What is cancer of the thyroid?
The butterfly-shaped thyroid gland is in the front of the neck. Its main job is to make thyroid hormones, which control the metabolism, heart rate, blood pressure, and temperature of the body.
Thyroid cancer is not as common as other types of cancer. In the U.S. in 2021, there were likely 44,280 cases. But over the past 20 years, this number has been going up. This could be because imaging techniques have gotten better, making it easier to find smaller tumors that might not have been found before.
Overall, the expected course of thyroid cancer is good. This is called the prognosis. The chance of living for five years is 98.3%.
Cancers of the thyroid
The type of thyroid cancer is based on the kinds of cells that are in the tumor. The type of cancer is an important part of figuring out how to treat it.
These are the kinds of thyroid cancer:
• Thyroid cancers that are different from each other: papillary, follicular, and Hurthle cell
Most cases of thyroid cancer are papillary thyroid cancer, which makes up 80% of all cases. It is a slow-growing cancer, and the outlook is good for all but a few subtypes. Even if papillary thyroid cancer has spread to neck lymph nodes, it usually responds well to treatment. About 10% of people with thyroid cancer have follicular thyroid cancer, which is a good sign. Papillary thyroid cancer, on the other hand, is more likely to spread to the lungs and bones. About 3% of thyroid cancers are cancers of the Hurthle cell. Even though most people do well, the prognosis can change depending on how bad the disease is when it is found.
• Cancer of the middle thyroid
About 4% of thyroid cancers are caused by this type of cancer. This type of thyroid cancer is different from others and can run in families. It is linked to some genetic endocrine syndromes. If medullary thyroid cancer is found before it spreads, treatment is more likely to work.
• Thyroid cancer with no tumors
This type of thyroid cancer is the most dangerous. It makes up about 1% of all thyroid cancers. It is a type of cancer that spreads quickly and doesn’t respond well to treatment.
Lymphoma, sarcoma, and other tumors can sometimes also be found in the thyroid.
Thyroid cancer is most likely to happen if someone in your family has had it, if you have some genetic changes, or if you have been exposed to radiation, especially in the head and neck area. Also, it happens more often in women, as 75% of people with thyroid cancer are women.
The only sign of most thyroid cancers is a lump in the neck. Most of the time, doctors find lumps during exams or by accident when they do CT or ultrasound scans of the neck. People sometimes find lumps by themselves. If the mass is big enough, it can cause problems like trouble swallowing and breathing, hoarseness, and coughing.
When a lump or nodule is found, the next step in figuring out what’s wrong is a fine-needle aspiration biopsy. Using a thin needle, cells from the lump are taken and looked at under a microscope.
Most people don’t have any problems with this procedure, which is usually done with the help of an ultrasound. An endocrinologist with special training in fine-needle aspiration biopsy can do the procedure and help the patient decide on a treatment plan based on the results.
About 80% of thyroid nodules are benign, which means they are not cancer, and about 10% are cancerous, or malignant. The diagnosis for the other 10% is not clear, and a second biopsy or surgery could be used to figure it out.
Treatment for thyroid cancer is different for each person, and most people with thyroid cancer can be cured by treatment. But you might not need treatment right away if the cancer is small and unlikely to spread to other parts of your body. If that happened, the cancer would be checked on often.
Most people need surgery to take out all or part of their thyroid gland. Lymph nodes in the area may also be taken out. If the whole gland is taken out, a daily pill like levothyroxine would be needed to replace the thyroid function and stop the production of a hormone that could make any remaining cancer cells grow faster.
Depending on the type and stage of the cancer, there are other ways to treat it besides surgery. These include radioactive iodine treatment, external beam radiation, alcohol ablation, and chemotherapy.
After the first treatment, imaging of the neck and levels of thyroid tumor markers are checked regularly to look for a return of the cancer and decide if more treatment is needed.