Thyroid cancer is relatively rare type of cancer with about 20.000 new cases each year in the United States. Thyroid cancer can occur in any age group, although it is more common after age 30 and most common in older patients. However, it is more likely that females have thyroid cancer at a ratio of three to one. Large majority of patients with a nodule on their thyroid do not have cancer: over 99% of thyroid nodules are benign, which means not cancerous! It is also true that most of us have nodule in out thyroid gland- this is not the case with young people, but as we get older, more and more people develop a nodule. However, when a thyroid cancer begin to grow within a thyroid gland, it almost always does so within a discrete nodule within the thyroid, but most thyroid cancers are treatable and can be completely cure with surgery. Statistics show that there are only 1000 deaths from thyroid cancer per year in United States, which is less than 1% of all cancer deaths.
Types of Thyroid cancer and their Symptoms
- Papillary and/or mixed papillary/follicular (it occurs in 78% of all cases)
- Follicular and/or Hurthle cell (it occurs in 17% of all cases)
- Medullary (it occurs in 4% of all cases)
- Anaplastic (it occurs in 1% of all cases)
Papillary and follicular cancers account for about 90% of thyroid cancers and are usually associated with the best outcomes mainly because they tend to grow very slowly especially in young patients.In younger patients both papillary and follicular cancers can be expected to have better than 97% cure rate if they are treated properly. Papillary cancer is the most curable of all cancers that humans get, and if you must choose a type of cancer to have, papillary cancer would be your choice.
Patients with papillary and follicular cancer usually have no symptoms, only some experience voice change or chronically swollen lymph node.
Medullary thyroid cancer does not arise from thyroid cells, but rather from %26quot;C%26quot; cells which are neuroendocrine cells within the thyroid and has worse prognosis. It is not as localized as papillary and follicular and it tends to spread to large numbers numbers of lymph nodes very early on, therefore requires much more aggressive operation: complete thyroid removal and dissection to remove the lymph nodes of the front and sides of the neck. Patients with medullary cancer usually have no symptoms; later stage symptoms include hoarseness, difficulty swallowing and breathing, and chronically swollen lymph node, while hereditary forms of medullary cancer may produce hypertension, increased heart rate, headaches or other endocrine diseases.
Anaplastic cancer is on the other hand very rare type of thyroid cancer which is very aggressive and is associated with a poor prognosis, which means that it tends to be found after it has spread and is not cured in most cases; actually it is very uncommon to survive anaplastic thyroid cancer. Anaplastic thyroid cancer is the worst thyroid cancer of all, and includes difficulty breathing, voice change and chronically swollen lymph node.
Thyroid cancer treatments
Four types of treatment are used for patients with thyroid cancer; of course the treatment of thyroid cancer depends on the type and stage of the disease, and the patient%26rsquo;s age and overall health:
- Surgery
- Radiation therapy
- Hormone therapy
- Chemotherapy
Surgery is the most common treatment of thyroid cancer. Cancer may be removed if using one of the four operations: lobectomy, near-total thyroidectomy, total thyroidectomy, lymph node dissection.
Lobectomy removes only the side of the thyroid where the cancer is found. Usually lymph nodes in the area may be biopsied to see if they contain cancer. Near-total thyroidectomy removes all of the thyroid except for a small part. Total thyroidectomy removes the entire thyroid. Lymph node dissection removes lymph nodes in the neck that contain cancer.
With radiation therapy high dose of x-rays or other high energy rays are used to 'kill' cancer. Most, but not all patients with thyroid cancer need radioactive iodine treatments after their surgery. Two types of radiation therapy are applied: external radiation therapy, where radiation for thyroid cancer may come from a machine outside the body, and internal radiation therapy, where a liquid that contains radioactive iodine is drank. Radiation therapy usually has very positive response with thyroid cancer. Most thyroid cancer cells retain this ability to absorb and concentrate iodine, which provides a perfect chemotherapy strategy. Because the thyroid takes up iodine, the radioactive iodine collects in any thyroid tissue remaining in the body and kills the cancer cells. Since not all other cells of our bodies can absorb toxic iodine, they are unharmed, while as mentioned before thyroid cancer cells, however, will concentrate the poison within themselves. There is usually no pain, nausea or sickness, diarrhea or hair loss after the use of radioactive iodine.
Another form of thyroid cancer treatment is hormone therapy, which is usually applied as pills: hormones are used to stop cancer cells from growing or they are used to stop the body from making other hormones that might make cancer cells grow.
Chemotherapy also uses drugs to kill cancer cells: it may be taken by pill, or it may be put into the body by a needle in the vein or muscle.
How does typical thyroid cancer treatment look?
First step is biopsy: doctor sticks a needle into a thyroid nodule (another option is removal of problematic thyroid nodule by a surgeon) and then nodule or tissue is looked under a microscope by a pathologist who decides whether the nodule is benign, and if it is not, pathologist also decides which type of thyroid cancer it is: papillary, follicular, mixed papilofollicuar, medullary, or anaplastic. Surgery, appropriate for the type of cancer is done: usually (entire) thyroid is removed by a surgeon and sometimes also the lymph nodes in the neck too. After the thyroid gland has been removed, which is approximately 4-6 weeks after the removal, the patient undergoes radioactive iodine treatment, which is consisted of taking a single radioactive iodine pill. Few days after the pill patient must avoid contact with other people so they are not exposed to radioactive materials.
Since people cannot live without the thyroid hormone, patient is a week or two after the radioactive iodine treatment put on a thyroid hormone pill. Patient must take one pill per day for the rest of their life.
Patient must return every 6 %26ndash; 12 months to his endocrinologist for blood test to determine if the dose of daily thyroid hormone is correct and to make sure that the thyroid tumor is not coming back.
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