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Thyroid cancer isn’t that common, but it can still leave some traumatic imprints in the lives of those diagnosed with it. It is considered to be one of the ‘good cancers’ due to the fact that it responds well to therapy. In this blog, let us understand different types of thyroid cancers like papillary, follicular, and anaplastic, thyroid cancer symptoms, diagnosis, and treatment options such as thyroidectomy and radioactive iodine therapy.
Synopsis
The Thyroid Gland and Its Function
The butterfly-like gland right below Adam's apple is known as the thyroid, which produces hormones that are responsible for regulating a person’s metabolism, temperature, heart rate, and blood pressure. Thyroid cancer begins at the stage when the cells in the gland forget apoptosis (programmed cell death) and proliferate uncontrollably. It then leads to the development of a solid tumor, often pointed out as a nodule (mass/lump) at the base of one’s throat.
The formation of thyroid nodules or lumps is pretty common, especially in middle & old age. About 50% of the population above the age of 60 years can be diagnosed with a thyroid nodule. But more than 90% of these nodules never turn into cancer. Children and young adults rarely develop thyroid nodules. However, when they do develop thyroid nodules, there is a high probability of it turning out to be cancerous. Thyroid cancer is more commonly diagnosed in females than in males.
Causes and Symptoms of Thyroid Cancer:
Thyroid cancer is rarely present with any symptoms. However, if the patient reports a symptom, it is mostly a swollen neck, which is caused by the nodules. Although one may not point it out themselves, others might. As the thyroid nodule grows, the lump can be felt as a slight bump in front of the neck. When swelling becomes very large, the nodules become large enough to cause complications. Pain is rarely present in patients with thyroid cancer.
Thyroid cancer symptoms that may need a visit to the doctor include:
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Lump in neck
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Problems while moving the head or neck
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Persistent cough
Different Types of Thyroid Cancer:
Thyroid cancer is classified into four different types.
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Papillary thyroid cancer |
About 80-85% of all cases of thyroid cancer are of this type. This is also one of the most curable forms of cancer. |
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Follicular thyroid cancer |
About 10-15% of all thyroid cancer cases can be diagnosed with follicular thyroid cancer. It is slightly more aggressive than papillary thyroid cancer. This type spreads through the bloodstream to affect other body parts. A rare type of follicular thyroid cancer, called Hurthle cell cancer, is infamous for being very aggressive. |
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Medullary thyroid cancer |
Less than 3% of the total population with thyroid cancer suffer from this type of thyroid cancer. |
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Anaplastic thyroid cancer |
This is the most dreadful type of thyroid cancer. Not only does it have a poor prognosis, but it also tends to resist chemotherapy with time. About 2% of all cases account for this type of cancer. It is the most aggressive type and invades the other body parts pretty quickly. |
Risk Factors of Thyroid Cancer:
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Exposure to radiation, especially during childhood, is one of the common causes that induce genetic mutations in people, which can cause thyroid cancer.
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People with a family history of thyroid cancer or other thyroid problems may also be at an increased risk.
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Certain medical conditions, such as thyroiditis, multiple endocrine neoplasia syndrome, Cowden syndrome, and familial adenomatous polyposis, can increase the risk of developing thyroid cancer.
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Common conditions like obesity or deficiency diseases like goitre can also cause thyroid cancer.
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People undergoing radiation treatment for other medical conditions are also at an increased risk of developing thyroid cancer.
How Is Thyroid Cancer Diagnosed?
A fine-needle biopsy is often prescribed to confirm a thyroid cancer diagnosis after initial observation of the thyroid glands by an oncologist. If the cells are indeed cancerous, surgery planning will be carefully made.
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Imaging techniques like CT scans or thyroid ultrasounds can help the surgeon to localize cancer.
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Blood tests for thyroid function and calcitonin levels may also be required.
Treatment Options for Thyroid Cancer
Surgical and non-surgical approaches
Surgical removal of the thyroid gland (thyroidectomy) is usually the primary treatment for thyroid cancer, especially to cure small, isolated papillary and follicular cancers. Radioactive iodine therapy and thyroid hormone replacement therapy with levothyroxine are the treatment options commonly followed after surgery. Chemotherapy for thyroid cancer may sometimes be used for anaplastic thyroid cancer or other aggressive types that don’t respond to other therapies. If cancer is advanced or metastasized, radioactive iodine treatment is necessary.
Post-Operative Care
Post-operative care is crucial for a smooth recovery and involves managing pain, monitoring for complications such as hypocalcemia, and initiating thyroid hormone replacement. Patients are closely observed for any signs of bleeding or swelling in the neck. The cancer care team closely works with an endocrinologist during the cancer care journey. The team of oncologist and onco surgeon guides the initial treatment plan, whereas the endocrinologist takes over with thyroid hormone replacement and long-term follow-up care.
Recovery and Living with Thyroid Cancer
Thyroid cancer is one of the few types of cancer that are highly responsive to treatments. It is a curable form of cancer with a high survival rate. It is, in fact, considered one of the ‘good cancers’; however, proper care has to be taken for a quicker recovery. Some patients after treatment may experience some fatigue or changes in their metabolism, but these symptoms usually improve with proper medication management. Living with thyroid cancer involves ongoing management to monitor for any signs of cancer recurrence.
Follow-up protocols include:
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Adherence to medications and follow-up appointments as suggested by the doctor
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Regular blood tests to check thyroid-stimulating hormone (TSH) levels and thyroglobulin
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Ultrasounds to check for any suspicious nodules or lymph nodes
Conclusion
Many times, people delay consulting an oncologist because they don’t develop any symptoms. Sadly, when the symptoms do manifest, it could be too late. Nevertheless, with early diagnosis, the prognosis for the patient with thyroid cancer could be greatly improved. Adopting a healthy lifestyle, which includes a balanced diet with adequate iodine and avoiding tobacco products, can help manage preventable risks.
Looking for expert thyroid cancer care? Book a consultation with our experienced surgical oncology team at Manipal Hospitals, Malleshwaram, Bangalore for personalised diagnosis and treatment plans.
FAQ's
Papillary thyroid cancer is the most common form of thyroid cancer, accounting for about 80% of cases. This type of cancer often grows slowly and is also highly responsive to treatments, even if it spreads to lymph nodes in the neck.
No, a lump in the neck may not always mean cancer. Although it can be a sign of thyroid cancer, the majority of lumps in the neck are non-cancerous (benign). Swollen lymph nodes (due to infections), cysts, or other benign growths are the most common causes of a neck lump. However, if you notice such symptoms, it is always best to get it evaluated by a doctor.
The side effects of radioactive iodine (RAI) therapy can vary. Common short-term effects can include neck discomfort, tenderness, swelling, salivary gland swelling, and taste disturbances. Long-term side effects rarely occur - a little increased risk of a second cancer, and some report temporary or permanent dry mouth, or changes to the tear ducts.
Yes, thyroid cancer can recur, even many years after it was first diagnosed. It can occur in the lymph nodes in the neck, in small pieces of thyroid tissue left behind after surgery, or in more distant parts of the body, like the lungs and bones. Regular follow-up appointments and monitoring are important to catch any recurrence early.
The survival rate for papillary thyroid cancer is impressive. For localized and regional stages, the 5-year relative survival rate is over 99%. Even for more distant stages of cancer, the survival rate is very high compared to other types of cancer.
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