Thyroid Cancer

Thyroid cancer is an abnormal growth of cells in the thyroid gland, located at the base of your throat. It is a type of cancer where cells in the thyroid gland grow uncontrollably. This gland is located in the neck, just below the voice box, and has a butterfly shape with two lobes connected by tissue. It plays a vital role in regulating metabolism, growth, and maturation by releasing hormones into the bloodstream.

According to the National Cancer Institute (NCI), thyroid cancer is the 12th most common cancer in the United States, affecting approximately 13.9 people per 100,000 each year.

Types of Thyroid Cancer

There are four main types of thyroid cancer, each with varying characteristics:

• Papillary carcinoma: This is the most common type, usually growing slowly and often spreading to the lymph nodes in the neck. However, it’s usually very treatable.
• Follicular carcinoma: This type can spread to other parts of the body beyond the lymph nodes. While the outlook is less favorable than papillary carcinoma, it’s still generally treatable.
• Anaplastic carcinoma: This is the rarest and most aggressive form of thyroid cancer, spreading quickly and being difficult to treat.
• Medullary carcinoma: This type arises from different cells in the thyroid and makes up a small percentage of all thyroid cancers.

Thyroid cancer is relatively common, accounting for about 2.2 percent of all new cancer cases in the United States, with an estimated 44,000 new cases in 2023, as reported by the National Cancer Institute (NCI). Over the past two decades, the number of cases has nearly doubled, largely due to improved detection methods like computed tomography (CT) scans.

Notably, women are three times more likely than men to develop thyroid cancer, and around two-thirds of new cases occur in individuals aged 20 to 65, with a peak diagnosis rate between ages 55 and 64, typically at around 51 years old. Additionally, individuals of Asian descent are more prone to thyroid cancer compared to other ethnic groups.

Risk Factors

Certain factors can increase your risk of developing this abnormal cell growth, including:

• Age (more common between 20-65)
• Gender (women are more susceptible)
• Race (more common in Asian descent)
• Family history of thyroid cancer
• Radiation exposure to the neck area
• Certain genetic conditions

Thyroid cancer exhibits noticeable signs and symptoms, making early detection and treatment possible. These signs include a lump in the neck, which may grow rapidly, along with neck swelling, persistent coughing unrelated to colds, difficulty swallowing or breathing, pain in the neck extending to the ears, hoarseness, or voice changes.

While some cases may not initially display symptoms, as the tumor grows, symptoms become more apparent. It’s crucial to note that other health conditions may present symptoms similar to thyroid cancer, emphasizing the importance of medical evaluation for proper diagnosis and treatment.

Signs and Symptoms

Early detection is crucial for successful treatment. Here are some signs and symptoms to watch out for:

• Lump in the neck, especially if growing quickly
• Difficulty swallowing or breathing
• Hoarseness or voice changes
• Neck pain or swelling
• In some cases, no initial symptoms are present

Diagnosis

Detecting thyroid cancer typically begins with a thorough assessment of your symptoms and medical history by your doctor, including any familial predispositions to the disease. During a physical examination, your doctor will carefully palpate your thyroid gland and the lymph nodes in your neck to check for any abnormalities or signs of cancer spread.

If there are suspicions of this abnormal cell growth, your doctor or a specialist may recommend several tests:

1. Laryngoscopy: This involves inserting a thin, flexible tube with a camera into your throat to check for any tumors pressing on the vocal cords.
2. Neck ultrasound: This imaging test helps determine if any nodules or lumps in the thyroid are solid or fluid-filled, with solid nodules being more likely to be cancerous.
3. CT scans: These cross-sectional X-ray images help locate and measure thyroid cancers accurately.
4. MRI: Magnetic resonance imaging provides detailed images of the thyroid gland.
5. PET scans: Positron emission tomography scans are used to detect the spread of thyroid cancer throughout the body, usually conducted after a diagnosis.
6. Blood tests: These measure hormone levels like thyroid-stimulating hormone (TSH), T3, and T4 to assess thyroid function. Additionally, markers such as elevated calcitonin levels may indicate medullary carcinoma, a type of thyroid cancer.

To confirm a diagnosis, a biopsy is essential. In a fine-needle aspiration biopsy, a specialist inserts a thin needle into the thyroid gland to collect tissue samples from various areas. If the results are inconclusive, a surgical biopsy may be necessary. This more invasive procedure involves either a core biopsy, where a larger needle is used to extract tissue, or an open biopsy, where a portion of the thyroid or a thyroid nodule is removed surgically for further examination under a microscope.

Treatments for thyroid cancer

Thyroid cancer boasts an impressive survival rate, with approximately 99 percent of patients surviving at least five years after diagnosis, as reported by the National Cancer Institute (NCI). This high rate is largely attributed to early detection, with around 68 percent of diagnoses occurring while the cancer remains localized within the thyroid gland.

Treatment options for this abnormal cell growth vary depending on the type and stage of the cancer. Here are the main approaches:

1. Surgery: Surgery is the primary treatment for thyroid cancer, except in cases of aggressive types like anaplastic carcinoma. Depending on the extent of the cancer, the surgeon may perform either a lobectomy, removing only one lobe of the thyroid gland, or a thyroidectomy, removing the entire gland. In some cases, lymph nodes in the neck may also be removed if they are affected. Potential side effects of surgery include temporary or permanent voice hoarseness, low blood calcium levels, bleeding, and infections. Additionally, patients may need to take daily thyroid hormone pills after a thyroidectomy.

2. Radiation Therapy: Radiation therapy may be used alongside surgery to eliminate any remaining cancer cells. This involves directing high-energy X-rays or other radiation types to the affected area. Alternatively, radioactive iodine therapy may be employed, where radioactive iodine is ingested, and the thyroid gland absorbs it, destroying cancer cells. Side effects of radiation therapy include fatigue, skin changes, and throat issues such as difficulty swallowing.

3. Medication-Based Therapies: Medications may be prescribed for certain cases of thyroid cancer. Thyroid hormone therapy can help slow cancer growth by suppressing the production of thyroid-stimulating hormone. Chemotherapy may be used for advanced cases that have spread to other parts of the body, but it often comes with side effects such as hair loss and fatigue. Targeted therapy, a newer form of chemotherapy, targets specific molecules in cancer cells to inhibit their growth.

Each treatment option has its benefits and potential side effects, and the most suitable approach depends on factors like the cancer stage, type, and individual patient circumstances.

Living with Thyroid Cancer

The survival rate for this abnormal cell growth is very high, especially when detected early. With proper treatment and follow-up care, many people with thyroid cancer live long and healthy lives.

Additional Resources:

• National Cancer Institute: https://www.cancer.gov/
• American Cancer Society: https://www.cancer.org/
• American Thyroid Association: https://www.thyroid.org/