Cancer that begins in the thyroid cells is called thyroid cancer. This is a butterfly-shaped organ located at the neck base below the Adam’s apple and it produces important hormones that help regulate multiple body functions including heart rate, blood pressure, body temperature, and others. In most cases, this cancer type does not cause any symptoms in the beginning, which makes it difficult to diagnose it. Most people experience symptoms when it grows as causes swelling in the neck, voice changes, and swallowing problems.
There are multiple types of thyroid cancers. While most types of this cancer grow slowly, some of them are aggressive and may cause major health problems. Furthermore, most thyroid cancer types can be cured with treatment (including surgery and medicines).
Nowadays, the cases of thyroid cancer tend to increase but it may be due to good imaging technology that may identify even a small thyroid cancer accidentally. Thyroid cancers usually are found in the early stages during imaging tests for other health conditions.
Symptoms
Usually, thyroid cancer does not cause any symptoms until it goes into an advanced stage. Check below some symptoms that may occur in people with this cancer type:
- A lump (nodule) in the neck that can be felt through the skin
- Swallowing problems
- Lymph nodes swelling
- Pain in the throat and neck
- Voice changes (such as hoarseness)
- Feelings that close-fitting shirt collars become too tight
Immediately visit your healthcare professional if any of the previous symptoms appear.
Causes
All cancer types usually begin to appear when cells of specific organs or tissues develop DNA changes. Thus, DNA gives different instructions to the cells, which makes them grow and multiply quickly. In such cases, DNA mutations (changes) happen in the thyroid gland cells. Furthermore, abnormal cells can invade healthy ones and destroy them and when they become too much, they form a mass called a tumor. If the tumor becomes too large, it may break and invade nearby tissues (such as lymph nodes) as well as other body organs (such as the lungs) and structures. In any case, healthcare providers do not fully understand why it happens.
Thyroid Cancer Types
Physicians classified this cancer type into different types according to the involved cell type. To determine which type of thyroid cancer you experience, doctors will perform a biopsy (take a small sample of the affected tissues and send it to the laboratory for testing). Check below some examples:
Differentiated Thyroid Cancers
In such cases, the cancer begins to develop in the cells that produce and store hormones of the thyroid gland. These cells are known as follicular cells and they are similar to healthy cells when viewed under a microscope.
- Papillary thyroid cancer – Usually, this cancer type negatively affects people between 30 and 50 years old but may happen at any age as well. It is the most common thyroid cancer type and it often is small and responds to treatment quite well even if spread to nearby tissues (such as lymph nodes).
- Follicular thyroid cancer – This is a rare form of thyroid cancer and it mostly happens in people over 50 years old. While mild forms of follicular thyroid cancer do not spread to nearby lymph nodes or other body structures, there are some aggressive forms that may spread to other body parts (such as bones, lungs, and others).
- Hurthle cell thyroid cancer – This thyroid cancer type also happens rarely and previously was considered a follicular thyroid cancer type. Nowadays, it is considered apart because it responds differently to treatments.
- Poorly differentiated thyroid cancer – This is one of the aggressive forms of thyroid cancer and it usually does not respond to treatment like other thyroid cancer types.
Other Thyroid Cancer Types
- Anaplastic thyroid cancer – This form of thyroid cancer often develops quickly and may be challenging to treat. In any case, there are several treatments that may help slow down the cancer progression. It commonly appears in people over 60 years old and may cause neck swelling, breathing or swallowing problems, and others.
- Medullary thyroid cancer – This cancer type begins in the thyroid gland cells called C cells responsible for producing Calcitonin. If you have high levels of Calcitonin in the blood, it may be diagnosed early by performing a blood test. Sometimes, this cancer type happens due to an abnormal gene (RET gene) that passes from biological parents to biological children.
- Other thyroid cancer types – Other cancers begin in the thyroid gland but they happen quite rarely. For example thyroid lymphoma, thyroid sarcoma, and others.
Risk Factors
While it is not possible to determine the exact cause of thyroid cancer, doctors identified some factors that may increase your risk of developing it. For example:
- Sex – Women are more prone to develop thyroid cancers than men because they have more Estrogen than males.
- Exposure to increased radiation levels – People who experience radiation therapy, especially to the head or neck are at increased risk of developing thyroid cancer.
- Inherited genetic syndromes – Certain genetic syndromes also may elevate your risk of developing thyroid cancer including familial medullary thyroid cancer, multiple endocrine neoplasia, Cowden syndrome, and familial adenomatous polyposis.
What Are The Possible Complications of Thyroid Cancer?
People who have this cancer type may develop some complications, especially if they do not respond to treatment or even do not get it. For example:
Recurrence of the Thyroid Cancer
This cancer type may return nonetheless successful treatment or if the thyroid gland is removed. It commonly occurs because some cancer cells may remain even after treatment or thyroidectomy (surgery to remove the thyroid gland).
However, there is an increased chance of cancer recurrence if you have had an aggressive form or it grows too large and spreads throughout the body. Anyway, recurrent thyroid cancer has a good prognosis, and commonly people get rid of it with treatment. Moreover, the thyroid cancer that returns may happen in the nearby neck lymph nodes, small thyroid pieces that may remain after surgery, or other body parts (such as lungs, bones, and others).
That’s why it is advised to have regular checkups with your doctor after treatment for thyroid cancer. When it comes back, people may experience the following symptoms. These include a lump in the neck, swallowing problems, neck pain, and voice changes (such as hoarseness).
Metastasize
When the tumor grows too large, it may break and spread throughout the body. This process is called metastasizing. First, it spreads to nearby lymph nodes and without treatment may go in the whole body. Check below locations where thyroid cancer may spread:
- Brain
- Skin
- Bones
- Lungs
- Lymph nodes in the neck
- Liver
Healthcare providers, usually determine the thyroid cancer that metastasizes by performing imaging tests.
How to Prevent Thyroid Cancer?
Physicians do not know a sure way to thyroid cancer because they cannot identify the exact cause. However, if you are at increased risk of developing thyroid cancer due to inherited genes, you can consider thyroidectomy.
People who live near nuclear power plants may take some medicines that block the effect of the radiation on the thyroid gland. Doctors usually recommend potassium iodide for people who are continuously exposed to radiation.
Diagnosis
To diagnose this cancer type, physicians usually perform the following tests and procedures. For example:
- Physical examination – Physicians perform this procedure to check for thyroid gland abnormalities (such as nodules (a lump) in the gland).
- Thyroid function blood tests – Doctors usually perform blood tests to check thyroid gland function.
- Ultrasound imaging – This test uses sound waves to produce images of the thyroid gland. It helps doctors understand better if the nodules in the thyroid gland are cancerous or not. However, additional tests to confirm thyroid cancer are needed.
- Biopsy – This is a test in which doctors get a small sample of the affected tissue and send it to the laboratory to check for cancer cells.
- Other imaging tests – Sometimes, healthcare professionals may perform additional imaging tests to determine whether cancer spreads or not. These include ultrasound, CT (computerized tomography) scan, or MRI (magnetic resonance imaging) scan.
- Genetic testing – This test is often performed to check for abnormal genes, especially if you are diagnosed with medullary thyroid cancer.
In most cases, additional tests are required to determine the extent (stage) of the cancer.
Treatment
The treatments prescribed by doctors for people with thyroid cancer are usually different because they depend on several factors. These include the stage of cancer, existing health problems, and your age and preferences. In any case, approximately all people with this cancer type have a good prognosis, which means they are successfully cured.
In some cases, people do not require treatment, especially if they have small papillary thyroid cancers because they do not grow or spread. However, you should have regular checkups with your healthcare professional (such as neck examinations, blood tests, and ultrasound once or twice per year).
Surgery
Approximately all people with thyroid cancer require surgery to remove a part or even all of the thyroid gland. However, there are different surgeries and which one is best for you will be determined by your doctor. Check below some surgery types used in people with this cancer type:
- Thyroidectomy (surgery to remove all or most of the thyroid gland) – During this procedure, physicians usually leave a small amount of thyroid tissue around the parathyroid glands to prevent damage. Parathyroid glands are responsible for controlling calcium levels in the blood. Sometimes, these small pieces of the thyroid gland may contain cancerous cells, which may lead to thyroid cancer recurrence.
- Thyroid lobectomy – This surgery type is often recommended for people with slow-growing cancer and without suspicious nodules. Surgeons usually remove half of the thyroid gland during lobectomy.
- Lymph node dissection (removal of the lymph nodes located in the neck) – This surgery is required for people whose thyroid cancer spreads to the nearby lymph nodes. However, before this procedure, doctors may perform an ultrasound or remove some lymph nodes and send them to the laboratory for testing.
However, thyroidectomy carries certain risks including bleeding, infection, and damage to the parathyroid glands. In some cases, people who experience this surgery may notice vocal cords not working properly causing hoarseness and voice changes. However, this problem can be reversed with treatment.
In addition, you should have some blood tests to determine if the cancer is removed. These blood tests usually measure levels of thyroglobulin, calcitonin, and carcinoembryonic antigen.
Thyroid Hormone Therapy
Most people require thyroid hormone replacement after a complete thyroidectomy. However, the amount of people who require this treatment option after lobectomy is quite low. Healthcare professionals commonly prescribe a medicine that comes in a pill or tablet form to replace thyroid hormones after surgery or suppress the cancer cells that begin to grow in the thyroid gland.
Radioactive Iodine
This treatment option uses a radioactive iodine form to destroy cancer cells that remain after surgery or to reduce the risk of spreading cancer to other body parts. However, this treatment option is not good for all thyroid cancer types. For example differentiated thyroid cancers (including papillary, follicular, and Hurthle cell are more likely to respond to this treatment. Furthermore, this treatment may give you some adverse reactions including altered taste or smell, mouth pain, inflammation of the eyes, or dry mouth.
Treatments for People with Advanced Thyroid Cancer
- Targeted drug therapy – This treatment option is used in people with severe thyroid cancer forms. It works by blocking specific chemicals in the cancer cells causing them to die.
- Radiation therapy – This treatment option uses powerful energy beams that come from different sources (such as X-rays) to destroy cancer cells. It is often recommended by doctors when other treatments do not work.
- Chemotherapy – It involves strong medications given intravenously (IV) to destroy cancer cells throughout the body. In some cases, doctors may prescribe chemotherapy along with radiation therapy.
Frequently Asked Questions
What is the survival rate for thyroid cancer?
Approximately 100% of people have a 5-year survival chance when the cancer does not spread to other body organs or structures. However, the survival rate is near 80% even if the cancer metastasizes.
Can thyroid cancer be cured?
Yes, most of the thyroid cancers are successfully cured with treatment. In any case, the cancer may return or negatively affect other body parts (such as bones or lungs). Discuss with your healthcare provider for more details.
What are the possible complications of thyroid cancer?
People with this cancer type may develop some complications. For example:
- Reduced calcium levels due to parathyroid gland damage or removal
- Damage to the voice box
- Blood clots
- Bleeding
- Infections
- Lung issues
- Cancer recurrence
If any of the previous complications occur, immediately visit your healthcare professional. Ask your doctor if you have additional questions.
