CONDITIONS

What Is Thyroid Cancer

Thyroid cancer isn’t that common in the United States, but rates seem to be increasing, likely due to new technology allowing for detection of small thyroid cancers that might not have been as detectable in the past. The good news? Most cases of thyroid cancer can be cured with treatment.

Thyroid cancer is the abnormal and uncontrollable growth of cells in the thyroid gland, a gland located in front of the esophagus responsible for the production of several crucial hormones. The thyroid is composed of two main types of cells:

  • Follicular cells, which are responsible for making thyroid hormone, a hormone that helps to regulate metabolism.
  • C cells, which are responsible for making calcitonin, a hormone that helps regulate calcium use in the body.

There are many different types of thyroid cancer. The classification of thyroid cancer depends on the cells it arises from. Most often, thyroid cancers develop from follicular cells.

Types of thyroid that arise from follicular cells include:

  • Papillary carcinoma (80% of cases)
  • Follicular carcinoma (10% of cases)
  • Hurthle cell carcinoma (3% of cases)

Other types of thyroid cancers include:

  • Medullary thyroid carcinoma (4% of cases)
  • Anaplastic carcinoma (2% of cases)
  • Thyroid lymphoma (<1% of cases)
  • Thyroid sarcoma (<1% of cases)

What Causes Thyroid Cancer

As with most cancers, the cause of thyroid cancer is unknown. It is known to be associated with several genetic diseases, and the irregular cell division that leads to cancerous growths is known to be caused by damage to cell DNA. There are several risk factors known to affect the chances of developing thyroid cancer.

Risk Factors For Thyroid Cancer

The following factors may affect your risk of developing thyroid cancer:

  • Sex. According to the American Cancer Society, women are three times as likely to develop thyroid cancers than men.
  • Age. Diagnosis of thyroid cancer in men most often occurs later in life (ages 60-80) than in women (40-60).
  • Environmental Factors. Exposure to certain environmental hazards such as radiation increases the risk of thyroid cancer. Thyroid cancer rates are much higher in areas that have been sights of radioactive fallout or nuclear testing.
  • Family History. Thyroid cancer is linked to several inheritable (though rare) diseases. Having a close relative with thyroid cancer greatly increases the chances of developing it. 

Diagnosing Thyroid Cancer

The road to a thyroid cancer diagnosis most often begins with a prompted or regular physical exam. Doctors will check the size and firmness of the thyroid gland as well as examine the rest of the body for signs of other conditions and/or symptoms.

If your doctor suspects you may have thyroid cancer, he or she will most likely conduct a biopsy of the tissue in which suspected thyroid cells are collected and sent to a lab to be tested for cancerous properties.

In addition to a biopsy, your doctor may recommend the following tests:

Imaging tests, to better visualize the thyroid and any potential growths. These include:

  • Ultrasound, in which sound waves are used to produce imaging of the thyroid.
  • Radioiodine scan, in which radioactive iodine is injected or swallowed and later absorbed into the thyroid gland. A special camera is then used to look at where the iodine has collected. Abnormalities in absorption levels indicate potentially cancerous cell growths.
  • Chest x-ray, in which x-rays are used to produce an image of the torso.
  • CT scan, in which a specialized computer scanner compiles a series of photos to create detailed cross-sectional images of the body.
  • PET scan, in which a radioactive substance is injected into the body and later absorbed by the bodily cells. A special camera allows for doctors to see where the radioactive material has collected.
  • MRI scan, which uses magnetic waves to produce and image of the body.

Blood tests, to check for levels of thyroid-related hormone and other proteins in the blood.

Symptoms of Thyroid Cancer

Though thyroid cancer does not have a definite set of symptoms, the following may be warning signs of thyroid cancer:

  • A lump in the neck
  • Swelling in the neck
  • Pain in the front of the neck
  • Hoarseness/changes in the voice
  • Trouble swallowing
  • Trouble breathing
  • Persistent cough

Prognosis

Generally, thyroid cancer is easily treatable if caught at an early stage. The prognosis for thyroid cancer also depends on the type of cancer.

The following are specific five year survival rates for the three most common types of thyroid cancers:

Follicular thyroid cancer:

  • Stage I – near 100%
  • Stage II – near 100%
  • Stage III – 71%
  • Stage IV – 50%

Papillary thyroid cancer:

  • Stage I – near 100%
  • Stage II – near 100%
  • Stage III – 93%
  • Stage IV – 51%

Medullary thyroid cancer:

  • Stage I – near 100%
  • Stage II – 98%
  • Stage III – 81%
  • Stage IV – 28%

Living With Thyroid Cancer

The following tips can help you live well with thyroid cancer:

  • Get educated. Read up on your cancer type and ask your doctor for source recommendations. Knowing about your condition can help you make informed choices about your treatment and recovery.
  • Exercise. Regular exercise will help regulate your body and release stress.
  • Eat a balanced diet and drink plenty of water. A healthy diet is essential to give your body the strength it needs to go through treatment.
  • Talk to your loved ones about your condition if you feel comfortable. A solid support system can make treatment and recovery seem less daunting.
  • Join a support group for thyroid cancer patients and survivors. Sharing experiences can help you better understand your condition as well as be an emotional release. 

Screening

Because thyroid cancer is much easier to treat at an early stage, a physical examination of the thyroid gland is recommended once a year along with a regular physical. For those with a higher risk of thyroid cancer, a physical examination of the thyroid gland is recommended two or more times per year.

If your doctor suspects you may thyroid cancer, he or she will most likely conduct a series of diagnostic tests.

Prevention

There are no known modes of prevention for thyroid cancer. If possible, avoid excessive exposure to radiation. High levels of radiation have been linked to increased rates of thyroid cancer.

Medication And Treatment

The following treatments are available for thyroid cancer patients:

Surgery. Complete or partial removals of the thyroid are the most common modes of treatment for thyroid cancer. Common types of surgery include:

  •   Lobectomy, in which the lobe of the thyroid containing the cancerous cells is removed.
  •   Near-total thyroidectomy, in which all but a small portion of the thyroid gland is removed
  •   Total thyroidectomy, in which the entire thyroid is removed
  •   Lymphadenectomy, in which the cancerous lymph nodes draining the thyroid tumor are removed.

Radiation therapy. Radiation therapy involves the use of high-power x-rays or radioactive substances. Radiation treatments vary greatly from case to case depending on the extent of the cancer and can be effective in non-operable cases.

Chemotherapy. In chemotherapy, high strength drugs target and kill or interrupt the growth process of cancerous cells.

Thyroid hormone-therapy. In thyroid hormone therapy, the production of certain thyroid hormones is inhibited, causing the cancerous cells producing the hormones to die.

Targeted therapy. In targeted therapy, a specific protein is used to block biological processes leading to tumor growth.

Complementary and Alternative Treatment

Though there is a limited amount of supporting evidence for alternative treatments for thyroid cancer, members of the alternative medicine community assert that there are several modes of alternative and complimentary treatments for thyroid cancer. These include:

Mind/body practices such as guided imagery, meditation, yoga, and reiki.

Dietary supplements, including:

  • Vitamin D & calcium, which together help promote bone health. Bone health supplements are especially critical for thyroid cancer patients because of the potential loss of calcitonin, a hormone involved in bone production.

Acupuncture. Acupuncture may help lessen overall stress levels as well as regulate bodily energy.

Massage and Acupressure. Many patients report an overall increase in well-being due to massage and acupressure therapies.

Care Guide

One of the most important things you can do for your body while fighting thyroid cancer is staying in overall good health. Tips for living well include:

  • Eat a healthy, balanced diet. Eating a balanced diet with plenty of fruits and vegetables can give the body the right fuel it needs to fight off cancer and recover from treatment therapies.
  • Drink plenty of water. This rule applies to all people, whether they have thyroid cancer or not. Water helps to keep you hydrated and can assist your body in flushing out toxins.
  • Keep your routine. Even during treatment, try not to give up on your regular activities and hobbies.. Keeping up with hobbies and favorite activities can help keep your mind off of your treatment and prognosis.
  • Talk to trusted family, friends, or other cancer survivors. Sharing your experience can help you process your condition as well as help others that are going through the same thing.
  • Get educated. Read up on your cancer type and ask your doctor for source recommendations. Knowing about your condition can help you make informed choices about your treatment and recovery.

When To Contact A Doctor

If you suspect you may have thyroid cancer,  contact a doctor if you experience any of the following:

  • Unexplained changes in the voice
  • Rapidly enlarging growths on or around the neck
  • Sudden changes in breathing
  • Prolonged cough

If you are undergoing treatment for thyroid cancer, contact a doctor immediately if you experience any of the following:

  • Persistent nausea/vomiting
  • Difficulty breathing
  • Irregular heartbeat
  • Sudden changes in body temperature

Questions For Your Doctor

You may want to include the following types of doctors in your care team:

  • Primary care physician
  • Endocrinologist, a doctor who specializes in the endocrine system (of which the thyroid is a part.)
  • Radiologist, who specializes in imaging techniques that help doctors to visualize the cancer cells. Your endocrinologist or primary care physician will most likely be able to refer you to a radiologist if you are in need of imaging.

Questions For A Doctor

You may want to ask your doctor several questions about your treatment and condition. It may be helpful to write down questions that you have beforehand and bring them with you to make sure you do not forget to ask any.

The following are questions you may want to ask your doctor about your thyroid cancer:

  • What type of thyroid cancer do I have?
  • What stage is it?
  • What treatment options are available?
  • What treatment do you think is the best for me?
  • What are the side effects of treatment?
  • What can I do to help along my recovery?
  • Do you have recommendations for reliable sources of information on my condition?
  • What are my chances of survival?
  • Should I be worried about the cancer spreading?
  • If treatment is successful during the first round, what is the likelihood that the cancer returning?