HEALTH - THYROID CANCER (THYROID GLAND) SYMPTOMS & TREATMENT
What is Thyroid Cancer?
Thyroid cancer begins in the thyroid gland, which is located in the front of the neck just below the larynx (voice box). The thyroid gland is part of the endocrine system, which regulates hormones in the body. The thyroid gland absorbs iodine from the bloodstream to produce thyroid hormone, which regulates your metabolism, heart rate, blood pressure, body temperature and weight..
Thyroid cancer begins when the cells in the thyroid begin to change, grow uncontrollably, and eventually form a tumor. There are two types of tumors: benign (noncancerous) and malignant (cancerous, meaning that it can spread to other parts of the body). Thyroid tumors can also be called nodules, and 90% of all thyroid nodules are benign.
A healthy thyroid gland is a little larger than a quarter. It usually cannot be felt through the skin. The thyroid is shaped like a butterfly and lies at the front of the neck; and a normal gland has two lobes, one on each side of the windpipe, joined by a narrow strip of tissue called the isthmus. If a tumor develops in the thyroid, it is felt as a lump in front of the neck. A swollen or enlarged thyroid gland is called a goiter, which may be due to iodine deficiency. Most Americans receive enough iodine from salt, and a goiter under these circumstances is caused by other reasons.
The thyroid gland contains two types of cells: follicular cells, which are responsible for the production of thyroid hormone, and C cells, which make calcitonin, a hormone that participates in calcium metabolism.
Thyroid cancer isn't common in the United States. About 37,000 people are diagnosed with thyroid cancer each year, according to the National Cancer Institute. Thyroid cancer rates seem to be increasing, which doctors think may be due to new technology that allows them to find small thyroid cancers that may not have been found previously. Thyroid cancer is the seventh most common cancer in women.
Four main types of thyroid cancer:
Papillary thyroid cancer. Papillary thyroid cancer develops from the follicular cells and grows slowly. It is usually found in one lobe; only 10% to 20% of papillary thyroid cancers appear in both lobes. Papillary thyroid cancer is a differentiated thyroid cancer, meaning that the tumor looks similar to normal thyroid tissue under a microscope.
Follicular thyroid cancer. Follicular thyroid cancer also develops from the follicular cells and usually grows slowly. Follicular thyroid cancer is also a differentiated thyroid cancer, but it is less common that papillary thyroid cancer.
These two types of cancer are very often curable, especially when found early and in people younger than 45. Together, papillary and follicular thyroid cancers make up 80% to 90% of thyroid cancers.
Medullary thyroid cancer (MTC). MTC develops in the C cells and is sometimes the result of a genetic syndrome called multiple endocrine neoplasia type 2 (MEN2). This tumor has very little, if any, similarity to normal thyroid tissue. MTC can often be controlled if it is diagnosed and treated before it spreads to other parts of the body. MTC accounts for 5% to 10% of thyroid cancers.
Anaplastic thyroid cancer. This rare and fast-growing, poorly differentiated thyroid cancer starts from differentiated thyroid cancer or a benign tumor of the thyroid gland. Anaplastic thyroid cancer can be subtyped into giant cell classifications. Because this type of cancer grows so quickly, it can be more difficult to treat successfully.
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Health: Risk Factors of Thyroid Cancer (Thyroid Gland)
No one knows the exact causes of thyroid cancer. Doctors can seldom explain why one person gets this disease and another does not. However, it is clear that thyroid cancer is not contagious. No one can "catch" cancer from another person.
Research has shown that people with certain risk factors are more likely than others to develop thyroid cancer. A risk factor is anything that increases a person's chance of developing a disease.
The following risk factors are associated with an increased chance of
developing thyroid cancer:
- Family history. Having a parent with MEN 2A, MEN 2B or familial medullary cancer means you have a 50 percent chance of having the genetic mutation that causes these diseases. If you have one of these types of cancer yourself, your children have a 50 percent chance of developing cancer. Your doctor or a genetic counselor can give you more health information and answer any questions you may have regarding genetic screening and treatment.
- Exposure to radiation. This includes radiation you may have received as a treatment for acne or other childhood diseases as well as radiation from nuclear fallout. If you're concerned about possible radiation exposure, talk to your doctor. Or contact the National Cancer Institute's Cancer Information Service at (800) 4-CANCER, or (800) 422-6237, for more information.
- Certain inherited conditions. Your risk of papillary thyroid cancer increases if you have Gardner's syndrome or familial adenomatous polyposis — genetic disorders in which large numbers of precancerous polyps develop throughout your colon and upper intestine. Untreated, Gardner's syndrome and familial adenomatous polyposis usually lead to colon cancer. Having Cowden disease, a rare, inherited disorder that causes lesions on your face, hands and feet, and inside your mouth, also increases your risk of developing thyroid cancer and breast cancer.
- Gender. For reasons that aren't clear, women are two to three times as likely as men to develop thyroid cancer.
- Reproductive history. Women whose last pregnancy occurs at age 30 or later appear to be at higher risk of thyroid cancer than are women who have children earlier in life.
- Age. Papillary and follicular thyroid cancers can develop at any age but are more common in young adulthood. Sporadic medullary thyroid cancer usually occurs in adults. MEN 2 and familial medullary cancer also occur in adults but can affect children and infants as well.
- Race. White Americans are more likely to develop thyroid cancer than black Americans are.
- Diet low in iodine. Iodine is needed for normal thyroid functioning. In the United States, iodine is added to salt to help prevent thyroid problems.
People
with thyroid cancer often experience the following symptoms. Sometimes,
people with thyroid cancer do not show any of these symptoms in the early stages. Or, these
symptoms may be similar to those of other health conditions. If you
are concerned about any symptoms on this list, please talk with your
doctor or health care provider. These symptoms may be caused by thyroid cancer; other thyroid
problems, such as a goiter; or an health condition not related to the thyroid,
such as an infection. Thyroid cancer isn't common, so your doctor may investigate other causes of your symptoms first. Talk with your doctor for more information. Health: Diagnosis of Thyroid Cancer (Thyroid Gland)
Doctors
use many tests to diagnose cancer and determine if it has metastasized
(spread). Some tests may also determine which treatments may be the
most effective. For most types of cancer, a biopsy is the only way to
make a definitive diagnosis of cancer. If a biopsy is not possible, the
doctor may suggest other tests that will help make a diagnosis. Imaging
tests may be used to find out whether the cancer has metastasized. Your
doctor may consider these factors when choosing a diagnostic test: The following tests may be used to diagnose thyroid cancer: Physical examination. The doctor will feel the neck, thyroid,
throat, and lymph nodes (the tiny, bean-shaped organs that help fight
infection) in the neck for unusual growths or swelling. If surgery is
recommended, the larynx may be examined at the same time with a
laryngoscope (thin, flexible tube with a light). Blood tests. The doctor may use a blood test to check the
level of thyroid-stimulating hormone (TSH). A measurement of thyroid
hormone levels and antithyroid antibodies may be done as well. If MTC
is a possibility, the doctor will order a test to check for high
calcitonin levels and a blood test to detect the presence of RET proto-oncogenes (Risk Factors). The search for RET proto-oncogenes is often recommended if there is a family history of MTC. Ultrasound. An ultrasound uses sound waves to create a
picture of the internal organs. An ultrasound wand or probe is guided
over the skin of the neck area. High-frequency sound waves create a
pattern of echoes that show the doctor the thyroid gland size and
specific information about any nodules, including whether they are
solid or cysts (fluid-filled sacs). Biopsy. A biopsy is the removal of a small amount of tissue
for examination under a microscope. The way to determine whether a
nodule is malignant or benign is through a biopsy. During this
procedure, the doctor removes cells from the nodule that are then
examined by a cytopathologist (a doctor who specializes in analyzing
cells and tissue) to determine if cancer is present. A biopsy for
thyroid nodules will be done one of two ways: Radionuclide scanning. This test, also called a full body
scan or a radioactive iodine (RAI) scan, is used most often to learn
more about a thyroid nodule. In this test, the patient swallows a
small, harmless amount of radioactive iodine, which allows the doctor
to see differences between thyroid cells and other body structures.
Health: Symptoms of Thyroid Cancer (Thyroid Gland)
Health: Staging of Thyroid Cancer (Thyroid Gland)
If the diagnosis is thyroid cancer, the doctor needs to know the stage,
or extent, of the disease to plan the best treatment. Staging is a
careful attempt to learn whether the cancer has spread and, if so, to
what parts of the body.Staging is a way of describing a cancer, such
as where it is located, if or where it has spread, and if it is
affecting the functions of other organs in the body.
Doctors use diagnostic tests to determine the cancer’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis (chance of recovery). There are different stage descriptions for different types of cancer.
_______________________________________________________________________________________________________
Natural Alternative Treatment Options: NATURAL CANCER TREATMENT
_______________________________________________________________________________________________________
Health: Conventional Treatment for Thyroid Cancer (Thyroid Gland)
The treatment of thyroid cancer depends on the
size and location of the tumor, the type of thyroid cancer, whether the
cancer has spread, and the person’s overall health. In many cases, a
team of doctors will work with the patient to determine the best
treatment plan, including a surgeon, endocrinologist (a doctor
specializing in problems with glands and the endocrine system), medical
oncologist, and radiation oncologist.
Thyroid cancer is treated by one or a combination of treatments, including surgery, radioactive iodine, hormone treatment, external-beam radiation therapy, and/or chemotherapy. The main treatment options are described below, followed by an outline of treatment options by stage.
Surgery
Surgery is the main treatment for most thyroid cancers. Depending on
the size of the nodule, the surgeon will perform a total thyroidectomy
(surgery to remove the entire thyroid gland), a near-total
thyroidectomy (surgery to remove the thyroid gland except for a small
part), or a lobectomy (surgery to remove the lobe with the cancerous
nodule).
Total or near-total thyroidectomies are the most common operations for thyroid cancer; lobectomies are performed on some patients with papillary or follicular thyroid cancer. If there is evidence or risk of spread of cancer to the lymph nodes in the neck, the surgeon may also perform a neck dissection (surgery to remove the lymph nodes in the neck).
Without the thyroid gland, the body stops producing thyroid hormone, which is essential to a body’s functioning. Hormone replacement (see below), usually given by a daily pill, is the best solution. The patient may also have to take vitamin D and calcium supplements if the parathyroid gland function is impaired after surgery.
Thyroid surgery is performed by making an incision in the skin at the
base of your neck. Thyroid surgery carries a risk of bleeding and
infection. Damage can also occur to your parathyroid glands during
surgery, causing low calcium levels in your body. There's also a risk
of accidental damage to the nerves connected to your vocal cords, which
can cause vocal cord paralysis, hoarseness, soft voice or difficulty
breathing, temporarily or permanently.
Hormone treatment
After thyroid cancer surgery, you'll take the thyroid hormone medication levothyroxine (Levothroid, Synthroid, others) for life. This has two benefits: It supplies the missing hormone your thyroid would normally produce, and it suppresses the production of thyroid-stimulating hormone (TSH) in your pituitary gland. High TSH levels could conceivably stimulate any remaining cancer cells to grow. You'll likely have blood tests to check your thyroid hormone levels every few months until your doctor finds the proper dosage for you.
In addition to replacing the hormone that is needed by the body, the thyroid hormone medication will slow down the growth of any remaining differentiated cancer cells, an important double purpose.
Thyroid hormone replacement is levothyroxine. Levothyroxine typically comes as a pill that
should be taken daily, at the same time each day. Thyroid pills have
few side effects. Occasionally, some patients develop a rash or lose
some hair during the first months of treatment. The doctor will monitor
the patient’s thyroid hormone levels through regular blood tests.
Hyperthyroidism (too much hormone) may cause weight loss, chest pain, rapid heart rate or arrhythmias (irregular heartbeat), cramps, and diarrhea; patients may also feel hot and sweaty. Hypothyroidism (too little hormone) may cause fatigue, weight gain, and dry skin and hair; patients may also feel cold. The amount of thyroid hormone required is different for every patient and tumor type, and it can change as a person ages.
Radioactive iodine (radioiodine) therapy
Radioactive iodine treatment uses large doses of a form of iodine that's radioactive. Radioactive iodine treatment is often used after thyroidectomy to kill any remaining healthy thyroid tissue, as well as microscopic areas of thyroid cancer that weren't removed during surgery. Radioactive iodine treatment may also be used to treat thyroid cancer that recurs after treatment or that spreads to other areas of the body.
Radioactive iodine treatment comes as a capsule or liquid that you swallow. The radioactive iodine is taken up primarily by thyroid cells and thyroid cancer cells, so there's a low risk of harming other cells in your body.
Side effects may include:
- Nausea
- Dry mouth
- Dry eyes
- Altered sense of taste or smell
- Pain where thyroid cancer cells have spread, such as the neck or chest
Most of the radioactive iodine leaves your body in your urine in the first few days after treatment. During that time you'll need to take precautions to protect other people from the radiation. For instance, you may be asked to temporarily avoid close contact with other people, especially children and pregnant women.
External-beam radiation therapy
Radiation uses high-energy x-rays to kill cells. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. Radiation therapy is usually given as outpatient therapy five days a week for about five to six weeks either in a hospital or clinic.
For thyroid cancer, radiation therapy is used only in certain circumstances, typically when advanced thyroid cancer has not responded to radioiodine therapy. Radiation therapy is usually given after surgery, and treatment is concentrated on a specific area, only affecting cancer cells at that site.
Side effects depend on the treatment dosage and area and may include redness of the skin, odynophagia (painful swallowing), cough, occasional hoarseness, nausea, and fatigue. Most side effects go away soon after treatment is finished.
Chemotherapy is the use of drugs to kill cancer cells and is sometimes used to treat thyroid cancer. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. The goal of chemotherapy can be to destroy cancer remaining after surgery, slow the tumor’s growth, or reduce symptoms.
The side effects of chemotherapy depend on the individual and the dose used. The side effects of chemotherapy depend on the individual and the dose used but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.
At this time, the use of systemic chemotherapy for the treatment of thyroid cancer is determined on an individual basis and is most often given as part of a clinical trial (research study). With new knowledge in the molecular abnormalities of cancer cells, scientists are developing therapies that specifically target such abnormalities. In turn, the cancer therapy can be more specific.
The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications you've been prescribed, their purpose, and their potential side effects or interactions with other medications.
Treatment options by stage
If the thyroid cancer is only within the tissues of the neck, both in the thyroid gland and in the lymph nodes, surgery will typically be the first treatment. Patients with more advanced disease may be treated with surgery as well, but other treatments may be done first.
Stage I: Surgery; hormone therapy; possible radioactive iodine therapy after surgery
Stage II: Surgery; hormone therapy; possible radioactive iodine therapy after surgery
Stage III: Surgery; hormone therapy; possible radioactive iodine therapy or external-beam radiation therapy after surgery
Stage IV (advanced): Stage IV thyroid cancer is the most advanced stage of the disease. The cancer has spread beyond the thyroid to the lymph nodes and other organs, such as the bones or lungs.
Symptoms of advanced thyroid cancer are similar to those present when the disease was first diagnosed:
- A lump in the front of the neck, near the Adam’s apple
- Hoarseness
- Swollen glands, especially in the neck
- Difficulty swallowing
- Difficulty breathing
- Pain in the throat or neck
- A cough that persists and is not caused by a cold
- Bone pain, specifically when metastases develop in the skeleton
Treatment for advanced thyroid cancer may include a combination of surgery, hormone therapy, radioactive iodine therapy, external-beam radiation therapy, and chemotherapy. Radiation therapy may also be used to reduce pain and other health problems. Patients with advanced thyroid cancer may consider participating in clinical trials.
Health: Complications of Thyroid Cancer (Thyroid Gland)
Recurrent thyroid cancer is cancer that comes back after treatment. Despite treatment, thyroid cancer can return, even if you've had your thyroid removed. This could happen if microscopic cancer cells spread beyond the thyroid before it's removed. Thyroid cancer recurrence can occur decades after thyroid cancer treatment.
Thyroid cancer most often recurs in:
- Lymph nodes in the neck
- Small pieces of thyroid tissue left behind during surgery
- Other areas of the body — most often the lungs or the bones
Thyroid cancer that recurs can be treated. Your doctor may recommend periodic blood tests or thyroid scans to check for signs of a thyroid cancer recurrence.
Health: Prevention of Thyroid Cancer (Thyroid Gland)
It's often not possible to prevent thyroid cancer. But the following measures may reduce or eliminate the risk:
- Preventive (prophylactic) surgery. If you've inherited a defective RET gene, you may choose to have your thyroid gland surgically removed, even though the gland appears to be healthy. This pre-emptive approach eliminates the risk of medullary thyroid cancer but doesn't reduce the likelihood of adrenal or parathyroid tumors in people with MEN 2 syndrome.
-
Potassium iodide tablets. Heightened concerns about national security have focused attention on nuclear power plants in the United States. Current government guidelines recommend that people within 10 miles of these plants be provided with potassium iodide tablets.
Taken just before or immediately after exposure to nuclear fallout, potassium iodide protects your thyroid gland from iodine 131, though not from other radioactive material. Children are most at risk from exposure to radioactive iodine, and potassium iodide is safe and effective for even very young children when taken in the proper dosage.
Short-term side effects, which are more common in adults than in children, include intestinal problems, allergic reactions and minor rashes. You shouldn't take potassium iodide if you have multinodular goiter, Graves' disease or autoimmune thyroiditis.
-
A healthy diet. A diet high in fruits and vegetables and low in animal fat can reduce your risk of many types of cancer. The American Cancer Society recommends eating at least five servings of fruits and vegetables every day. They contain antioxidants, which protect your cells from damage that occurs as a result of normal metabolism.
In addition, emphasize unsaturated fats (omega-3 fatty acids), especially those found in salmon and other fish, because they may help protect against cancer. Maintaining a healthy weight can also help protect against many diseases, including cancer of the thyroid.
_______________________________________________________________________________________________________
Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.
Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services_______________________________________________________________________________________________________
<<Previous (Home Page) Next>>
