Understanding Thyroid Cancer
Thyroid cancer develops in the thyroid gland, a butterfly-shaped gland found at the base of your neck, just below your Adam’s apple. The thyroid plays an essential role in regulating your metabolic rate, heart and digestive function, muscle control, brain development, and bone maintenance through the release of hormones. Thyroid cancer often begins with genetic changes or mutations in the cells of the thyroid gland. These mutations can be inherited or acquired during a person’s life.
Here are the main types of thyroid cancer:
- Papillary Thyroid Cancer: This is the most common type, accounting for approximately 75% of all thyroid cancer cases. It generally grows slowly and is often confined to the thyroid gland when diagnosed. Papillary thyroid cancer has a high cure rate, especially when diagnosed early.
- Follicular Thyroid Cancer: Including Hurthle cell cancer, this type represents about 10-15% of all thyroid cancers. It is more likely to spread and invade blood vessels but still carries a relatively good prognosis if treated early.
- Medullary Thyroid Cancer: Accounting for 3-4% of thyroid cancers, medullary thyroid cancer can be more aggressive and difficult to treat. It sometimes runs in families and can be associated with genetic syndromes that may involve other glandular abnormalities.
- Anaplastic Thyroid Cancer: This is the least common and most aggressive type of thyroid cancer, representing less than 2% of cases. It grows rapidly and is often advanced by the time it is diagnosed, making it more challenging to treat effectively.
Signs and Symptoms of Thyroid Cancer
Thyroid cancer often begins without any symptoms, but as it develops, it can produce several signs and symptoms. Not all individuals with thyroid cancer will experience all of these symptoms, and having one or more of these symptoms does not necessarily mean that a person has thyroid cancer. However, any persistent or unexplained symptoms should be evaluated by an Endocrinologist.
- Neck Swelling: The most obvious symptom of thyroid cancer is an enlarged thyroid gland that appears as a swelling at the base of your neck. This swelling might be uneven due to the irregular sizes of the nodules.
- Hoarseness of Voice: Thyroid cancer can cause hoarseness or other voice changes that do not go away. This happens when the cancer affects the nerves that control the vocal cords.
- Difficulty Breathing: If the nodules are large enough, it can exert pressure on the windpipe (trachea), leading to respiratory difficulties. This might be more apparent during physical activities or when lying down.
- Difficulty Swallowing: The enlarged gland can also press on the oesophagus, which can interfere with the normal swallowing of food. Patients might experience a sensation of food being stuck in the throat, especially with solid foods.
- Chronic Cough: A continuous cough that is not associated with a cold or respiratory infection and does not go away can be a sign of thyroid cancer.
Diagnosing Thyroid Cancer
Seriousness of Thyroid Cancer
Diagnosing Thyroid Cancer
In order to determine whether the lesions are malignant or benign, Endocrinologists may employ various methods, including:
- Detailed medical history taking: Your Endocrinologist will understand your current health issues and past medical history, which will guide further assessments and decisions.
- Physical examination: This includes inspecting the neck from the front and side to determine the lump’s location. The neck will also be examined for abnormal enlargement, contour, asymmetry, and masses, especially during repeated swallowing, by physically touching and feeling the lumps.
- Imaging tests: Imaging tools like ultrasound, CT scans, and MRI also provide invaluable diagnostic information about the nature of the neck lumps.
- Biopsy: Fine Needle Aspiration (FNA) involves using a thin needle to take a tiny tissue sample from the lump. The sample will be scrutinised under a microscope.
Seriousness of Thyroid Cancer
If left untreated, thyroid cancer can become a serious and life-threatening condition. The seriousness of untreated thyroid cancer depends on the type of cancer, its stage at diagnosis, and how quickly it grows and spreads. Without treatment, most types of thyroid cancer have a high probability of growing and spreading to other parts of the body, such as the lymph nodes and distant organs. This can complicate treatment and reduce the chances of a successful outcome.
Treatment Options for Thyroid Cancer
After providing you with a detailed diagnosis, our Thyroid Specialists will recommend a tailored thyroid cancer treatment plan. It may involve one or more of the following options:
- Thyroidectomy: Complete or partial removal of the thyroid gland. It is the most common treatment for most thyroid cancers.
- Lymph Node Dissection: Removal of nearby lymph nodes if the cancer has spread.
- Follow-up and Monitoring: Endocrinologists are integral in the long-term follow-up of thyroid cancer patients, which involves regular check-ups, blood tests to monitor thyroid hormone and thyroglobulin levels, and imaging studies to ensure remission and early detection of recurrence.
References:
- Thyroid Cancer – Conditions & Treatments | SingHealth. www.singhealth.com.sg. https://www.singhealth.com.sg/patient-care/conditions-treatments/thyroid-cancer
- Mayo Clinic. Thyroid Cancer – Diagnosis and treatment – Mayo Clinic. Mayoclinic.org. Published 2019. https://www.mayoclinic.org/diseases-conditions/thyroid-cancer/diagnosis-treatment/drc-20354167
