Today, more than 40,000 people in the United States are diagnosed with thyroid cancer each year in the United States only. The disease is often treatable, but patients need to know what to expect from their care team.
In this blog post, we’ll take a look at everything patients need to know about thyroid cancer, including treatment options, causes, risk factors, and warning signs.
What is thyroid cancer?
Thyroid cancer is a type of cancer that affects the thyroid gland, an organ located in the front of the neck. This gland produces hormones that help regulate metabolism, body temperature, and heart rate.
The most common form of thyroid cancer is papillary thyroid cancer, which starts in the cells that form the follicles of the thyroid gland. It can spread to other parts of the body if left untreated. Other types of thyroid cancer include medullary thyroid cancer, follicular thyroid cancer, and anaplastic thyroid cancer.
Since thyroid cancer grows in gland tissue, it usually produces thyroid hormones and causes hyperthyroidism. However, there are different presentations of thyroid cancer, and not all will produce thyroid hormone at the same rate.
Causes of thyroid cancer
The exact causes of thyroid cancer are unknown, but there are some factors that may increase the risk of developing it. These include genetics, radiation exposure, certain medications, age, gender, and a family history of thyroid cancer.
-
- Genetics, in particular, play a role in the development of thyroid cancer, as certain gene mutations can increase the risk of developing the disease.
- Radiation exposure, such as radiation therapy treatments for other types of cancer, can also increase the risk of developing thyroid cancer.
- Additionally, certain medications, such as lithium, which is used as a treatment for bipolar disorder, can also increase the risk of goiter, and these patients may have a higher risk of thyroid cancer, too.
- Age, gender, and a family history of thyroid cancer can also increase the risk of developing the disease.
Screening for thyroid cancer
Most types of thyroid cancer are not as aggressive as anaplastic thyroid cancer. However, that does not mean that you can stay quiet doing nothing about it. It is recommended to screen for thyroid cancer, even if you feel you don’t have anything to worry about.
Regular screenings for thyroid cancer are recommended for individuals at higher risk, such as those with a family history of the disease or specific genetic mutations. Early detection and treatment can improve the chances of long-term survival.
It also is important for individuals to be aware of the symptoms of thyroid cancer, which may include a lump in the neck, difficulty swallowing, pain in the throat and neck, hoarseness, and changes in the voice.
Signs and symptoms of thyroid cancer
Thyroid cancer is characterized by the abnormal growth of cells in the thyroid gland, which is located at the base of the neck. Thus, the disease is often characterized by volume changes and obstruction symptoms in the throat.
Symptoms of thyroid cancer can vary widely and can include:
-
- A lump or swelling on the thyroid or neck, which is usually noted in a thorough physical exam
- Goiter, which is a move obvious enlargement of the thyroid gland
- Hoarseness and other changes in the voice because the thyroid is located close to the vocal cords
- Difficulty swallowing, especially when the tumor grows to the inside portion of the gland
- A feeling of tightness in the throat, especially when swallowing
- Fatigue, which happens in a late stage disease or when thyroid cancer produces thyroid hormone
- Weight loss, which is more pronounced in aggressive disease
- Rapid or irregular heartbeat, which is also a sign of hyperthyroidism
- Nervousness as a result of elevated thyroid hormone in the blood
Diagnosis of thyroid cancer
Diagnosis of thyroid cancer is usually determined through a combination of physical examination, medical imaging, blood tests and biopsy.
- During a physical examination, a doctor will feel for lumps or swelling in the neck and may use a stethoscope to listen for changes in the sound of the thyroid gland.
- Medical imaging such as ultrasound, CT scans and MRI scans help to identify lumps or enlargement in the thyroid and any other suspicious areas in the surrounding tissue.
- Blood tests, such as a TSH test, can be used to measure the amount of thyroid hormones in the body and to determine whether the thyroid is overactive or underactive.
- A biopsy can then be performed to analyse a sample of the thyroid tissue and definitively diagnose thyroid cancer.
Types of thyroid cancer
A) Papillary thyroid cancer
Papillary thyroid cancer is the most common type of thyroid cancer, accounting for approximately 80 percent of all cases. It is slow growing and usually presents as a single lump or nodule. Papillary thyroid cancer is often treated with surgery to remove the affected tissue, followed by radioactive iodine therapy to destroy any remaining cancer cells.
The prognosis of papillary thyroid cancer is better than other types of cancer, and it grows in the epithelial tissue of the thyroid gland. This type of cancer is usually found as a solid mass, but in rare cases, doctors can find it as a cyst or fluid-filled sac.
B) Follicular thyroid cancer
Follicular thyroid cancer is the second most common type of thyroid cancer, making up approximately 10 to 15 percent of cases. It is often found as a single lump or nodule and is usually treated with surgery to remove the affected tissue, followed by thyroid hormone therapy.
Together with papillary thyroid cancer, it makes up 95% of the cases of thyroid cancer. Similar to papillary thyroid cancer, it has a somewhat good prognosis because it is a highly differentiated type of tumor. However, around 11% of patients may have metastases at the moment of the diagnosis, and the prognosis is better in younger patients.
C) Medullary thyroid cancer
Medullary thyroid cancer is the third most common form of thyroid cancer, making up approximately 3 to 4 percent of cases. It is often found as a single lump or nodule and is usually treated with surgery to remove the affected tissue, followed by chemotherapy and/or radiation therapy.
Medullary thyroid cancer grows in the inside of the thyroid gland, in an area known as medulla. This area of the thyroid contains parafolicular C cells, which produce thyroid hormone. If the tumor starts to release thyroid hormone right away, patients will start to experience symptoms. Otherwise, symptoms will start when the nodule is big and causes obstruction.
D) Anaplastic thyroid cancer
Anaplastic thyroid cancer is the rarest and most aggressive form of thyroid cancer, making up 2 percent of cases in the United States, and sometimes less than that. It is also found as a single lump or nodule in most cases, and the treatment is similar, with chemotherapy or radiation therapy, sometimes a combination of both.
It is an undifferentiated carcinoma of the thyroid gland, which means that anaplastic thyroid cancer contains highly mutated cells. Since these cells undergo several mutations, this type of cancer is often more aggressive and difficult to treat. The prognosis is very poor, with a mortality close to 100% because most patients already have metastasis at the moment of diagnosis.
Stages of thyroid cancer
The stages are different for each type of thyroid cancer and the age of the patient. Thus:
-
- In patients younger than 55 years with papillary or follicular thyroid cancer, there are stage 1 and stage 2. The only difference is that stage 1 has no distant metastasis but may or may not have regional invasion and lymph node infiltration. Stage 2 has distant metastasis and a poorer prognosis.
- When patients are older than 55 years and are diagnosed with papillary or follicular thyroid cancer, doctors talk about three stages. Stage 1 is a small tumor with no spread to the lymph nodes and no distant spread. Stage 2 is a large tumor with no spread. Stage 3 features spread to lymph nodes. Stage 4 is divided into A, B, and C, depending on how severe is the invasion of the tumor (to nearby tissue, to lymph nodes in outside the central compartment, and to distant organs).
- The same classification with four stages is given to medullary thyroid cancer
- All forms of anaplastic thyroid cancer are considered stage IV cancer and they are divided into A, B, or C, depending on how severe is the invasion of the tumor.
Treatment of thyroid cancer
Treatment of thyroid cancer often involves a combination of approaches, including surgery, radiation therapy, and hormone therapy.
-
- Surgery is the most common form of treatment and can involve either a partial or total thyroidectomy, depending on the stage and type of cancer.
- Radiation therapy is a form of targeted therapy that uses high-energy radiation to kill cancer cells and can also be used following surgery to destroy any remaining cancer thyroid tissue samplesed to reduce the levels of hormones produced by the cancerous cells and can be used to prevent the recurrence of thyroid cancer.
- Other treatments, such as chemotherapy and immunotherapy, may also be used in conjunction with the above treatments to reduce the risk of recurrence.
What happens after thyroid cancer treatment?
When it comes to the prognosis for thyroid cancer, it is largely dependent on the stage and type of cancer, as well as the patient’s age, gender, and other risk factors. Early detection and treatment using the above treatments can improve the prognosis significantly. Additionally, regular follow-up care and regular screenings are important to monitor for any recurrence. With the right treatment, thyroid cancer can be cured in many cases.
In some cases, the entire thyroid gland may need to be removed, which can lead to a condition known as hypothyroidism. That’s why post-treatment for thyroid cancer often involves monitoring the patient’s hormone levels with regular blood tests, and taking medications to replace the hormones that the thyroid gland normally produces.
Recovery after thyroid cancer treatment
For people who have undergone radiation treatment, the recovery time may vary depending on the type and dose of radiation they received. Common side effects include fatigue, difficulty swallowing, and changes in taste and smell. It is essential to rest and take breaks when needed and to seek medical advice if any symptoms become severe or persist. Generally, radiation-induced side effects tend to fade over time.
For those who have had surgery for their thyroid cancer, the recovery period may involve a stay in the hospital and close monitoring by doctors. While in the hospital, patients may receive pain medications, blood tests, and other treatments to help them heal and reduce their risk of infection. After being discharged from the hospital, patients should follow their doctor’s instructions for follow-up care, including regular check-ups and blood tests. For those who have had their larynx removed, speech therapy can help with any communication difficulties.
» Conclusion
As with any cancer, early diagnosis is important to ensure the best outcome in thyroid cancer. Several tests can be done to diagnose this disease,, including ultrasounds, biopsies, and blood tests. Once the diagnosis is made, it is crucial to have a trusted team of medical professionals to guide you through the treatment process. This team may include an endocrinologist, an oncologist, a radiation oncologist, a surgeon, and a nurse practitioner.
Regarding treatment options, radiation therapy, chemotherapy, and surgery are all possible options. Different treatments may be recommended depending on the stage and type of cancer. Radiation therapy uses high-energy X-rays to kill cancer cells. Chemotherapy is the use of drugs to kill cancer cells, and surgery is the removal of cancerous cells or tissues. The side effects of these treatments can vary and may include fatigue, nausea, hair loss, and skin changes.
Along with medical treatment, many supportive care options can help with coping with thyroid cancer. These include support groups, counseling, nutrition and exercise programs, and complementary therapies. It is important to have a positive attitude and to stay informed and educated about the disease. Taking good care of yourself and staying connected to others can help you cope with the physical, emotional, and mental demands of the cancer journey.