Overview
Thyroid cancer is a type of cancer that starts in the thyroid gland, which is a butterfly-shaped gland located at the base of the neck, just below the Adam's apple. The thyroid gland produces hormones that regulate various bodily functions such as heart rate, blood pressure, body temperature, and weight. Thyroid cancer may not cause any symptoms initially, but as it grows, it can lead to signs such as swelling in the neck, voice changes, and difficulty swallowing. There are several types of thyroid cancer, and most types grow slowly, but some can be aggressive. Most thyroid cancers can be cured with treatment. The increase in thyroid cancer rates may be due to improved imaging technology that detects small thyroid cancers on CT and MRI scans done for other conditions. When thyroid cancer spreads, it most commonly travels to lymph nodes in the neck, lungs, bones, brain, liver, and skin.
Understanding the disease
Symptoms
The symptoms of thyroid cancer can include a lump (nodule) that can be felt in the neck, a feeling that close-fitting shirt collars are becoming too tight, changes to the voice, including increasing hoarseness, difficulty swallowing, swollen lymph nodes in the neck, and pain in the neck and throat. These symptoms can appear as the cancer grows. It is recommended to see a health care provider if any signs or symptoms are experienced that cause worry.
Risk Factors
Risk factors for developing thyroid cancer include being female, exposure to high levels of radiation, and certain inherited genetic syndromes such as familial medullary thyroid cancer, multiple endocrine neoplasia, Cowden syndrome, and familial adenomatous polyposis. Additionally, certain types of thyroid cancer, such as medullary thyroid cancer and papillary thyroid cancer, may run in families due to genetic predisposition. Other rare types of thyroid cancer may originate from immune system or connective tissue cells. It's important to note that the exact cause of thyroid cancer is not fully understood, and risk factors may vary from person to person.
Development
The various types of thyroid cancer develop when cells in the thyroid gland undergo changes in their DNA, leading to mutations that cause the cells to grow and multiply rapidly. This results in the formation of a tumor. Thyroid cancer can originate from different types of thyroid cells, including follicular cells and C cells, and may be further classified based on the specific mutations present in the cells. Some rare forms of thyroid cancer, like thyroid lymphoma and thyroid sarcoma, begin in immune system cells and connective tissue cells of the thyroid, respectively. The exact cause of these DNA changes and mutations may not always be clear, but factors such as genetic inheritance, radioactive exposure, and certain medical conditions can increase the risk of developing thyroid cancer.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect thyroid cancer if you experience any of the following symptoms: swelling in your neck, voice changes, difficulty swallowing, or if you notice a lump in your neck. Additionally, if you have a family history of thyroid cancer or have been exposed to high levels of radiation, it's essential to consult a healthcare provider for early detection and appropriate evaluation. Remember, early detection and treatment can improve outcomes for thyroid cancer patients.
Diagnosis
To diagnose thyroid cancer, your healthcare provider will typically start with a physical exam to feel for any lumps or abnormalities in your neck. They may also ask about your risk factors, such as past exposure to radiation and family history. Blood tests measuring thyroid hormones and imaging tests, such as ultrasound, are often used to help identify potential thyroid cancer. If the results are inconclusive, additional tests like biopsies, molecular marker testing, or radioactive iodine scans may be recommended. Imaging tests can also help determine the size of the thyroid gland and detect nodules.
Management and Treatment
Complications
Potential complications of thyroid cancer include recurrence, complications from treatments, and the cancer spreading to other parts of the body. The cancer may recur in lymph nodes in the neck, small pieces of thyroid tissue left behind during surgery, or other areas of the body such as the lungs, bones, brain, liver, skin, and more. Complications from treatments may also occur, depending on the type of therapy used. Some possible side effects of treatment for thyroid cancer include damage to the parathyroid glands, which can cause low blood calcium levels, and damage to the nerves that control the vocal cords, leading to hoarseness or other voice changes. The cancer spreading to other parts of the body, known as metastasis, can cause additional health problems and affect overall prognosis.
Prevention
While there are certain measures that can be taken for individuals with high-risk factors, such as prophylactic thyroidectomy for those with inherited gene mutations, there is no known way to prevent thyroid cancer for people with average risk.
Treatment
Treatments for thyroid cancer may include surgery, radioactive iodine therapy, external beam radiation, targeted therapy, and/or chemotherapy, depending on the type and stage of the cancer. Most thyroid cancers can be cured with treatment.
Preparing for medical consultation
To prepare for an appointment for thyroid cancer, you should:
- Write down questions to ask your healthcare provider, including questions about the type and stage of thyroid cancer, recommended treatments, benefits and risks of each option, managing other health problems, working and doing usual activities during treatment, seeking a second opinion, and seeing a specialist.
- Be aware of any pre-appointment restrictions or instructions, such as dietary limitations.
- Write down any symptoms you're experiencing, including those that may seem unrelated to thyroid cancer.
- Note down key personal information, such as major stresses or recent life changes.
- Make a list of all medications, vitamins, or supplements you're taking.
- Consider bringing a family member or friend along for support and to help remember important details.
- Gather previous scans, X-rays, and other medical records relevant to your situation for the appointment.