What is the Thyroid?
The thyroid is a small gland located in the neck, just below Adam’s apple. It is a part of the endocrine system, which is responsible for producing and regulating hormones in the body. The thyroid gland produces two hormones, thyroxine (T4) and triiodothyronine (T3), which help regulate the body’s metabolism and control many of its functions, including heart rate, body temperature, and energy levels. These hormones are produced and released by the thyroid gland in response to signals from the pituitary gland, a small gland located at the base of the brain, which produces thyroid-stimulating hormone (TSH). Any problems with the thyroid gland, such as overactivity or underactivity, can have significant effects on the body’s metabolism and overall health.
What is Thyroid Cancer?
Thyroid cancer is a type of cancer that affects the thyroid gland. It occurs when cells in the thyroid gland grow and multiply uncontrollably, forming a tumour. The exact cause of thyroid cancer is not known, but certain risk factors, such as exposure to radiation and certain genetic conditions, may increase a person’s risk of developing the disease.
Types of Thyroid Cancer
There are several types of thyroid cancer, including –
Papillary thyroid cancer:
This is the most common type of thyroid cancer, accounting for about 80% of cases. It typically grows slowly and often spreads to nearby lymph nodes, but is usually treatable.
Follicular thyroid cancer:
This type of thyroid cancer is less common than papillary thyroid cancer and tends to be more aggressive. It typically spreads to other parts of the body, such as the lungs and bones.
Medullary thyroid cancer:
This type of thyroid cancer develops in the cells that produce the hormone calcitonin. It can occur as part of a genetic syndrome or on its own and tends to be more aggressive than papillary and follicular thyroid cancer.
Anaplastic thyroid cancer:
This type is rare, accounting for about 1% of thyroid cancer. It is a fast-growing, poorly differentiated thyroid cancer that may start from differentiated thyroid cancer or a benign thyroid tumour. Anaplastic thyroid cancer can be subtyped into giant cell classifications. Because this type of thyroid cancer grows so quickly, it is more difficult to treat successfully.
Some thyroid tumours may be benign (not cancerous), such as follicular adenomas or nodular goitres. However, any thyroid nodule or lump should be evaluated by a healthcare professional to determine if it is cancerous or not.
Risk Factors of Thyroid Cancer
The exact cause of thyroid cancer is not known, but there are several factors that may increase a person’s risk of developing the disease. Some of these risk factors include –
Family history
Having a close relative, such as a parent or sibling, with thyroid cancer increases a person’s risk of developing the disease.
Gender
Women are two to three times more likely than men to develop thyroid cancer.
Radiation exposure
Exposure to radiation, particularly during childhood, increases the risk of developing thyroid cancer.
Certain genetic conditions
Certain genetic conditions, such as multiple endocrine neoplasia type 2 (MEN2) and familial medullary thyroid cancer (FMTC), increase a person’s risk of developing thyroid cancer.
Iodine deficiency or excess
A diet that is deficient or excess in iodine may increase the risk of developing thyroid cancer, although this is not well established.
Certain benign thyroid conditions
Certain benign thyroid conditions, such as goitre or thyroid nodules, may increase the risk of developing thyroid cancer.
Having one or more of these risk factors does not necessarily mean a person will develop thyroid cancer, and many people with thyroid cancer have no known risk factors. Regular thyroid check-ups and screenings can help detect thyroid cancer early when it is most treatable.
Symptoms of Thyroid Cancer
In many cases, thyroid cancer does not cause any symptoms in its early stages. However, as cancer grows, it may cause the following symptoms –
- A lump or swelling in the neck: This is the most common symptom of thyroid cancer. The lump may be painless or tender to the touch.
- Pain in the neck or throat: Some people with thyroid cancer may experience pain in the neck or throat, especially when swallowing.
- Hoarseness or voice changes: Thyroid cancer can cause changes in the voice, such as hoarseness or a raspy quality.
- Difficulty swallowing or breathing: As the tumor grows, it may put pressure on the esophagus or trachea, making it difficult to swallow or breathe.
- Enlarged lymph nodes: Thyroid cancer may cause the lymph nodes in the neck to become swollen and tender.
- Fatigue or weakness: Some people with thyroid cancer may experience fatigue, weakness, or a general feeling of unwellness.
Many of these symptoms can be caused by other conditions as well, so it’s important to see a healthcare professional for an accurate diagnosis. Additionally, not all thyroid cancers cause symptoms, which is why regular thyroid check-ups and screenings are important for early detection.
Diagnoses of Thyroid Cancer
The diagnosis of thyroid cancer typically involves a combination of physical exams, imaging tests, and biopsy procedures. Here are the main steps involved in the diagnosis of thyroid cancer –
Physical exam:
The healthcare professional will examine the neck for any lumps or swelling. If surgery is recommended, the larynx may be examined at the same time with a laryngoscope, which is a thin, flexible tube with a light.
Blood tests:
Blood tests may be performed to measure the levels of thyroid hormones and thyroid-stimulating hormone (TSH). Blood testing for thyroid cancer may include:
- Thyroid hormone levels. As explained in the Introduction, thyroid hormones regulate a person’s metabolism. The doctor will use this test to find out the current levels of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) in the body.
- Thyroid-stimulating hormone (TSH). This blood test measures the level of TSH, a hormone produced by the pituitary gland near the brain. If the body is in need of thyroid hormone, the pituitary gland releases TSH to stimulate production.
Ultrasound:
An ultrasound may be performed to visualize the thyroid gland and any nodules or lumps within it. High-frequency sound waves create a pattern of echoes that show the doctor the size of the thyroid gland and specific information about any nodules.
Fine-needle aspiration (FNA) biopsy:
This procedure involves using a thin needle to remove a small sample of cells from the thyroid nodule for examination under a microscope. FNA biopsy is the most common method used to diagnose thyroid cancer.
Imaging tests:
Imaging tests, such as a CT scan, MRI, or PET scan, may be performed to determine if cancer has spread to other parts of the body.
Surgical biopsy:
In some cases, a surgical biopsy may be needed to remove a larger portion of the thyroid nodule or the entire thyroid gland for examination.
Preventions and Treatments for Thyroid Cancer
Preventions to be considered are as follows
There is currently no known way to prevent thyroid cancer, but there are some steps you can take to reduce your risk of developing the disease or to detect it early –
- Get regular thyroid check-ups: Regular thyroid check-ups and screenings can help detect any abnormalities in the thyroid gland and any nodules that may be cancerous.
Protect yourself from radiation: Exposure to radiation, particularly during childhood, increases the risk of developing thyroid cancer. To reduce your risk, avoid unnecessary radiation exposure and wear protective gear when working in environments that expose you to radiation.
- Maintain a healthy diet: A diet that is high in fruits and vegetables and low in processed foods may help reduce the risk of developing thyroid cancer.
Check for iodine deficiency or excess: An iodine deficiency or excess may increase the risk of developing thyroid cancer. Checking your iodine levels and ensuring that your diet provides the appropriate amount of iodine can help reduce your risk.
Know your family history: Having a close relative, such as a parent or sibling, with thyroid cancer increases the risk of developing the disease. Knowing your family history and discussing it with your healthcare provider can help determine if you are at increased risk and if you need more frequent screenings.
Treatments required for Thyroid Cancer
The treatment for thyroid cancer depends on several factors, such as the type and stage of cancer, the size and location of the tumour, and the patient’s overall health. Here are the main types of treatment for thyroid cancer:
Surgery is the removal of the tumour and some surrounding healthy tissue during an operation, called a margin. Surgery may also be called a resection. It is the main treatment for most people with thyroid cancer. A surgical oncologist is a doctor who specializes in treating cancer using surgery. Depending on the size of the thyroid nodule, common surgical options include:
- Lobectomy: This surgery removes the lobe of the thyroid gland with the cancerous nodule.
- Near-total thyroidectomy: Also called a subtotal thyroidectomy, this is surgery to remove most of the thyroid gland. A small amount of thyroid tissue remains.
- Total thyroidectomy: This surgery removes the entire thyroid gland. Following are some of the techniques for performing thyroidectomy –
- Standard thyroidectomy. During a standard thyroidectomy, a surgeon makes a small incision (or cut) near the base or middle of the neck. This gives the surgeon direct access to the patient’s thyroid gland for the operation
- Endoscopic thyroidectomy. During an endoscopic thyroidectomy, the surgeon makes a single small incision. The surgery is similar to a standard thyroidectomy except that a scope and video monitor are used to guide the procedure rather than surgical loupe magnification.
Not all surgical options are recommended for all patients. Talk with your doctor about the best approach to treat you.
If there is evidence or risk of the spread of cancer to the lymph nodes in the neck, the surgeon may also perform a neck dissection. This is surgery to remove the lymph nodes in the neck. Neck dissection is also called lymphadenectomy.
After surgery, radioactive iodine may be given to destroy any remaining thyroid tissue or cancer cells. This treatment is particularly effective for papillary and follicular thyroid cancers, which absorb iodine.
Patients who are treated with surgery usually require thyroid hormone therapy. In addition to replacing the hormone that is needed by the body, thyroid hormone medication may slow down the growth of any remaining differentiated cancer cells.
Thyroid hormone replacement is levothyroxine (Levothroid, Levoxyl, Synthroid, Tirosint, Unithroid, and other brand names.) Levothyroxine typically comes as a pill that should be taken daily, at the same time each day before meals, so that the body receives a consistent supply. Thyroid hormone replacement is usually prescribed by an endocrinologist, which is a doctor specializing in treating problems with hormones, glands, and the endocrine system.
This treatment involves using high-energy X-rays or other types of radiation to destroy cancer cells. It may be used to treat larger or more aggressive tumours or to treat cancer that has spread to other parts of the body.
For thyroid cancer, external-beam radiation therapy is used only in certain circumstances, typically when later-stage thyroid cancer has spread to critical areas of the neck such as the trachea, voice box, or oesophagus. Radiation therapy is usually given after surgery, and treatment is concentrated on a specific area, only affecting cancer cells at that site. Radiation therapy is usually not used to manage thyroid cancer in young patients.
References:
What is the Thyroid?
The thyroid is a small gland located in the neck, just below Adam’s apple. It is a part of the endocrine system, which is responsible for producing and regulating hormones in the body. The thyroid gland produces two hormones, thyroxine (T4) and triiodothyronine (T3), which help regulate the body’s metabolism and control many of its functions, including heart rate, body temperature, and energy levels. These hormones are produced and released by the thyroid gland in response to signals from the pituitary gland, a small gland located at the base of the brain, which produces thyroid-stimulating hormone (TSH). Any problems with the thyroid gland, such as overactivity or underactivity, can have significant effects on the body’s metabolism and overall health.
What is Thyroid Cancer?
Thyroid cancer is a type of cancer that affects the thyroid gland. It occurs when cells in the thyroid gland grow and multiply uncontrollably, forming a tumour. The exact cause of thyroid cancer is not known, but certain risk factors, such as exposure to radiation and certain genetic conditions, may increase a person’s risk of developing the disease.
Types of Thyroid Cancer
There are several types of thyroid cancer, including –
Papillary thyroid cancer:
This is the most common type of thyroid cancer, accounting for about 80% of cases. It typically grows slowly and often spreads to nearby lymph nodes, but is usually treatable.
Follicular thyroid cancer:
This type of thyroid cancer is less common than papillary thyroid cancer and tends to be more aggressive. It typically spreads to other parts of the body, such as the lungs and bones.
Medullary thyroid cancer:
This type of thyroid cancer develops in the cells that produce the hormone calcitonin. It can occur as part of a genetic syndrome or on its own and tends to be more aggressive than papillary and follicular thyroid cancer.
Anaplastic thyroid cancer:
This type is rare, accounting for about 1% of thyroid cancer. It is a fast-growing, poorly differentiated thyroid cancer that may start from differentiated thyroid cancer or a benign thyroid tumour. Anaplastic thyroid cancer can be subtyped into giant cell classifications. Because this type of thyroid cancer grows so quickly, it is more difficult to treat successfully.
Some thyroid tumours may be benign (not cancerous), such as follicular adenomas or nodular goitres. However, any thyroid nodule or lump should be evaluated by a healthcare professional to determine if it is cancerous or not.
Risk Factors of Thyroid Cancer
The exact cause of thyroid cancer is not known, but there are several factors that may increase a person’s risk of developing the disease. Some of these risk factors include –
Family history
Having a close relative, such as a parent or sibling, with thyroid cancer increases a person’s risk of developing the disease.
Gender
Women are two to three times more likely than men to develop thyroid cancer.
Radiation exposure
Exposure to radiation, particularly during childhood, increases the risk of developing thyroid cancer.
Certain genetic conditions
Certain genetic conditions, such as multiple endocrine neoplasia type 2 (MEN2) and familial medullary thyroid cancer (FMTC), increase a person’s risk of developing thyroid cancer.
Iodine deficiency or excess
A diet that is deficient or excess in iodine may increase the risk of developing thyroid cancer, although this is not well established.
Certain benign thyroid conditions
Certain benign thyroid conditions, such as goitre or thyroid nodules, may increase the risk of developing thyroid cancer.
Having one or more of these risk factors does not necessarily mean a person will develop thyroid cancer, and many people with thyroid cancer have no known risk factors. Regular thyroid check-ups and screenings can help detect thyroid cancer early when it is most treatable.
Symptoms of Thyroid Cancer
In many cases, thyroid cancer does not cause any symptoms in its early stages. However, as cancer grows, it may cause the following symptoms –
- A lump or swelling in the neck: This is the most common symptom of thyroid cancer. The lump may be painless or tender to the touch.
- Pain in the neck or throat: Some people with thyroid cancer may experience pain in the neck or throat, especially when swallowing.
- Hoarseness or voice changes: Thyroid cancer can cause changes in the voice, such as hoarseness or a raspy quality.
- Difficulty swallowing or breathing: As the tumor grows, it may put pressure on the esophagus or trachea, making it difficult to swallow or breathe.
- Enlarged lymph nodes: Thyroid cancer may cause the lymph nodes in the neck to become swollen and tender.
- Fatigue or weakness: Some people with thyroid cancer may experience fatigue, weakness, or a general feeling of unwellness.
Many of these symptoms can be caused by other conditions as well, so it’s important to see a healthcare professional for an accurate diagnosis. Additionally, not all thyroid cancers cause symptoms, which is why regular thyroid check-ups and screenings are important for early detection.
Diagnoses of Thyroid Cancer
The diagnosis of thyroid cancer typically involves a combination of physical exams, imaging tests, and biopsy procedures. Here are the main steps involved in the diagnosis of thyroid cancer –
Physical exam:
The healthcare professional will examine the neck for any lumps or swelling. If surgery is recommended, the larynx may be examined at the same time with a laryngoscope, which is a thin, flexible tube with a light.
Blood tests:
Blood tests may be performed to measure the levels of thyroid hormones and thyroid-stimulating hormone (TSH). Blood testing for thyroid cancer may include:
- Thyroid hormone levels. As explained in the Introduction, thyroid hormones regulate a person’s metabolism. The doctor will use this test to find out the current levels of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) in the body.
- Thyroid-stimulating hormone (TSH). This blood test measures the level of TSH, a hormone produced by the pituitary gland near the brain. If the body is in need of thyroid hormone, the pituitary gland releases TSH to stimulate production.
Ultrasound:
An ultrasound may be performed to visualize the thyroid gland and any nodules or lumps within it. High-frequency sound waves create a pattern of echoes that show the doctor the size of the thyroid gland and specific information about any nodules.
Fine-needle aspiration (FNA) biopsy:
This procedure involves using a thin needle to remove a small sample of cells from the thyroid nodule for examination under a microscope. FNA biopsy is the most common method used to diagnose thyroid cancer.
Imaging tests:
Imaging tests, such as a CT scan, MRI, or PET scan, may be performed to determine if cancer has spread to other parts of the body.
Surgical biopsy:
In some cases, a surgical biopsy may be needed to remove a larger portion of the thyroid nodule or the entire thyroid gland for examination.
Preventions and Treatments for Thyroid Cancer
Preventions to be considered are as follows
There is currently no known way to prevent thyroid cancer, but there are some steps you can take to reduce your risk of developing the disease or to detect it early –
- Get regular thyroid check-ups: Regular thyroid check-ups and screenings can help detect any abnormalities in the thyroid gland and any nodules that may be cancerous.
Protect yourself from radiation: Exposure to radiation, particularly during childhood, increases the risk of developing thyroid cancer. To reduce your risk, avoid unnecessary radiation exposure and wear protective gear when working in environments that expose you to radiation.
- Maintain a healthy diet: A diet that is high in fruits and vegetables and low in processed foods may help reduce the risk of developing thyroid cancer.
Check for iodine deficiency or excess: An iodine deficiency or excess may increase the risk of developing thyroid cancer. Checking your iodine levels and ensuring that your diet provides the appropriate amount of iodine can help reduce your risk.
Know your family history: Having a close relative, such as a parent or sibling, with thyroid cancer increases the risk of developing the disease. Knowing your family history and discussing it with your healthcare provider can help determine if you are at increased risk and if you need more frequent screenings.
Treatments required for Thyroid Cancer
The treatment for thyroid cancer depends on several factors, such as the type and stage of cancer, the size and location of the tumour, and the patient’s overall health. Here are the main types of treatment for thyroid cancer:
Surgery is the removal of the tumour and some surrounding healthy tissue during an operation, called a margin. Surgery may also be called a resection. It is the main treatment for most people with thyroid cancer. A surgical oncologist is a doctor who specializes in treating cancer using surgery. Depending on the size of the thyroid nodule, common surgical options include:
- Lobectomy: This surgery removes the lobe of the thyroid gland with the cancerous nodule.
- Near-total thyroidectomy: Also called a subtotal thyroidectomy, this is surgery to remove most of the thyroid gland. A small amount of thyroid tissue remains.
- Total thyroidectomy: This surgery removes the entire thyroid gland. Following are some of the techniques for performing thyroidectomy –
- Standard thyroidectomy. During a standard thyroidectomy, a surgeon makes a small incision (or cut) near the base or middle of the neck. This gives the surgeon direct access to the patient’s thyroid gland for the operation
- Endoscopic thyroidectomy. During an endoscopic thyroidectomy, the surgeon makes a single small incision. The surgery is similar to a standard thyroidectomy except that a scope and video monitor are used to guide the procedure rather than surgical loupe magnification.
Not all surgical options are recommended for all patients. Talk with your doctor about the best approach to treat you.
If there is evidence or risk of the spread of cancer to the lymph nodes in the neck, the surgeon may also perform a neck dissection. This is surgery to remove the lymph nodes in the neck. Neck dissection is also called lymphadenectomy.
After surgery, radioactive iodine may be given to destroy any remaining thyroid tissue or cancer cells. This treatment is particularly effective for papillary and follicular thyroid cancers, which absorb iodine.
Patients who are treated with surgery usually require thyroid hormone therapy. In addition to replacing the hormone that is needed by the body, thyroid hormone medication may slow down the growth of any remaining differentiated cancer cells.
Thyroid hormone replacement is levothyroxine (Levothroid, Levoxyl, Synthroid, Tirosint, Unithroid, and other brand names.) Levothyroxine typically comes as a pill that should be taken daily, at the same time each day before meals, so that the body receives a consistent supply. Thyroid hormone replacement is usually prescribed by an endocrinologist, which is a doctor specializing in treating problems with hormones, glands, and the endocrine system.
This treatment involves using high-energy X-rays or other types of radiation to destroy cancer cells. It may be used to treat larger or more aggressive tumours or to treat cancer that has spread to other parts of the body.
For thyroid cancer, external-beam radiation therapy is used only in certain circumstances, typically when later-stage thyroid cancer has spread to critical areas of the neck such as the trachea, voice box, or oesophagus. Radiation therapy is usually given after surgery, and treatment is concentrated on a specific area, only affecting cancer cells at that site. Radiation therapy is usually not used to manage thyroid cancer in young patients.
References:
