What
is thyroid cancer and its symptoms?
Thyroid cancer is the most common endocrine-related cancer. The
outlook for patients with thyroid cancer is excellent in that safe
and effective therapy is available in most cases. A lump (nodule)
in the thyroid is the key sign of its presence. Most thyroid cancers
do not cause any symptoms, and only rarely do they cause pain, difficulty
in swallowing, or hoarseness. |
How is thyroid cancer
diagnosed? A diagnosis of thyroid cancer is made on the basis
of a biopsy of a thyroid nodule or after the nodule is removed during
surgery. Although thyroid nodules are very common, less than 1 in
10 harbor a thyroid cancer.
What are the types of thyroid cancer?
Papillary thyroid cancer is the most common type of thyroid
cancer (70% to 80% of thyroid cancers) and can occur at any age.
Follicular thyroid cancer (10% to 15% of thyroid cancers) tends
to occur in somewhat older patients than papillary cancer. Medullary
thyroid cancer (5% to 10% of thyroid cancers) is more likely to
run in families and may be diagnosed by genetic testing. Anaplastic
thyroid cancer (less than 5% of thyroid cancers) is the least likely
to respond to treatment. |
What
is the treatment of thyroid cancer?
- Surgery. The primary therapy for patients with thyroid cancer
is surgery, which is followed by thyroid hormone therapy for the
rest of their life. Radioactive iodine may be used as a “magic
bullet” to destroy thyroid cancer cells after surgical removal
of the thyroid gland.
- Radioactive iodine therapy. For radioactive iodine to be effective,
high levels of TSH need to be produced in your body. To reach
this goal, you will stop taking your thyroid hormone pills and
become hypothyroid for a time. A low iodine diet may also help
raise the TSH. Once the TSH level is high enough, a whole body
iodine scan is done. If enough cells show up, a large dose of
radioactive iodine (I131) is given, and then the thyroid
pills are re-started. Radioactive iodine is usually well-tolerated,
with few side effects.
What is the follow-up for thyroid
cancer patients?
Periodic follow-up examinations are essential for all thyroid
cancer patients and include a careful history, physical examination,
and blood tests to measure the levels of TSH, T4 and thyroglobulin,
which is a thyroid cancer marker. Your doctor may want to repeat
every so often a whole body iodine scan to determine if any thyroid
cells remain in the body. This can be done by having you stop your
thyroid hormone and become hypothyroid (see above) or by giving
you Thyrogen™ (synthetic human TSH) injections.
What is the prognosis of thyroid
cancer?
Overall, the prognosis of thyroid cancer is very good, especially
for patients younger than 40 years of age and those with small tumors.
Most of these patients can be cured. Even those patients who are
unable to be cured of their thyroid cancer can live a long time
and feel well despite their cancer.
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