Your thyroid is shaped like a small butterfly, and is usually found inside the lower front of your neck. It’s a gland that controls your metabolism. It also releases hormones that direct many functions in your body, including how you use energy, how you produce heat, and how you consume oxygen.
Thyroid cancer develops when cells change or mutate. The abnormal cells begin multiplying in your thyroid and, once there are enough of them, they form a tumor.
If it’s caught early, thyroid cancer is one of the most treatable forms of cancer.
Types of Thyroid Cancer
Researchers have identified four main types:
Papillary thyroid cancer. If you have thyroid cancer, you probably have this type. It’s found in up to 80% of all thyroid cancer cases. It tends to grow slowly, but often spreads to the lymph nodes in your neck. Even so, you have a good chance for a full recovery.
Follicular thyroid cancer makes up between 10% and 15% of all thyroid cancers in the United States. It can spread into your lymph nodes and is also more likely to spread into your blood vessels.
Medullary cancer is found in about 4% of all thyroid cancer cases. It’s more likely to be found at an early stage because it produces a hormone called calcitonin, which doctors keep an eye out for in blood test results.
Anaplastic thyroid cancer can be the most severe type, because it’s aggressive in spreading to other parts of the body. It’s rare, and it is the hardest to treat.
What Are the Symptoms?
If you have thyroid cancer, you probably didn’t notice any signs of it in the early stages. That’s because there are very few symptoms in the beginning.
But as it grows, you could notice any of the following problems:
- Neck, throat pain
- Lump in your neck
- Difficulty swallowing
- Vocal changes, hoarseness
What Causes It?
There is no clear reason why most people get thyroid cancer. There are certain things, though, that can raise your odds of getting it.
Inherited genetic syndromes. Some conditions, including cancer, come from the DNA you get from your parents. In 2 out of 10 cases of medullary thyroid cancer, for example, the cancer is a result of an abnormal gene you’ve inherited.
Iodine deficiency. If you don’t get much of this chemical element in your diet, you could be at more risk for certain types of thyroid cancer. This is rare in the United States because iodine is added to salt and other foods.
Radiation exposure. If your head or neck was exposed to radiation treatment as a child.
Who Gets It?
Thyroid cancer is more common in women than men. Women tend to get thyroid cancer in their 40s and 50s, while men who get it are usually in their 60s or 70s.
Follicular thyroid cancer happens more often in whites than blacks and in more women than men.
You can still get thyroid cancer if you’re younger. Papillary thyroid cancer, for example, happens most often in people between ages 30 and 50.
Is It Treatable?
Thyroid cancer is usually very treatable, even if you have a more advanced stage of it. That’s because there are effective treatments that give you a great chance for a full recovery. And surgery, when it’s needed, can sometimes cure it.
AM I RISK FOR THYROID CANCER?
The job of your thyroid gland is to make hormones that help your body use energy, stay warm, and control your blood pressure and heart rate. Cancer happens when healthy cells in the gland change and grow out of control.
On the list of most common cancers in the United States, thyroid cancer ranks fifth among women, and no other cancer is being diagnosed at a faster rate. One reason for this may be better tests. They allow doctors to find thyroid tumors that were too small to see in the past. Most of the time, thyroid cancer can be cured with treatment. Experts don’t always know what causes it, but they do know some things may raise your chance of getting it.
Gender and Age
Women are three times more likely to get thyroid cancer than men. You can get it at any age. But women are often diagnosed in their 40s and 50s. Men tend to be older — in their 60s and 70s — when they find out they have it. And in men, thyroid cancer grows and spreads more quickly.
Children who get radiation therapy for some cancers, such as lymphoma, have a higher chance of getting thyroid cancer. Compared with children, adults exposed to radiation have lower odds of getting it.
Heredity and Genetics
Your chances of getting thyroid cancer are higher if your mother, father, brother, sister or child got it. Also, thyroid cancer may be linked to certain genetic or hereditary problems. One of these causes extra tissue called polyps to form in the colon — it’s called familial adenomatous polyposis. If you have it, there’s a higher chance you’ll get certain kinds of cancer, including thyroid cancer.
Other genetic problems that increase the risk of thyroid cancer include:
- Familial medullary thyroid cancer
- Multiple endocrine neoplasia type 2
- Cowden disease
Not Enough Iodine in Your Diet
Iodine is a mineral found in some foods. Your body needs it to make thyroid hormones. Certain thyroid cancers are more common in parts of the world where people have low levels of iodine. In some countries, including the U.S., iodine is added to table salt and other foods to help give you a boost.
What Are the Symptoms of Thyroid Cancer?
Your thyroid is a butterfly-shaped gland at the base of your throat. It’s involved in some very big jobs, like managing your heart rate, blood pressure, body temperature, and weight.
Your thyroid has two lobes, left and right, that are connected by a thin piece of tissue. If it’s healthy, each lobe is about the size of a quarter and you won’t see or feel it under your skin. Thyroid cancer typically it first noticed as a thyroid nodule.
If you have symptoms of thyroid cancer, they may include:
- Trouble swallowing
- Difficulty breathing that is sometimes compared to sucking air through a straw
- Hoarseness or other voice changes
- A constant cough that is not due to a cold
- A lump in the front of the neck (around the Adam’s apple) that might grow quickly
- Swollen – but not painful — glands in the neck
- Pain that starts in the front of the neck and goes up into your ears
Also, if your face is turning red and you have frequent loose bowel movements, these may be signs of something called medullary thyroid cancer. Symptoms are not always a sign of thyroid cancer. In fact, they’re usually caused by other things. You’ll need to see your doctor to find out what it is.
What Else Could It Be?
A lump in your thyroid could be caused by an infection or a goiter, which is an abnormal growth of the thyroid gland. It might not be cancerous at all. Lumps in the thyroid usually aren’t. But it’s possible to have thyroid cancer without any symptoms at all.
Your doctor will examine your thyroid during routine physical exams. If you have any symptoms between checkups, such as a new nodule on the gland or a rapidly growing one, you should make an appointment to have your thyroid gland checked. Your doctor will do several tests to diagnose the source of the problem and decide on the best treatment.
Your doctor will examine any lumps, or nodules, you have on your neck. They might ask you some questions to find out if you’re at risk. The questions might be about whether you’ve been exposed to too much radiation, or if you have a family history of thyroid cancer or thyroid disease.
There is no blood test that can detect thyroid cancer. Still, your doctor may want you to get one to help figure out whether your thyroid gland is working right.
Based on your family history, your doctor might order genetic testing to find out if you have any genes that make you more likely to get cancer. It can also show genetic changes that could be a sign of certain types of thyroid cancer.
If you have a thyroid lump, you may need to have it tested. A biopsy will tell if it’s cancer or not. To do a biopsy, your doctor uses a small, thin needle to take a little sample from the lump, and maybe other places around it. You’ll probably get this “fine-needle biopsy” in your doctor’s office. You won’t need any recovery time afterward. After they get the sample, the doctor will send the sample to a lab for testing.
An ultrasound helps your doctor learn more about the thyroid nodule(s). It uses high-frequency sound waves to create an image of your thyroid. Your doctor will place a small device that looks like a wand in front of your thyroid gland. The image of your thyroid and any nodules, even those you can’t feel, will show up on a computer screen.
An ultrasound may show your doctor if a lump is filled with fluid or if it’s solid. A solid one is more likely to have cancerous cells, but you’ll still need more tests to find out. The ultrasound will also show the size and number of nodules on your thyroid.
This test uses radioactive iodine which will be taken up by thyroid cells. A scan measures radiation in the thyroid or other parts of the body.
Computed tomography, commonly called a CT scan or CAT scan, uses special X-rays to give your doctor a look inside of your body. It can show the size and location of thyroid cancer and whether it has spread to other parts of your body.
Your doctor might recommend a positron emission tomography, or PET scan. This test uses small amounts of radioactive material, called radiotracers, a special camera, and a computer to look at your organs and tissue. A PET scan looks at changes on the cellular level. It may be able to detect the cancer in a very early state and check for cancer spread.
Your doctor will give you the results of your tests.
Remember that the odds are the lump on your neck probably isn’t thyroid cancer, but you’re doing the right thing to get it checked out. And if it is, the sooner you find out and start treatment, the better.
What Are the Stages of Thyroid Cancer?
If you or someone you love has thyroid cancer, you want to know what treatments are available and what to expect. This depends on several things – starting with what type of thyroid cancer you have and its stage. It’s easy to get swamped by the numbers, letters, and unfamiliar words, even when you’re not under stress. This article will help you make better sense of what is happening based on the cancer’s stage.
Types of Thyroid Cancer
The thyroid is a gland at the base of your throat. It makes hormones that help your body work properly. There are four main types of thyroid cancer:
- Papillary (the most common type)
If your doctor finds cancer, they’ll begin the process of staging. They’ll run tests to see if it has spread to other parts of your body.
The ‘TNM’ Staging System
The American Joint Committee on Cancer created the system that’s most often used to describe the stages of thyroid cancer. It’s called the “TNM” system, and it focuses on these three things:
- T — What is the size and extent of the main, or primary, tumor?
- N — Has the cancer spread to nearby lymph nodes? (These are bean-shaped cells that help your body fight infection).
- M — Has the cancer spread, or metastasized, to other areas of the body or organs, namely the lungs, liver, and bones?
After your doctor runs tests to find out what type of thyroid cancer you have, they’ll add a number to each letter listed above. The higher the number, the more advanced is that aspect of the cancer. (For example, T2-T4 means a larger tumor than T1).
Next, your doctor will group this information into stages. These are represented by the Roman numerals I through IV. For the most advanced cases, the letters “A,” “B” and “C” also are used to indicate how far the cancer has spread.
What type of cancer you have, as well as your age, will have some bearing on your stage.
Here’s what each stage of thyroid cancer means, grouped by types:
Papillary or Follicular Thyroid Cancer — Patients Under Age 55
- Stage I — The tumor can be any size. It may have spread to nearby tissues or nearby lymph nodes. But it hasn’t spread to other parts of the body.
- Stage II — The tumor is any size. Cancer may have spread to your lymph nodes. It also has spread to other parts of your body, like your lungs or bones.
Papillary or Follicular Thyroid Cancer — Patients Age 55 and Older
- Stage I — You only have cancer in your thyroid. The tumor is 2 centimeters (about the size of a nickel) or smaller and hasn’t spread.
- Stage II — You only have cancer in your thyroid. The tumor is any sizer but is nowhere else in your body.
- Stage III –The tumor is any size and has spread to tissues near your thyroid, or it’s smaller and has reached your nearby lymph nodes.
Papillary and Follicular Thyroid Cancer, Stage IV
If you are at stage IV, it means the cancer has spread. Your doctor assigns the letters “A,” “B” and “C” to show how far.
- Stage IVA — The cancer has spread beyond your thyroid. It now is under your skin, or it affects your larynx, esophagus or trachea. A smaller tumor in more distant lymph nodes is also considered stage IVA.
- Stage IVB — The tumor has grown toward your spine or into nearby large blood vessels, like the carotid arteries. These carry blood to your brain, face, and neck. It might have also spread to your lymph nodes.
- Stage IVC — The cancer has spread beyond the thyroid, and to distant sites of the body. It may be in your lungs, bones, and lymph nodes.
Medullary Thyroid Cancer
The following things apply to everyone who has this type of cancer, no matter their age.
- Stage I — The tumor is 2 centimeters or smaller. It’s only in your thyroid.
- Stage II — It’s larger than 2 centimeters and found only in your thyroid. Or, it’s any size but has spread to tissues beyond your thyroid. It hasn’t spread to your lymph nodes.
- Stage III — It may be smaller or larger than 2 centimeters and may also be in the tissues beyond your thyroid. The cancer is now in the lymph nodes near your voice box and windpipe.
- Stage IV — As with follicular and papillary thyroid cancer, stage IV means that the cancer has spread to distant sites in your body, and the letters “A,” “B,” and “C” indicate where it has gone.
Anaplastic Thyroid Cancer
This is a fast-growing type of thyroid cancer. For this reason, it’s described only as stage IVA, IVB, or IVC. By the time your doctor finds it, it may have already spread to your neck. Here’s what each stage means:
- Stage IVA — Cancer is in your thyroid. It may have spread to nearby lymph nodes.
- Stage IV — It has spread beyond your thyroid. It may be in your lymph nodes.
- Stage IVC — It has spread to other areas of your body such as your lungs and bones. It may also be in your lymph nodes.
What Are The Treatments for Thyroid Cancer?
There are lots of ways to treat thyroid cancer. The treatment you get will depend on the type and stage of the cancer. It also depends on your age, general health, and other things that are unique to you.
Surgery is the most widely used method to get rid of thyroid cancer. If the entire thyroid gland is removed, It’s called a thyroidectomy. If part of your thyroid gland is removed, the procedure is called a lobectomy. Your surgery may also include removing lymph nodes in the neck area, and tissue around the thyroid gland. It will depend on the size and location of the tumor.
Radioactive Iodine Ablation
The thyroid gland and most thyroid cancers absorb iodine. Radioactive iodine (RAI) ablation is used to destroy any thyroid tissue that’s left after a thyroidectomy. The iodine goes to the thyroid tissue and the radiation destroys it. It may also be used for cancer that spreads to nearby lymph nodes, spreads to other parts of the body, or returns.The level of radiation in this treatment is far higher than what is used in a radioiodine scan.
You may have a special diet that is low in iodine for 1 or 2 weeks before you get the treatment. If you take thyroid hormone pills, you may have to stop taking them for a while.
Thyroid Hormone Therapy
If all of your thyroid gland was removed, you’ll take thyroid hormone pills. The pills also help stop leftover cancer cells from growing and returning. They do this by lowering the level of thyroid-stimulating hormone (TSH). TSH is made by your pituitary gland. It tells your thyroid gland to make thyroid hormones. But it also encourages growth of the cancer.
These treatments are mostly used for thyroid cancers that are less common or more advanced:
External beam radiation, or X-ray therapy, uses radiation to destroy cancer cells. It is very carefully delivered to protect the rest of your body as much as possible. You’ll get radiation therapy over several weeks.
Chemotherapy, or chemo, means using chemicals for treatment. For cancer, the medicines attack and kill fast-growing cells, like cancer cells. You may get pills, shots, or intravenous (IV) chemo. It has side effects, but your doctor will help you to manage them.
Targeted therapy is a newer treatment that targets only certain parts of cancer cells, to slow or stop growth. This is normally taken in pill form. Usually, there are fewer side effects than with chemotherapy.
Deciding on Treatment
If you get a diagnosis of thyroid cancer, your doctor will help you figure out the best treatment. They’ll explain the benefits and tell you about the risks.
Removing Thyroid Due To Cancer
If you have thyroid cancer, you may be facing surgery. It’s the most common treatment, and it’s usually very successful. Your surgery will depend on the kind of thyroid cancer you have. A thyroidectomy is when all or part of the thyroid gland is removed.
A lobectomy is when one of the two lobes of your thyroid is removed.
If the cancer has spread, lymph nodes in the neck area may be taken out, as well. Tissue around the thyroid gland may also be removed, depending on the size and location of the tumor.
Before surgery, you’ll have lab and imaging tests. They help the doctor know as much as possible about the cancer. You may have other exams or tests to check your overall health.
You’ll probably have general anesthesia during your surgery. This means you will sleep through the whole thing. The doctor may make one or more incisions (cuts) in your neck, but that will depend on which type of surgery you have.
Thyroid surgery usually takes place without problems. You will have pain in the neck area, but medicine will help. You may also have a hoarse voice or sore throat for a few days. There may be a drain from the site of the incision. It helps with healing and will later be removed.
You’ll either stay overnight at the hospital, or go home the day of the surgery. Again, it depends on what type of operation you have and well you do. You’ll get instructions about how to take care of yourself after the operation, and when to see your doctor for follow-up. Other cancer treatments may begin soon after the operation.
If all of the thyroid gland is removed, your doctor will probably prescribe thyroid hormone replacement medicine to replace the thyroid hormones. You may need this medication the rest of your life, and the doctor will probably have to make a few changes along the way to make sure you get the right amount. If only part of your thyroid was removed, you might not need the thyroid hormone replacement medicine.
Tips to Handle Thyroid Cancer Treatment Side Effects
Thyroid cancer is fairly rare. And thanks to very good treatments, it can be cured most of the time. The type of treatment you get depends on what kind of thyroid cancer you have, and if it has spread. Most people are treated with surgery alone, or with a combination of surgery and radioactive iodine. If you have side effects from treatment, there are ways to manage them that will help you feel better.
Thyroid surgery involves removing either part or all of the gland (thyroidectomy). In some cases, lymph nodes may also need to be removed. It’s not unusual to feel tired or sore for a few days after surgery. But pain medicines prescribed by your doctor can help. You may have some aches and pains in the neck and shoulders after surgery.
This usually goes away in a few weeks. In the meantime, your doctor can advise you about exercises to help relieve any stiffness. Some research shows that stretching exercises are very helpful and even reduce the need for pain medicine. Getting enough rest, eating well, drinking fluids, and walking will also go a long way in your recovery. You’ll be able to eat and drink as usual after the procedure. Most people who have their thyroid removed stay in the hospital about 24 hours. When you go home, you can usually return to normal activity within 10 days or so.
Thyroid Hormone Replacement
Since thyroid cancer surgery removes the cancer, it also affects the way the thyroid will do its job of making thyroid hormone. If your entire thyroid was removed, you will need medicine to replace the natural thyroid hormone.
Most do very well with thyroid hormone therapy. But the key is to find the right dosage for you at all stages of your life. Too much may cause you to have cramps or a rapid heart rate, and to feel hot or sweaty. With too little, you may feel cold and worn out. Your doctor will adjust dosage based on results of blood tests. Make sure you talk to your doctor about how you feel so any changes to your treatment can be made.
Radioactive Iodine Treatment
Surgery often gets rid of thyroid cancer. But depending on the type of thyroid cancer you have, or if it has spread, your doctor may also suggest you have treatment with radioactive iodine. This is done to get rid of any cancer cells that were not caught during surgery, and to help keep the cancer from coming back. Some people experience side effects from treatment, but these problems usually only last a short time.
- If you have neck tenderness, over-the-counter pain relievers usually help.
- Dental issues like dry mouth can also be a side effect. There are sprays and gels that help with this. Dry mouth can also cause tooth decay, so make sure to brush and floss regularly and visit your dentist if you have it.
- If your mouth feels tender, avoid harsh toothpastes and mouthwashes (the kind that whiten your teeth or contain alcohol, for example). Switch to something more gentle, or even make your own. For example, stir some baking soda in water for a mouthwash.
- Your salivary glands might swell and hurt. It might only last a few minutes, or it could be longer, and it might happen more than once. You can gently massage the area, but if that doesn’t help, your doctor may refer you to a specialist for help.
- Your eyes might not produce as many tears. It may help if you wear your glasses instead of contacts for a few days after each treatment.
Most people recover well from thyroid cancer treatment. But during treatment, you may want to consider a cancer support group. Even with lots of help from family and friends, you might want to check out support groups in your area. One of the main reasons people join is to be with others who face the same type of cancer. Some research shows that cancer support groups not only help you feel more hopeful, but also help you deal better with side effects.