Thyroid Cancer

Cancer is made of changed cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to lymph nodes or other parts of the body. This is called metastasis.

Thyroid cancer starts in the cells of the thyroid gland. The thyroid gland produces thyroid hormones and is part of the endocrine system. It’s in the front of your neck, over your windpipe. The thyroid gland is shaped like a butterfly with two lobes, a right and left lobe. The lobes are joined by a bridge of tissue, called the isthmus.

The thyroid is made up of two main types of cells. The follicular cells make and store thyroid hormones, which control your metabolism. The C cells, or parafollicular cells, make the hormone calcitonin. This helps control calcium levels in your body. The different types of thyroid cancer develop from the different types of cells.

There are four main types of thyroid cancer (carcinoma):

• Papillary carcinoma.

• Follicular carcinoma.

• Medullary thyroid carcinoma.

• Anaplastic carcinoma.

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. Risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control, but others may be things you can change.

The risk factors for thyroid cancer include:

• Middle to older age.

• History of radiation exposure, especially during childhood.

• Iodine deficiency.

• Family history of thyroid cancer and thyroid disease.

Talk with your healthcare provider about your risk factors for thyroid cancer and what you can do about them.

It’s not uncommon to have few or no symptoms early on. One of the most common symptoms is a lump (growth) called a nodule in the neck. Other symptoms of thyroid cancer include:

• A lump or swelling over your thyroid or elsewhere in your neck.

• Hoarseness or other changes in your voice that don’t go away or gets worse over time.

• Neck pain. This is usually in the front of your neck near your Adam’s apple and extends up to your ears.

• Swollen lymph nodes.

• Trouble breathing that feels like you are breathing through a straw.

• Trouble swallowing.

Most thyroid nodules are not cancer. Many of these may be caused by other health problems. It’s important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

If your healthcare provider thinks you may have thyroid cancer, you will need certain exams and tests to be sure. Your healthcare provider will ask you about your health history, your symptoms, risk factors, and family history of disease. He or she will also give you a physical exam. Finding thyroid cancer early on can happen during a routine exam when the healthcare provider notices a nodule. You may also have one or more tests.

A needle biopsy is the only way to confirm cancer. Cells are taken out from the thyroid using a small needle and checked for cancer cells. Your results will come back in about 1 week.

After a diagnosis of thyroid cancer, you’ll likely have other tests. These help your healthcare providers learn more about your cancer. They can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It is one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

Your treatment choices depend on the type of thyroid cancer you have, test results, and the stage of the cancer. Most thyroid cancers are slow to grow and spread (metastasize). But some thyroid cancer types can grow and spread quickly. Your provider will treat these differently. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be. Other things to think about are if the cancer can be removed with surgery and your overall health.

Types of treatment for cancer can be local, regional and/or systemic. Local treatments remove, destroy, or control cancer cells in the neck and usually involve surgery. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by mouth, radioactive iodine is a systemic treatment for the most common types of thyroid cancer. External radiation and/or chemotherapy are less commonly used. Thyroid replacement hormones are usually given after thyroid surgery to replace the hormone that is naturally made. You may have just one treatment or a combination of treatments.

Thyroid cancer may be treated with:

• Surgery.

• Radioactive iodine.

• Thyroid hormone treatment.

• External radiation therapy.

• Chemotherapy.

• Targeted therapy.

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effects of cancer and its symptoms on your daily life.

Also:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with as many protein foods as possible.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.