The thyroid is located in the front side of the neck. When you swallow, your thyroid gland rises and becomes more visible.
Thyroid Cancer Symptoms
Early thyroid cancer may cause few symptoms. As it grows, however, you may develop:
Pain in your neck or throat
Enlarged thyroid (goiter) or swelling in your neck
Difficulty swallowing or a feeling of food stuck in your throat
Swollen lymph nodes in your neck
Changes in your voice, including hoarseness
Diagnosing Thyroid Cancer
Your doctor may use one or more of the following methods to determine if you have thyroid cancer:
Physical exam: Your doctor will perform a physical exam that involves palpitating the neck and feeling for lump, bumps or asymmetry.
Family history: You and your doctor will discuss any family history of cancer or endocrine-related (hormone) conditions.
: Your doctor will biopsy the area to gather more information, usually with a needle. A fine-needle aspiration biopsy is commonly used to determine your thyroid tumor type prior to surgery.
: This imaging technology is used to detect any abnormalities or nodules felt in the neck, thyroid or lymph nodes. Abnormalities include growths or asymmetry of your thyroid or enlarged lymph nodes surrounding the gland.
: This diagnostic imaging procedure is used to create detailed images of the body, specifically the thyroid and surrounding structures. It may be used if your doctor needs additional information beyond what can be determined from the ultrasound.
: These tests are used to determine how well the thyroid is functioning. Other blood tests are ordered to aid in the diagnosis of cancer, such as thyroglobulin levels and thyroglobulin antibodies.
: Fiber-optic laryngoscopy involves placing a small, thin camera down the nose to view the larynx (voice box) and the surrounding area for abnormalities, such as motion impairment or growths.
Thyroid Cancer Treatment
Once you’ve been diagnosed with thyroid cancer, your doctor will design a custom treatment plan that may include one or more of the following:
Surgery: This is the most common treatment for thyroid cancer. It may involve the partial or total removal of the thyroid and surrounding lymph node tissue.
: This type of therapy uses X-rays, gamma rays and charged particles to fight cancer. Radioactive iodine is a common treatment for removing any remaining thyroid cells. This form of radiation is delivered by mouth in the form of a pill and collects in any remaining thyroid tissue.
: This treatment may infrequently be used to stop the growth and spread of thyroid cancer.
: This treatment involves using medicines that are designed to turn off the ability of the cancer cells to grow and spread.
Thyroid hormone replacement therapy
: This treatment replaces thyroid hormones after the removal or inactivation of the thyroid. Thyroid hormone is necessary, but various replacements are available.
: This treatment approach uses drugs and vaccines to harness the immune system’s natural ability to fight cancer. A few immunotherapy drugs have been approved for second-line therapy in advanced head and neck cancer, and investigators are testing other drugs and treatment combinations in clinical trials.
Types of Thyroid Cancer
Thyroid cancer is classified by its appearance under the microscope, including the use of specialized stains and other techniques. In general, the type of thyroid cancer can be helpful to understand both the appropriate treatment and also to project prognosis.
Papillary Thyroid Carcinoma
Papillary thyroid cancer, the most common type of thyroid cancer, usually grows slowly but can spread to lymph nodes. This type of cancer can be readily cured with appropriate treatment and is rarely fatal. About 80 percent of thyroid cancers are papillary cancer. This type of cancer arises as an irregular, solid or cystic mass that comes from otherwise normal thyroid tissue.
Follicular Thyroid Carcinoma
Follicular thyroid cancer, which originates from follicular cells, is the second most common type of thyroid cancer. It is uncommon for this type of thyroid cancer to spread to the lymph nodes, but invasion of the veins and arteries within the thyroid gland is more common. Several additional details, including size of the tumor and its behavior with respect to the surrounding tissues, can provide clues to the prognosis.
Medullary Thyroid Cancer
Medullary thyroid cancer, an uncommon type of thyroid cancer, can have a genetic predisposition as part of familial medullary thyroid cancer or multiple endocrine neoplasia syndrome. This type of cancer accounts for about 3 percent of all thyroid cancers. Unlike papillary thyroid cancer and follicular thyroid cancer that arise from thyroid hormone-producing cells, medullary thyroid cancer originates from the parafollicular cells (also called C cells) of the thyroid. Prognosis for this type of thyroid cancer is determined by how much the cancer has spread at the time of diagnosis and treatment. It is common for medullary thyroid cancer to have spread by the time it is first diagnosed. In addition to the normal thyroid lab tests, calcitonin and carcinoembryonic antigen, also known as CEA, can also be used to predict if the cancer has spread. Additional imaging of the chest and abdomen may be needed prior to surgery to determine if other tumors are present.
Anaplastic Thyroid Carcinoma
Anaplastic thyroid carcinoma is a rare but extremely aggressive form of thyroid cancer. When it is diagnosed early, surgery can be combined with chemotherapy and radiation therapy.
Thyroid Cancer Prognosis
According to the National Institutes of Health (NIH), approximately 1.1 percent of men and women will be diagnosed with thyroid cancer at some point during their lifetimes in the United States. Fortunately, very few people will ultimately die of thyroid cancer. With the right treatment in a timely fashion, thyroid cancer can be overcome and patients can lead normal lives.
Reviewed by Jonathon Russell, M.D., from the Department of Otolaryngology-Head and Neck Surgery
A New Type of Surgery on the Thyroid Gland Is Now Available in the US, Elizabeth Tracey Reports
Surgery on the thyroid gland to evaluate masses that might be cancerous is very common, but unfortunately, it leaves a scar right across the front of the neck. Now, a new approach avoids leaving a scar. Jon Russell, M.D., a head and neck surgeon at Johns Hopkins who utilizes this approach, says patients appreciate this.