Thyroid Cancer: All You Need to Know
What is thyroid cancer?
Thyroid cancer is a relatively rare but increasingly prevalent form of cancer that affects the thyroid gland, a small butterfly-structured gland located at the base of the neck. As with any cancer, understanding its types, symptoms, and threat factors is crucial for early discovery, diagnosis, and effective treatment. In this blog post, we will delve into the intricacies of thyroid cancer, providing valuable insights to help raise awareness and empower individuals with knowledge.
What are the types of thyroid cancer?
There are several types of thyroid cancer, each with distinct characteristics and treatments include:
- Papillary thyroid cancer (PTC): This is the most common type, accounting for about 80% of all thyroid cancers. PTC develops from follicular cells and tends to grow sluggishly. It frequently has a good prognosis and can occur at any age.
- Follicular thyroid cancer (FTC): FTC also arises from follicular cells and is the second most common type. It tends to grow sluggishly but may have a higher risk of spreading to other parts of the body compared to PTC.
- Medullary thyroid cancer (MTC): MTC originates from C cells (also called parafollicular cells) in the thyroid gland, which produce the hormone calcitonin. MTC can be sporadic or inherited, with the inherited form often associated with a genetic syndrome called multiple endocrine neoplasia (MEN) types 2.
- Anaplastic thyroid cancer: This is a rare and aggressive form of thyroid cancer that generally affects aged individualities. It arises from the follicular cells and has a high risk of spreading rapidly to other organs. Anaplastic thyroid cancer is the most challenging type to treat and has a poorer prognosis.
- Thyroid lymphoma: Lymphoma is a cancer of the lymphatic system, and occasionally it can involve the thyroid gland. Primary thyroid lymphomas are rare but can occur.
What are the warning signs of thyroid cancer?
The warning signs of thyroid cancer can be summarized as follows:
- Lump or swelling in the neck, below the Adam’s apple.
- Changes in voice, such as hoarseness.
- Difficulty swallowing or breathing.
- Neck pain or discomfort.
- Enlarged lymph nodes in the neck.
- Persistent cough.
- Fatigue and unexplained weight loss.
What causes thyroid cancer?
The exact causes are not completely understood. However, there are several factors that can contribute to its development:
- Inheritable mutations: Changes in the DNA of thyroid cells can lead to abnormal cell growth and the formation of cancer. Certain genetic mutations, such as BRAF and RET gene mutations, are associated with an increased risk of thyroid cancer.
- Radiation exposure: High levels of radiation, especially during childhood, can increase the risk of developing thyroid cancer. This can be due to medical treatments involving radiation or exposure to environmental sources of radiation.
- Family history: Having a family history of thyroid cancer or certain genetic syndromes, such as familial medullary thyroid cancer (FMTC) or multiple endocrine neoplasia type 2 (MEN2), can increase the risk of developing thyroid cancer.
- Gender and age: Thyroid cancer is more common in women than men. It often occurs between the ages of 25 and 65.
- Previous thyroid conditions: Certain benign thyroid conditions, like goiter or thyroid nodules, may slightly increase the risk of developing thyroid cancer.
How is thyroid cancer diagnosed?
- Medical history and physical examination: Your healthcare provider evaluates your medical history and performs a physical examination, paying attention to any abnormalities in the neck area.
- Imaging tests: Imaging tests like ultrasound, CT scan, MRI, or thyroid scan are used to visualize the thyroid gland and detect any nodules or tumors.
- Biopsy: A tissue sample is obtained from a suspicious area through a biopsy, often using a fine needle. The sample is then examined under a microscope to determine if cancer is present.
- Pathology evaluation: The tissue sample is analyzed by a pathologist who examines it for the presence of cancer cells, determines the type of thyroid cancer, and provides important details to guide treatment decisions.
Additional tests, such as blood tests and genetic testing, may be conducted to gather more information about the cancer and plan appropriate treatment.
How is thyroid cancer managed or treated?
The management and treatment of thyroid cancer depend on several factors, including the type and stage of cancer, as well as individual patient characteristics. The primary treatment options for thyroid cancer include:
- Surgery: Surgery is typically the mainstay of treatment for thyroid cancer. The goal of surgery is to remove the cancerous thyroid tissue. The extent of surgery may vary, ranging from removal of only the cancerous lobe of the thyroid (lobectomy) to the complete removal of the thyroid gland (total thyroidectomy). In some cases, nearby lymph nodes may also be removed.
- Radioactive iodine therapy: After surgery, radioactive iodine therapy may be recommended. Thyroid cells have the ability to absorb iodine, and radioactive iodine is used to destroy any remaining or recurrent thyroid cancer cells that may have spread beyond the thyroid gland. This therapy is most effective for certain types of thyroid cancer, such as papillary and follicular thyroid cancer.
- Thyroid hormone replacement therapy: Since the thyroid gland is usually removed or partially removed during surgery, lifelong thyroid hormone replacement therapy is necessary to maintain normal thyroid hormone levels in the body.
- External beam radiation therapy: In certain cases, external beam radiation therapy may be used to target and kill cancer cells in the thyroid or surrounding tissues, especially if cancer has spread or if it is not responsive to radioactive iodine therapy.
- Targeted therapy: For advanced or metastatic thyroid cancer that is not responding to standard treatments, targeted therapies may be used. These drugs specifically target specific molecules or pathways involved in cancer growth to inhibit tumor growth or spread.
How does thyroid cancer affect pregnancy?
Thyroid cancer can impact pregnancy in the following ways:
- Fertility: Certain treatments for thyroid cancer, such as radioactive iodine therapy, can affect fertility temporarily or permanently.
- Pregnancy after treatment: Most women who have successfully treated thyroid cancer can have a healthy pregnancy, but close monitoring of thyroid hormone levels is essential.
- Pregnancy during treatment: It is generally recommended to delay pregnancy until after completing thyroid cancer treatment due to potential risks to the fetus from radiation therapy or certain medications.
- Monitoring and adjustments: Regular monitoring of thyroid hormone levels is important during pregnancy, and dosage adjustments of thyroid hormone replacement medication may be needed.
- Risk of recurrence: The risk of thyroid cancer recurrence during or after pregnancy is generally low but requires close follow-up and surveillance.
What are the signs that thyroid cancer has spread?
When this cancer spreads, it may affect nearby tissues and organs, as well as spread to distant sites in the body. The signs and symptoms can spread, known as metastasis, can vary depending on the specific locations affected. Here are some common signs that this cancer has spread:
- Lymph node enlargement: The first site of the spread of thyroid cancer is often the lymph nodes in the neck. Swelling or enlargement of the lymph nodes can be felt or observed during a physical examination.
- Neck or throat pain: Thyroid cancer that has spread to nearby structures can cause pain or discomfort in the neck or throat area.
- Difficulty swallowing or breathing: As thyroid cancer grows or spreads to the surrounding structures, it can lead to compression or obstruction of the esophagus or trachea, resulting in difficulty swallowing or breathing.
- Hoarseness or voice changes: Thyroid cancer that affects the recurrent laryngeal nerve, which controls the vocal cords, can cause hoarseness or changes in voice.
- Persistent cough or coughing up blood: Thyroid cancer that has spread to the lungs may cause a persistent cough or the coughing up of blood.
- Bone pain or fractures: If thyroid cancer has spread to the bones, it can cause bone pain, particularly in the spine, hips, or other affected areas. In some cases, it may result in bone fractures.
- Fatigue, weight loss, or other systemic symptoms: Advanced thyroid cancer, particularly when it has spread to distant organs, may lead to general symptoms such as fatigue, unexplained weight loss, or a decline in overall health.
What are the thyroid cancer stages?
Thyroid cancer is typically staged based on the extent of tumor growth and spread. The most commonly used staging system is the American Joint Committee on Cancer (AJCC) TNM system, which considers three primary factors: tumor size and invasion (T), lymph node involvement (N), and distant metastasis (M). The stages of thyroid cancer are as follows:
- Stage I: The cancer is limited to the thyroid and has not spread to lymph nodes or distant sites. It is divided into two subcategories:
- Stage IA: The tumor is 2 centimeters (cm) or smaller and is confined to the thyroid.
- Stage IB: The tumor is larger than 2 cm but not larger than 4 cm and is confined to the thyroid.
- Stage II: The tumor is larger than 4 cm but still confined to the thyroid.
- Stage III: This stage is divided into three subcategories:
- Stage III: The tumor has spread beyond the thyroid and invaded nearby tissues or structures, such as the larynx (voice box), trachea (windpipe), or esophagus.
- Stage III: The cancer has spread to nearby lymph nodes.
- Stage III: The tumor has spread to both nearby tissues and lymph nodes.
- Stage IV: This stage is divided into two subcategories:
- Stage IVA: The tumor has spread to nearby structures or invaded the prevertebral fascia, which is the tissue covering the spine.
- Stage IVB: The cancer has spread to distant sites or organs, such as the lungs, bones, or distant lymph nodes.
Is thyroid cancer curable?
Yes, It is often curable, especially when detected early and appropriately treated. The prognosis and likelihood of cure depend on several factors, including the type, stage at diagnosis, age, overall health, and response to treatment.
When should I see my healthcare provider?
You should see a thyroid cancer specialist for thyroid cancer if you experience any of the following:
- Presence of a lump or swelling in the neck
- Changes in voice or hoarseness lasting for more than a few weeks
- Difficulty swallowing or breathing
- Enlarged lymph nodes in the neck
- Personal or family history of thyroid cancer
- History of radiation exposure to the head and neck region
Seeking medical attention allows for proper evaluation, diagnosis, and appropriate management if needed.