or some other condition. If cancer is present, the doctor will stage the condition to determine how far it has progressed before developing an effective treatment plan.
Thyroid Cancer Treatments
After an accurate diagnosis of thyroid cancer has been verified, the doctor will formulate an effective treatment plan depending on the patient's age and health, the type of cancer and how far the cancer has progressed (stage). Most individuals will undergo surgery to remove a portion or all the thyroid gland. Sometimes a surgical procedure is performed when a suspicious nodule or lump cannot be accurately identified as being cancerous or not.
- Thyroidectomy – The doctor will remove most or all of the gland by making an incision at the base of the neck.
- Thyroid Lobectomy – If the cancer is small and regionalized, the surgeon might remove just a portion (lobe) of the thyroid gland.
- Lymph Node Removal – During other thyroid surgery procedures, the surgeon might elect to remove a lymph node in the neck that has become enlarged due to the cancerous condition.
Doctors will often recommend radioactive iodine as a post surgical procedure to ensure that any remaining thyroid tissue is destroyed. Many individuals can live a long and healthy life without of thyroid gland and will need to take thyroid hormone replacement drugs for the remainder of their life. The drugs are necessary to prevent hypothyroidism where the body has too little thyroid hormone in the bloodstream.
- Radioactive Iodine – Individuals who have undergone a thyroidectomy to kill off healthy thyroid tissue will usually follow that was radioactive iodine treatments that are swallowed as a liquid or capsule. This procedure can cause significant side effects including dry eyes, dry mouth, nausea, fatigue, altered smell or taste.
- External Radiation Therapy – Using proton's in x-ray technology, a machine can kill thyroid tissue with pinpoint accuracy.
- Chemotherapy – Chemical drugs are used to destroy cancer cells. This type of treatment is usually reserved for an alternative when other therapies are unresponsive.
- Targeted Drug Therapy – Thyroid cancer treatment drugs like cabozantinib, sorafenib, or vandetanib are used to attack certain vulnerabilities of abnormal (cancerous) cells.
If the disease has progressed to its final stage, doctors will offer palliative care to provide relief from pain and discomfort.