What is Thyroid Cancer?
Thyroid gland, which consists of two lobes located on either side of the windpipe, is responsible for releasing three hormones (triiodothyronine or T3, thyroxine or T4 and calcitonin) that affect various functions in the body.
Thyroid cancer is a rare form of cancer that affects the butterfly-shaped thyroid gland. The disorder is first detected as a painless lump or swelling in the neck. Four main types of thyroid cancers exist. These are:
- Papillary carcinoma (most common; affects people below 40 years of age, especially women)
- Follicular carcinoma (generally in older adults)
- Medullary thyroid carcinoma (tendency to run in families)
- Anaplastic thyroid carcinoma (rarest, most aggressive; generally affects older people)
Follicular and papillary carcinomas are sometimes referred to as differentiated thyroid cancers (DTCs), and mostly require similar form of treatment.
What are the main causes?
The exact cause of thyroid cancer is unknown.
However, certain risk factors may increase a person's likelihood of developing it. These include:
- Heredity or faulty gene in family
- Presence of a non-cancerous (benign) thyroid condition
- Exposure to radiation
What one needs to know about symptoms or signs?
Common symptoms of thyroid cancer include:
- Painless lump in the throat
- Unexplained hoarseness in voice
- Difficulty in breathing and swallowing
- Pain in the neck
- Swollen lymph nodes in the neck
Which specialist should be consulted in case of signs and symptoms?
On experiencing any of the signs and symptoms related to thyroid cancer, an affected person must consult a general practitioner. If a thyroid problem is suspected, the doctor will refer the person to an endocrinologist, a specialist in treating disorders of the endocrine system.
What are the screening tests and investigations done to confirm or rule out the disorder?
Thyroid cancer is diagnosed through the following tests:
- Physical exam- The doctor will examine the neck for any lumps in the thyroid and swelling of lymph nodes.
- Blood tests - An overactive thyroid gland (hyperthyroidism) or underactive thyroid gland (hypothyroidism) condition can be detected by measuring the levels of thyroid-stimulating hormone (TSH) in the body using a thyroid function test.
- Imaging tests- An ultrasound of the neck can describe the nature of the nodule and detect enlarged lymph nodes.
- Fine needle aspiration cytology or FNAC (biopsy)- A small needle is inserted into the lump in the neck to draw out a sample of cells from the area. The cells are studied under the microscope to detect the presence and type of thyroid cancer cells.
What treatment modalities are available for management of the disorder?
Most cases of thyroid cancer can be treated, though the type of treatment depends on the stage of cancer and the patient's overall health. Options include:
- Surgery - The most common surgical method involves removing all or most of the thyroid (thyroidectomy), leaving small amount of tissue near the parathyroid gland. The surgeon may also remove enlarged lymph nodes during the surgery for testing them in laboratory for presence of cancerous cells.
- Replacement hormone therapy- A hormone medication is prescribed post surgery to supply the body with the missing thyroid hormone in absence of the removed gland. The medication also suppresses the production of thyroid stimulating hormone (TSH) that could stimulate any remaining cancer cells to grow.
- Radioactive iodine treatment- A course of radioactive hormone can destroy any remaining cancer cells in the body.
- External radiation therapy- High-energy beams are directed at specific points in the body to kill cancerous cells.
- Chemotherapy - Drugs are used to treat cancer, generally in cases when it has spread to other body parts.
What are the known complications in management of the disorder?
There is a risk of cancer returning even after years of surgery and radioactive iodine treatment.
What are the dietary and physical activity requirements during the course of the treatment?
Recovering patients must pay close attention to their diet during and after treatment. They will be asked to maintain a low iodine diet few weeks before the start of radioactive treatment.
Is there any risk to other family members of having the disorder?
The medullary thyroid carcinoma has a tendency to run in families and family members of a patient suffering from it may be at risk if they carry the same faulty gene.
How can the disorder be prevented from happening or recurring?
There's no way to prevent thyroid cancer from occurring but people who have recovered from it must attend regular check-ups to help treat any returning cancer at the earliest.
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