Early symptoms of thyroid cancer

tyroid cancer

The early symptoms of thyroid cancer include lumps and swelling in the neck, near the Adam’s apple. Thus, the American Cancer Society recommends doctors to include an examination of the thyroid as part of cancer-related checkups during a routine physical exam. Moreover, some physicians even advise patients to check their own necks for growths or lumps two times a year.

Other thyroid cancer symptoms include:

·         Hoarseness and other voice changes.

·         Swollen neck glands and lymph nodes.

·         Swallowing problems.

·         Breathing problems.

·         Throat or neck pain.

·         Pain in the front of the neck that may go up to the ears.

·         Persisting cough not caused by a cold.

Thyroid cancer begins in the thyroid gland when the cells contained there – either follicular cells or C cells – grow out of control and form a tumor, which in this part of the body is also known as a nodule. Ninety-percent of thyroid tumors are benign. When the nodule is indeed cancerous, it is one of four different types.

Types of thyroid cancer

Papillary

The most common type. Slow-growing, it develops from the follicular cells. Generally located in one lobe with only 10%-20% found in both lobes. The tumor resembles normal thyroid tissue under the microscope. It can affect people of any age but mostly those between 30 and 50.

Follicular

Similar to papillary thyroid cancer but less common.

Medullary

Develops in the C cells and has little resemblance to normal thyroid tissue. Causes about 5% of thyroid cancers, sometimes as a result of a multiple endocrine neoplasia type 2 genetic syndrome.

Anaplastic

Quickly-growing and hard to treat but also very rate, accounting for approximately 2% of thyroid cancers. It usually occurs in people aged 60 or older.

 

The cause of thyroid cancer is not clear, but certain risk factors have been established, such as:

·         Gender. Females are 2-3 times more likely to be diagnosed with thyroid cancer than males.

·         Age. Two thirds of all thyroid cancers occur between 20 and 55 years of age.

·         Ethnicity. Whites and Asians are more likely to be diagnosed with thyroid cancer.

·         Family history of medullary thyroid cancer, goiter, or precancerous colon polyps.

·         Exposure to radiation.

·         Low-iodine diet.

If you’re in these risk groups or have experienced the early symptoms of thyroid cancer, your doctor may run some tests and make a diagnosis.

Diagnosing thyroid cancer

 

Blood tests

·         Thyroid hormone (T3 and T4) levels.

·         Thyroid-stimulating hormone (TSH) levels.

·         Thyroglobulin (Tg) and thyroglobulin antibodies (TgAb).

·         Calcitonin.

Biopsy

·         Fine needle aspiration.

·         Surgical biopsy.

 

 

Imaging

·         Ultrasound.

·         Radioiodine scan.

·         Chest x-ray.

·         Computed tomography scan.

·         Magnetic resonance imaging scan.

·         Positron emission tomography scan.

 

These diagnostic tests help to stage the tumor. Thyroid cancer staging depends on the type of type of cancer (types described above).

Stage

Type of thyroid cancer

 

Papillary or follicular in patients under 45 years of age

I

A tumor of any size that has not spread to distant organs and may or may not have spread to regional lymph nodes.

II

A tumor of any size that has spread to distant organs and may or may not have spread to regional lymph nodes.

 

Papillary or follicular in patients aged 45 and older

I

A 2cm or smaller tumor that has not grown beyond the thyroid and has not spread to regional lymph nodes or distant organs.

II

A tumor larger than 2cm but smaller than 4cm that has not grown beyond the thyroid and has not spread to regional lymph nodes or distant organs.

III

A tumor larger than 4cm or slightly grown beyond the thyroid that has spread to lymph nodes around the thyroid but not to other lymph nodes or distant organs; or, a tumor of any size that may have grown slightly beyond the thyroid, has spread to lymph nodes around the thyroid but not to other lymph nodes or distant organs.

IVA

A tumor of any size that has grown outside the thyroid and into regional neck tissues and may or may not have spread to regional lymph nodes but not to distant organs; or, a tumor of any size that may have grown slightly beyond the thyroid, has spread to certain neck lymph nodes or to lymph nodes in the upper chest or behind the throat but not to distant organs.

IVB

A tumor of any size that has grown either back toward the spine or into regional large blood vessels, and may or may not have spread to regional lymph nodes but not to distant organs.

IVC

A tumor of any size that has spread to distant organs, may or may not have grown beyond the thyroid, and may or may not have spread to regional lymph nodes.

 

Medullary thyroid cancer

I

A 2cm or smaller tumor that has not grown beyond the thyroid and has not spread to regional lymph nodes or distant organs.

II

A 2cm-4cm tumor that has not grown beyond the thyroid and has not spread to regional lymph nodes or distant organs; or, a tumor larger than 4cm or slightly grown beyond the thyroid, but which has not spread to regional lymph nodes or distant organs.

III

A tumor of any size that may have grown slightly beyond the thyroid and has spread to lymph nodes around the thyroid but not to other lymph nodes or distant organs.

IVA

A tumor of any size that has grown outside the thyroid and into regional neck tissues, and may or may not have spread to regional lymph nodes but not to distant organs; or, a tumor of any size that may have grown slightly beyond the thyroid, has spread to certain lymph nodes in the neck, or lymph nodes in the upper chest or behind the throat, but has not spread to distant organs.

IVB

A tumor of any size that has grown either back toward the spine or into regional large blood vessels, and may or may not have spread to regional lymph nodes but not to distant organs.

IVC

A tumor of any size that has spread to distant organs, may or may not have grown beyond the thyroid, and may or may not have spread to regional lymph nodes.

 

Anaplastic thyroid cancer (always considered IV stage)

IVA

The tumor remains inside the thyroid and may or may not have spread to regional lymph nodes but not to distant organs.

IVB

The tumor has grown beyond the thyroid and may or may not have spread to regional lymph nodes but not to distant organs.

IVC

The tumor has spread to distant organs and may or may not have grown beyond the thyroid and spread to regional lymph nodes.

 

The stage of the cancer is a key factor in determining the patient’s survival rate. Obviously, a tumor that has grown and spread unchecked presents treatment difficulties that compromise a positive outlook, as opposed to a smaller one that has not metastasized.

Thyroid cancer 5-year relative survival rates

 

 

Type of cancer

Stage

Papillary

Follicular

Medullary

Anaplastic

I

Near 100%

 

II

Near 100%

98%

81%

III

93%

71%

IV

51%

50%

28%

7%

 

Staging also has a bearing on treatment, among other factors. The main treatment option for most thyroid cancer patients is surgery, of which there are several alternatives as well.

Surgery for thyroid cancer

Name of the procedure

Part of the body removed

·         Lobectomy

The thyroid gland’s lobe with the tumor.

·         Near-total thyroidectomy

The thyroid gland minus a small part.

·         Total thyroidectomy

The entire thyroid gland.

·         Lymphadenectomy

Lymph nodes in the neck.

 

Other treatments include:

·         Hormone treatment.

·         Radioactive iodine therapy.

·         External beam radiation therapy.

·         Chemo and targeted therapy.

·         Alcohol ablation.

Once again, the cancer’s stage dictates the treatment option:

Thyroid cancer treatment by stage

I

 

Surgery, hormone therapy, possibly radioactive iodine therapy following surgery

II

III

IV

Surgery, hormone therapy, radioactive iodine therapy, external beam therapy, targeted therapy, and chemotherapy.

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