Thyroid cancer occurs when the cells of the thyroid gland begin to grow abnormally. Thyroid cancer is more common among women than men. Initially, it may not have any symptoms. However, as the disease progresses, it may cause symptoms, such as pain and swelling in the neck region. About 90% of thyroid tumours are reported to be benign.
Although the incidence of thyroid cancer is on the rise in recent years, it is one of the cancers with excellent survival rates.
There are multiple types of thyroid cancers; some are aggressive, while some progress slowly.
Other rare types of thyroid cancers include thyroid lymphoma and thyroid sarcoma.
Early on, thyroid cancers may not show any symptoms. However, as the disease progresses, it can lead to the following symptoms:
In recent years, researchers have identified a few key risk factors that are strongly associated with thyroid cancer, and they are:
Most of the thyroid lumps are non-cancerous. However, it is not wise to ignore them. If there is any lump or swelling or pain in the neck region that lasts for more than two weeks, it is important to consult a specialist. Following are the common test methods used for detection and diagnosis of thyroid cancers:
a. Physical Exam:The doctor examines the thyroid gland for lumps (nodules). He/she may also look for abnormal growths or swelling in the neck and adjacent lymph nodes.
b. Blood Tests:Thyroid-Stimulating Hormone (TSH) levels in the blood may be checked if thyroid problems are suspected. TSH levels that are too high or too low indicate that the thyroid is not functioning properly.
c. Ultrasound Scan:To get clear images of the thyroid gland and surrounding tissues, an ultrasound scan may be indicated. Thyroid nodules that are too tiny to feel can be seen in this image. The majority of nodules that are filled with fluid are not cancerous. Solid nodules could be cancerous.
d. Thyroid scan:During a thyroid scan, the patient is made to swallow a small amount of radioactive substance, which is usually radioactive iodine; this is ingested and carried through the bloodstream. On a scan, the thyroid cells, which absorb the radioactive substance, can be seen easily. Those tissues that absorb the radioactive substance in larger quantities appear as bright spots and are called hot nodules. The majority of these hot nodules are not cancerous; however, they may also indicate thyroid cancer in a few cases. Further tests may be recommended for definitive diagnosis.
e. Biopsy:One way to obtain a definitive diagnosis of thyroid cancer is through a biopsy. A pathologist examines a sample of thyroid tissue under a microscope for cancer cells.
Thyroid cancers are usually treated with a multimodal approach. At HCG, we have a multidisciplinary team that carefully studies the patient’s health condition and accordingly devises the best suitable treatment plan, which could either involve one or more treatment modalities.
a. Surgery:Surgery involves the removal of the tumour along with a small portion of healthy tissue (margin) around it. Various surgical options available for thyroid cancer are:
If the thyroid cancer has spread to nearby lymph nodes, they may be removed as well.
b. Thyroid Hormone Therapy: Thyroid hormone therapy is a hormone replacement treatment wherein synthetic thyroid hormones are administered to improve the abnormally low levels of natural thyroid hormones. Thyroid hormone therapy, which is usually given in pill form, is essential to maintain the bodily functions that are regulated by the thyroid hormones. This treatment is recommended after the surgery.
c. Radioactive Iodine (Radioiodine) Therapy:Radioactive iodine therapy is a form of radiation therapy wherein a radioactive isotope of iodine is given to kill the tumour cells. Radioactive iodine treatment is usually given after surgery to kill the residual cancer cells. The radioiodine is administered either in liquid or pill form.
d. External Beam Radiation Therapy:During radiation therapy, high-energy radiation beams are used to target the tumour precisely and destroy the cancer cells. Here, radiation is delivered from an external source (a linear accelerator), unlike radioactive iodine therapy. Usually, radiation therapy is given after the surgery to enhance the effectiveness of the overall treatment.
e. Chemotherapy:Chemotherapy uses powerful drugs to destroy cancer cells. These drugs travel throughout the body and kill the cancer cells wherever they are present. In the case of thyroid cancer, chemotherapy is recommended when cancer has metastasized. Chemotherapy can be administered both orally and intravenously. It may also be recommended to ease pain and other symptoms caused by the disease in terminally ill patients.
Thyroid cancer is one of the highly treatable cancers with excellent survival rates. However, the disease prognosis depends on the stage at which the disease is diagnosed. Early-stage thyroid cancers have relatively higher survival rates with excellent quality of life when compared to advanced-stage thyroid cancers.
Therefore, it is important to not ignore any lump, swelling or pain in the neck region that lasts for more than two weeks.
Although thyroid cancers can be successfully treated, stringent follow-up care is necessary since most thyroid tumours grow slowly and can relapse even after 10 to 20 years. A thorough history and physical examination, with special attention to the neck area, as well as specific blood tests and other testing methods, are all recommended during follow-up visits. These follow-up visits aid in the prevention and early detection of relapse.
If left undiagnosed in early stages, thyroid cancers can spread from the thyroid gland to nearby lymph nodes and surrounding organs, such as the esophagus and windpipe. In advanced stages, these cancers can potentially migrate to the lungs or bones, too.
No, hyperthyroidism or an overactive thyroid gland does not always indicate thyroid cancer. However, a few studies have found that a small percentage of thyroid cancer patients have a history of benign thyroid conditions.