Thyroid cancer (patient information)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Ammu Susheela, M.D. [3]; Alison Leibowitz [4]

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The thyroid gland, a butterfly-shaped gland in the neck, produces body-regulating hormones. Thyroid cancer starts in the thyroid gland and manifests without early-stage symptoms. As the cancer further develops, noticeable symptoms begin to arise, such as vocal hoarseness, difficulty swallowing, a lump in the neck, which can be felt through the skin, neck or throat pain, and swollen lymph nodes. Treatment options include surgery, radiation therapy, chemotherapy, and thyroid hormone therapy.

While patients with early thyroid cancer do not present with any symptoms, as the tumor grows larger people may notice one or more of the following symptoms:

• A nodule, lump, or swelling in the neck, which may be perceptible by touch
• Pain in the throat/neck
• Vocal hoarseness
• Difficulty swallowing
• Swollen lymph nodes

• While the exact cause of thyroid cancer is unknown, certain genetic mutations are suspected to be associated with the disease.
• People who have had radiation therapy to the neck area, or as children are at higher risk for developing thyroid cancer. Radiation therapy was commonly used in the 1950’s to treat skin disorders and enlarged thymus gland, adenoids, and tonsils.

Clinical data have suggested that the development of thyroid cancer is related to various factors, such as:

• A diet low in iodine: thyroid cancers are more common in regions characterized by iodine-deficient diets.
• Radiation exposure
• Patients over the age of 45-years

Firstly, a doctor will likely perform a physical exam (noting swollen lymph nodes and lumps in the neck that are perceptible by touch) and review patient medical history. Based upon the physical examination the patient’s self-reported symptoms, the doctor may recommend the following tests:

• Laryngoscopy
• Thyroid biopsy
• Thyroid scan
• Ultrasound of the thyroid

Call your health care provider if symptoms of thyroid cancer develop.

Patients with thyroid cancer have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radioactive iodine, and chemotherapy. In case surgery is not viable, radiation therapy can also be administered.

• Surgery: Surgery is the main treatment for thyroid cancer. Usually, surgery of removing the tumor and all or part of the remaining thyroid gland is recommended.
• Radiation therapy: It includes radioactive Iodine (Radioiodine) therapy and external beam radiation therapy. Radioactive iodine (RAI) known as I-131 can be taken into the body to destroy the thyroid gland and any other thyroid cells including cancer cells. During external beam radiation therapy, the doctors use high-energy rays to destroy cancer cells or slow their rate of growth.
• Chemotherapy: Chemotherapy may be helpful for according to types of thyroid cancer.
• Thyroid hormone therapy: This treatment is to take daily pills of thyroid hormone. The aim is to help maintain the body’s normal metabolism (by replacing missing thyroid hormone) and prevent some thyroid cancers from returning.

Directions to Hospitals Treating thyroid cancer

There are no primary preventive measures available for thyroid cancer, although the following may aid in risk reduction:

• Consuming an adequate amount of iodine
• Avoiding radiation exposure
• Alert doctors of family history

The prognosis of thyroid cancer depends on the following:

• The histological type
• The stage of cancer: the size of the tumor, whether the cancer has spread outside the thyroid gland
• Whether or not the tumor can be removed by surgery
• Patient’s age
• Size of the tumor

• Injury to the voice box and hoarseness after thyroid surgery
• Low calcium levels from accidental removal of the parathyroid glands during surgery
• Spread of the cancer to the lungs, bones, or other parts of the body

https://www.nlm.nih.gov/medlineplus/ency/article/000331.htm