Thyroid Cancer

Thyroid cancer is a type of cancer that originates in the thyroid gland, a butterfly-shaped gland located at the base of the neck, just below the Adam's apple. The thyroid gland produces hormones that are crucial for regulating metabolism, heart rate, blood pressure, and body temperature. While a diagnosis of cancer can be frightening, most types of thyroid cancer have a very high cure rate, especially when detected early.

Understanding the Thyroid Gland

The thyroid gland is a vital part of the endocrine system. It uses iodine from food to make two main hormones:

• Triiodothyronine (T3)
• Thyroxine (T4)

These hormones travel through the bloodstream and affect nearly every cell in the body, controlling how quickly the body uses energy and makes proteins.

Types of Thyroid Cancer

Thyroid cancer is classified into different types based on the kind of cells from which the cancer grows. The prognosis and treatment approach vary significantly depending on the type.

Common Symptoms and Signs

In its early stages, thyroid cancer may not cause any symptoms. As it grows, it can cause:

• A lump or nodule that can be felt through the skin on the neck.
• Changes to the voice, including increasing hoarseness.
• Difficulty swallowing (dysphagia).
• Pain in the neck and throat.
• Swollen lymph nodes in the neck.
• A persistent cough not related to a cold.

Risk Factors

Factors that may increase the risk of developing thyroid cancer include:

• Gender and Age: It is about three times more common in women than in men. It can occur at any age, but it is most often diagnosed in people between the ages of 30 and 50.
• Radiation Exposure: High levels of radiation exposure, especially to the head and neck during childhood (e.g., from certain medical treatments), significantly increase the risk.
• Family History and Genetics: A family history of thyroid cancer or certain genetic syndromes, such as Familial Medullary Thyroid Cancer (FMTC) and Multiple Endocrine Neoplasia (MEN) type 2A and 2B, increases risk.
• History of Goiter: Having a history of goiter (an enlarged thyroid) can be a risk factor.

Diagnosis and Treatment

Diagnosis typically involves a combination of the following:

1. Physical Exam: A doctor feels the neck for lumps or swelling.
2. Blood Tests: To check thyroid hormone levels and, for MTC, calcitonin levels.
3. Ultrasound: To get a detailed image of the thyroid and any nodules.
4. Fine-Needle Aspiration (FNA) Biopsy: A thin needle is used to remove a small sample of cells from the nodule for microscopic examination. This is the most definitive way to diagnose thyroid cancer.

Treatment options depend on the type and stage of the cancer:

• Surgery: The most common treatment. This can involve a lobectomy (removing one lobe of the thyroid) or a thyroidectomy (removing the entire thyroid gland). Nearby lymph nodes may also be removed.
• Radioactive Iodine (RAI) Therapy: Often used after a thyroidectomy for papillary or follicular cancer to destroy any remaining thyroid tissue and cancer cells.
• Thyroid Hormone Therapy: Lifelong daily medication (levothyroxine) is required after a thyroidectomy to replace the hormones the thyroid used to make and to suppress the growth of any remaining cancer cells.
• External Beam Radiation Therapy: Uses high-energy rays to kill cancer cells, typically for more advanced or aggressive cancers.
• Targeted Drug Therapy & Chemotherapy: Used for advanced cancers that do not respond to other treatments, particularly anaplastic and advanced medullary cancers.