Thyroid cancer

(or carcinoma)

 

is a malignant lump or growth that starts from cells inside
the thyroid gland in the lower neck. There are three basic types of thyroid cancer (see
more information below):
• Differentiated (papillary, follicular, and Hurthle Cell)
• Medullary
• Anaplastic (or undifferentiated)

 

Thyroid cancer is fairly common (11th most common cancer in the United States).

 

 

What are the symptoms of thyroid cancer?

Often there are no symptoms and thyroid lumps are found on accident when people
have medical imaging done for other reasons (“incidental”). However, thyroid cancer
can cause symptoms such as:
• Enlarging lump or mass on the thyroid gland (lower neck)
• A lump or mass on the side of the neck (lymph gland)
• Hoarseness or change in voice
• Pressure, tightness or fullness in the lower neck (enlarged thyroid)
• Difficulty swallowing
• Many early thyroid cancer do not show any symptoms

What causes thyroid cancer?

As with many other cancers, we do not know all of the reasons why cancer develops.
However, there are several known risk factors for thyroid cancer:
• Radiation to the head or neck (especially during childhood)
• Family history of thyroid or other endocrine tumors
• History of enlarged thyroid (goiter) or autoimmune thyroid problems (e.g., Hashimoto’s or Graves’ thyroiditis)
• Gender: More than 75% of thyroid cancers affect women. However, men with a
thyroid lump are at a higher risk of their lump being cancer.
• History of iodine deficiency (rare in the United States)

How is thyroid cancer diagnosed?

After a thyroid nodule is discovered, it may be recommended for a biopsy based on size
and appearance on ultrasound. An FNA biopsy is a quick, safe and reliable method of
evaluating thyroid nodules. Several very thin needles are inserted into the nodule (with
the assistance of an ultrasound), and cells are extracted (aspirated) into the needle.
Slides are made with the material collected in the needle, and a cytopathologist (a
physician who is trained to diagnose thyroid diseases by the examination of cells) will
evaluate the sample under the microscope. Sometimes, gene mutation or molecular
tests are ordered as part of an FNA biopsy to get additional information about a nodule
and its risk of cancer.

How is thyroid cancer treated?

Treatment is dependent on the type of thyroid cancer and usually involves surgical
removal of all or part of the thyroid (and sometimes lymph glands). After surgery, thyroid
hormone replacement pills are generally required. Additional treatments (such as a
radioactive iodine treatment or other medications) may be recommended depending on
the tumor type and stage of disease. Long-term monitoring and treatment is usually recommended by a Medical
Endocrinologist.

What is the general prognosis for thyroid cancer?

Most thyroid cancers are very treatable and have an excellent prognosis. Because
thyroid cancer deposits can live dormant for many years, life-long follow up is required.
Long term, up to 1 in 5 patients may need a second treatment which could be many
years later.

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