Thyroid cancer doesn’t get a lot of headlines, but each year in the United States, thousands of people are diagnosed with the disease. This year alone, the American Cancer Society estimates that 44,020 new cases of thyroid cancer will be diagnosed.
Thyroid cancer is a type of cancer that originates in the thyroid gland. It’s what’s known as an “endocrine cancer,” meaning a cancer that forms in a gland or organ that’s part of the endocrine system.
The thyroid is a tiny, butterfly-shaped gland located in the neck. When it’s functioning normally, we rarely even think about it, but when it’s affected by illness or dysfunction, it can affect nearly all aspects of our health, including breathing, heart rate, weight, and digestion.
What happens when cancer develops in the thyroid? You can find the answers to some common questions about thyroid cancer below.
Q: Are there different types of thyroid cancer?
A: Thyroid cancer isn’t one-size-fits-all. There are multiple forms of thyroid cancer, varying by the type of cells they affect in the thyroid:
- Differentiated thyroid cancers are most common. These cancers develop in thyroid follicular cells and include papillary cancer, follicular cancer, and Hurthle cell cancer.
- Medullary thyroid carcinoma forms in the C cells of the thyroid gland, which create a hormone called calcitonin. This type of cancer accounts for 4 percent of all thyroid cancers.
- Anaplastic thyroid cancer, also called undifferentiated carcinoma, often spreads quickly. It’s called undifferentiated because the cancer cells don’t resemble regular thyroid cells. This type of cancer is rare, causing only 2 percent of all thyroid cancers. These are the most aggressive types of thyroid cancer, with the least favorable prognosis.
Less commonly, thyroid lymphomas, thyroid sarcomas, and other rare tumors may also affect the thyroid.
Q: What are the symptoms of thyroid cancer?
A: When it first develops, thyroid cancer may not cause any noticeable symptoms. When symptoms do occur, they may include:
- A lump in the neck
- Difficulty breathing
- Difficulty swallowing
- Hoarseness or voice changes
- Pain in the neck, which may also radiate to the ears
- Persistent cough
- Swelling in the neck
Of these symptoms, a neck lump—also called a nodule—is most common. A nodule may appear alongside other symptoms, or it may occur on its own.
Many of these symptoms, including a lump in the neck, can be related to less serious health issues. It is important to know that most thyroid nodules will be benign, but because they can be a sign of thyroid cancer, it’s important to have them checked out by a medical provider, who can diagnose the underlying cause.
Q: Who’s at risk of developing thyroid cancer?
A: For reasons that aren’t well-understood, thyroid cancer is much more common in women than in men—occurring three times more often. It most often occurs in middle age for both men and women.
The risk factors for thyroid cancer vary somewhat between the types of cancer. Medullary thyroid carcinoma (MTC), for example, is strongly connected with family medical history. Approximately 20 percent of all cases of medullary thyroid carcinoma are familial or connected with a person’s genetic makeup. Familial thyroid cancers, including MTC, may be diagnosed in childhood.
Other risk factors for thyroid cancer include:
- Being exposed to radiation, particularly head and neck radiation therapy
- Being overweight or obese
- Having a family history of thyroid disease or thyroid cancer
- Having an enlarged thyroid (a goiter)
- Having certain gene mutations connected to endocrine disease
Having thyroiditis, an inflammation of the thyroid gland
Low iodine intake can also increase the risk of thyroid cancer. Iodine deficiency is uncommon in the United States due to a diet that includes iodized salt.
Q: How is thyroid cancer treated?
A: If you’re experiencing symptoms of thyroid cancer or a medical provider suspects you may have the disease, a number of tools may be used to confirm a diagnosis. This may include blood tests, imaging scans, biopsy, and a specialized test known as a radioiodine scan.
If you’re diagnosed with thyroid cancer, have hope! The prognosis for most types of thyroid cancer is quite good when cancer is detected in an early stage. The five-year survival rate for all stages of papillary, follicular, and medullary thyroid cancer is higher than 90 percent.
Most people who are diagnosed with thyroid cancer are treated with some type of surgery, either as a standalone treatment or along with other therapies. Surgical treatment may include a lobectomy, which removes the lobe of the thyroid that contains cancer or a total thyroidectomy, which removes the entire thyroid gland. Occasionally, thyroid cancer can spread to nearby lymph nodes in the neck, which can require a specialized surgery to remove.
If the entire thyroid gland is removed, you’ll need thyroid hormone medication for the rest of your life to help regulate your metabolism and other aspects of your health that your thyroid is responsible for. During surgery, nearby lymph nodes may also be removed and tested for cancer.
Your treatment plan may also include additional radioactive iodine therapy (a target type of radiation that only affects thyroid cells and thyroid cancer cells). Your care team, which includes your primary doctor, surgeon and endocrinologist, will work together to set you up with a regular surveillance program (labs and ultrasound), to monitor your cancer for recurrence. Systemic chemotherapy, radiation therapy and immunotherapy are much less commonly used in thyroid cancer.
The thyroid gland absorbs nearly all iodine in the body. During this therapy, a small amount of radioactive iodine is given to a patient in a pill, liquid, or injectable form. The radioactive iodine then collects in the thyroid, destroying the thyroid gland and cancer cells without affecting the rest of the body. This type of therapy may be used to destroy, or ablate, any thyroid tissue that couldn’t be removed during surgery.
Your care team, including a surgeon and endocrinologist, will look at several factors to determine your best treatment options, including your overall health and the stage and type of thyroid cancer you have. Certain types of thyroid cancers may also require the involvement of medical oncology, though this is less common.
Learn more
If you or a loved one have been diagnosed with cancer, the Cancer Services team at Northeast Georgia Medical Center is here to help. Call 770-525-5349 or click here to learn more.