Thyroid Cancer

ExitCare ImageThe thyroid gland is a butterfly-shaped gland in the middle of the neck, located just below the voice box. It makes thyroid hormone. Thyroid hormone has an effect on nearly all tissues of your body by regulating your metabolism. Metabolism is the breakdown and use of food that you eat or energy that is stored in your body. Your metabolism affects your heart rate, blood pressure, body temperature, and weight.

Thyroid cancer occurs when cells in your thyroid gland begin to form abnormally (mutate). This mutation allows the abnormally formed cells to grow and multiply rapidly. These abnormal cells do not die as normal cells do. The accumulation of these abnormal cells forms a cancerous tumor.

There are 4 main types of thyroid cancer:

  1. Papillary cancer. This is the least harmful type of thyroid cancer. Typically, it affects women of child-bearing age. It can be caused by exposure to radiation.

  2. Follicular cancer. Follicular cancer accounts for about 20% of all thyroid cancers and is more likely to recur (come back after treatment) and spread.

  3. Medullary cancer. Although most thyroid cancers are not passed down through the genes of family members (genetic), this type of thyroid cancer can be inherited. If your family members have this gene for this cancer, you can be tested for it. This cancer develops in most people who have this gene.

  4. Anaplastic cancer. This is the rarest and most harmful (malignant) type of thyroid cancer. It spreads quickly to structures such as your windpipe (trachea), causing compression of your trachea and breathing difficulties. It is such an aggressive type of cancer that it is difficult to completely get rid of. Anaplastic thyroid cancer is more common in people 65 years old or older.

RISK FACTORS

  • Radiation exposure or radiation treatments to your head and neck during infancy or childhood.

  • Enlarged thyroid.

  • Family history of thyroid disease.

  • Female sex.

  • Asian race.

SYMPTOMS

  • Enlargement of your thyroid gland or lumps or swelling in your neck.

  • Hoarseness or a change in your voice.

  • Cough or coughing up blood.

  • Difficulty swallowing.

  • Shortness of breath if your trachea is compressed.

DIAGNOSIS

Your caregiver will physically examine your thyroid. If a lump is found, an ultrasound test may be done. Your caregiver may order blood tests to see if a lump is causing your thyroid to make too much thyroid hormone. Sometimes a biopsy is performed. This is the removal of a small piece of tissue for examination under a microscope by a specialist (pathologist). This is often done with a very fine needle. The pathologist can tell if the tissue sample contains cancer.

TREATMENT

Some types of thyroid cancer grow faster than others. The success of treatment depends on the type of thyroid cancer, whether it has spread to other parts of the body, and the patient's age and overall health. Most thyroid cancers can be treated successfully.

Typically, removal of most or all of the thyroid gland (thyroidectomy) is the course of treatment for most thyroid cancers. In some cases it is necessary to remove lymph nodes in the neck that are close to the thyroid. Often, follow-up procedures are necessary to ensure that all the cancer is eliminated and to keep it from recurring. These procedures include:

  • Thyroid hormone therapy. This can be done by taking a pill. This medication serves 2 purposes:

  • It replaces the hormone in your body that is normally made by your thyroid.

  • It suppresses a thyroid stimulating hormone, a hormone that activates your thyroid but also makes any remaining cancer cells grow.

  • Radioactive iodine treatment. This treatment often is used to destroy any remaining thyroid tissue and cancerous tissue that could not be seen and was not removed during the thyroidectomy. This treatment also may be used to treat thyroid cancer that has spread to other parts of the body or has recurred.

  • External radiation. This typically is used to treat thyroid cancer that has spread to your bones. The treatment is administered a few minutes at a time, 5 days per week, for 5 to 6 weeks.

PREVENTION

In some people who have the gene linked to medullary cancer, thyroidectomy is done to prevent cancer from developing.