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What is thyroid?

thyroid gland illustration 

Illustration of thyroid gland

The thyroid is a butterfly-shaped gland in the neck, just above the collarbone. Thyroid is a part of the endocrine system. The thyroid gland makes hormones that help the body work normally. It plays a major role in regulating the body`s metabolism.

What is thyroid cancer?

Thyroid cancer is a cancerous growth of the thyroid gland.

Types of thyroid cancer

There are several types of thyroid cancer:

  • Papillary thyroid cancer or Papillary carcinoma is the most common type (about 80% of thyroid cancer cases), and usually affects women of childbearing age. It spreads slowly and is the least dangerous type of thyroid cancer.
  • Follicular thyroid cancer or Follicular carcinoma accounts for about 15% of all cases and is more likely to come back and spread.
  • Medullary thyroid cancer or Medullary carcinoma is a cancer of nonthyroid cells that are normally present in the thyroid gland. It makes up about 3% of all thyroid cancer cases. This form of the thyroid cancer tends to occur in families. It requires different treatment than other types of thyroid cancer.
  • Anaplastic thyroid cancer or Anaplastic carcinoma (also called giant and spindle cell cancer) is the most dangerous form of thyroid cancer. It is rare (about 2% of all thyroid cancers), and does not respond to radioiodine therapy. Anaplastic carcinoma spreads quickly and invades nearby structures such as the windpipe (trachea), causing breathing difficulties.

Risk factors for thyroid cancer

  • Being between ages 25 and 65
  • Being a woman
  • Being Asian
  • Having a family member who has had thyroid disease or medullary thyroid cancer
  • Having radiation treatments to your head or neck
  • Family history of goiters or colon growths

Signs and symptoms of thyroid cancer

  • A lump in the front of the neck
  • Hoarseness or voice changes
  • Swollen lymph nodes in the neck
  • Enlargement of the thyroid gland
  • Neck swelling
  • Pain in the throat or neck that does not go away
  • Cough
  • Difficulty swallowing or breathing

Note: Symptoms may vary depending on the type of thyroid cancer.

Diagnostic tests and exams for thyroid cancer

  • Physical exam to check the thyroid for lumps (nodules), and neck and nearby lymph nodes for growths or swelling.
  • Laryngoscopy to see if the vocal cords are moving normally.
  • Elevated serum calcitonin (for medullary cancer) or serum thyroglobulin (for papillary or follicular cancer).
  • Blood hormone studies to check for abnormal levels of thyroid-stimulating hormone (TSH) and the calcitonin hormone.
  • Blood chemistry studies to measure the amounts of certain substances released into the blood by organs and tissues in the body.
  • Radioactive iodine scan (RAI scan) to find areas in the body where thyroid cancer cells may be dividing quickly.
  • Ultrasound exam to show the size of a thyroid tumor and whether it is solid or a fluid -filled cyst. Ultrasound may be used to guide a fine-needle aspiration biopsy.
  • CT scan (CAT scan)
  • MRI (magnetic resonance imaging)
  • PET scan (positron emission tomography scan)
  • Fine-needle aspiration biopsy of the thyroid to remove thyroid tissue samples to look for cancer cells.
  • Surgical biopsy to remove the thyroid nodule or one lobe of the thyroid during surgery to check for signs of cancer.

Treatment of thyroid cancer

Treatment options depend on the following:

  • Patient`s age
  • Thyroid cancer type (papillary, follicular, medullary, or anaplastic)
  • Cancer stage
  • Patient`s general health
  • Whether the patient has multiple endocrine neoplasia type 2B (MEN 2B)
  • Whether the cancer has just been diagnosed or has recurred (come back)
  • Whether the cancer has spread

Following are the treatment options in use:

  • Surgery: Surgery is the most common treatment of thyroid cancer. One of the following procedures may be used:
    • Lobectomy: Removal of the lobe in which thyroid cancer is found. Biopsies of lymph nodes in the area may be done to see if they contain cancer.
    • Near-total thyroidectomy: Removal of all but a very small part of the thyroid.
    • Total thyroidectomy: Removal of the whole thyroid.
    • Lymphadenectomy: Removal of lymph nodes in the neck that contain cancer.
  • Radioactive iodine therapy (RAI): Radiation therapy may be given after surgery to kill any thyroid cancer cells that were not removed. Follicular and papillary thyroid cancers are sometimes treated with radioactive iodine (RAI) therapy. Higher doses than the amounts used to diagnose thyroid cancer are used. RAI is taken by mouth and collects in any remaining thyroid tissue, including thyroid cancer cells that have spread to other places in the body. Since only thyroid tissue takes up iodine, the RAI destroys thyroid tissue and thyroid cancer cells without harming other tissue. Before a full treatment dose of RAI is given, a small test-dose is given to see if the tumor takes up the iodine.
  • Thyroid hormone therapy: Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. In the treatment of thyroid cancer, drugs may be given to prevent the body from making thyroid-stimulating hormone (TSH), a hormone that can increase the chance that thyroid cancer will grow or recur. Also, because thyroid cancer treatment kills thyroid cells, the thyroid is not able to make enough thyroid hormone. Patients are given thyroid hormone replacement pills.
  • External radiation therapy: Use of high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
  • Chemotherapy: Use of drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

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