Thyroid Cancer: Symptoms and Treatment

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Thyroid cancer starts in the thyroid gland, located in the front part of the neck. According to the American Cancer Society’s estimated 2017 statistics, nearly 57,000 people will be diagnosed with thyroid cancer and nearly 75% of them will be women. Thyroid cancer has a much lower death rate than most cancers (only about 2,000 of those 57,000 diagnosed) and is normally found at a much younger age than most adult cancers. The diagnosis of thyroid cancer has tripled in the past three decades, but the low death rate has remained steady, due to early detection procedures.

Causes of Thyroid Cancer

The cause of thyroid cancer has not yet been determined. However, several risk factors have been identified. Some of these risk factors can be changed, such as the following:

Low Iodine diet
Radiation exposure
Age
Gender (higher for females)
Smoking
Family history
Hereditary conditions

Symptoms of Thyroid Cancer

Lump in the neck (these are often benign but should always be checked)
Pain or swelling in the neck
Persistent hoarseness or voice changes
Difficulty in breathing or swallowing

Diagnosis of Thyroid Cancer

Thyroid cancer can sometimes be found during a routine exam by your doctor. Other possible steps include the following:

Medical history and physical exam
Blood tests
Imaging tests like thyroid Ultrasound
Laryngoscopy (vocal cord exam)
Thyroid Biopsy

Staging of Thyroid Cancer

The diagnostic tests not only help in making the diagnosis but also in determining the stage of cancer (how far the cancer has spread). Age is a big factor in the staging of thyroid cancer and depends on the type, as listed below:

Differentiated Thyroid Cancer

All patients under age 55 have an excellent chance of survival with this type, so they are always Stage 1 (or 2 if the cancer has distant spread).

For those over age 55:

Stage 1: The cancer is no larger than 4 cm and has not spread to nearby lymph nodes or distant sites.

Stage 2: The cancer is up to 4 cm and has spread to nearby lymph nodes but not distant sites.

OR The cancer is larger than 4 cm but confined to the thyroid or it has grown into the strap muscles around the thyroid. It may or may not have spread to nearby lymph nodes, but not to distant sites.

Stage 3: The cancer is any size and has grown into nearby tissues of the neck (larynx, trachea, esophagus, or the nerve to the larynx). It may or may not be in nearby lymph nodes but has not spread to distant sites.

Stage 4: The cancer is any size and has spread extensively beyond the thyroid (distant lymph nodes, organs, bones).

Undifferentiated Thyroid Cancer is always considered Stage 4.

Medullary Thyroid Cancer

Stage I: Cancer is 2 cm or smaller and has not spread beyond the thyroid.

Stage II: Cancer is 2-4 cm and has not spread to nearby lymph nodes or distant sites. OR

Cancer is bigger than 4 cm and confined to thyroid, or is any size and growing outside the thyroid but not involving nearby structures, nor has it spread to nearby lymph nodes or distant sites.

Stage III: Cancer is any size and might be growing outside the thyroid but has not involved nearby structures. It has spread to lymph nodes in the neck but not to other lymph nodes or to distant sites.

Stage IV: Cancer is any size and has spread into other tissues of the neck (larynx, trachea, esophagus, or nerve to larynx). It may or may not have spread to nearby lymph nodes or distant sites (liver, lungs, bone, or brain).

Treatment of Thyroid Cancer

Treatments options include the following:

Surgery
Radioactive iodine treatment
Thyroid hormone therapy
External beam radiation therapy
Chemotherapy
Targeted therapy

Most of time, thyroid cancer can be cured with one or more of the above treatments.

Prevention of Thyroid Cancer

There is no sure way to prevent thyroid cancer.