What Is Thyroid cancer: Causes,Risk factor,Symptoms,Diagnosis,and Treatment.
What is thyroid cancer-
Thyroid cancer is three times more common in women than in men.
What causes thyroid cancer?
The exact cause of thyroid cancer is not known, though there are factors that may be associated with an increased risk of developing cancer. Even if the risk factors are present, there is not a way of knowing whether cancer might develop; patients without risk factors still may develop thyroid cancer.
Symptoms of thyroid cancer-
Early thyroid cancer has no symptoms. You won’t be able to feel your thyroid gland if it’s healthy. As thyroid cancer progresses, the following symptoms may occur:
- a lump in the throat
- a cough
- hoarseness
- pain in the throat and neck
- difficulty swallowing
- swollen lymph nodes in the neck
- Talk to your doctor if you have any of these symptoms.
⇒Also read Symptoms of hypothyroidism
⇒Also read symptoms of hyperthyroidism
What are the risk factors for thyroid cancer?
- Most solitary thyroid nodules (lumps) are benign, but the risk of cancer increases if they occur in people younger than 30 or older than 60.
- Women are three times more likely to develop thyroid cancer than men and at a slightly younger age (40 to 50 years old for women versus 60 to 70 for men).
- A solitary nodule found in a male is more likely to be cancerous than a solitary nodule found in a female.
- A rapidly growing nodule is more likely to be cancerous and is an ominous sign.
- X-rays and CT scans of the neck use low doses of radiation but medical testing has not been found to cause thyroid cancer. Nevertheless, in general, it is important to limit the number of exposures to the least amount of radiation that will provide a clear enough image to help make a diagnosis.
- Diets low in iodine may increase the risk of thyroid cancer, but in developed countries, there is usually enough iodine used as food additives that this is not a problem. Lower levels of iodine in the diet may enhance the risk of radiation-induced thyroid cancer.
- There may be a relationship between poorly controlled diabetes and an increased risk of thyroid cancer.
- Children who have had radiation exposure to the neck are at higher risk for thyroid cancer. Studies have looked at children who were given radiation treatments 50-60 years ago when the risks of radiation were less well understood, and their rate of thyroid cancer is increased. Children and women survivors of nuclear reactor accidents (Chernobyl in 1986 have been studied) have an increased risk of thyroid and other types of cancer.
- Agent orange exposure may increase the risk of developing thyroid cancer.
- There may be a genetic predisposition to thyroid cancer, especially in certain rare types of thyroid cancer.
- While smoking is associated with thyroid disease, worsening hypothyroidism and being a risk factor for Graves' disease, smoking does not appear to increase the risk of thyroid cancer.
Types of thyroid cancer and incidence-
The nationwide relative frequency of thyroid cancer among all the cancer cases was 0.1%–0.2%. The age-adjusted incidence rates of thyroid cancer per 100,000 are about 1 for males and 1.8 for females as per the Mumbai Cancer Registry, which covered a population of 9.81 million subjects. The histological types of thyroid cancer were studied in a Hospital Cancer Registry of 1185 “new cases” of thyroid cancer.
The commonest cancer type was papillary, followed by follicular cancer.
Thyroid cancers are relatively uncommon. In the United States, it’s the tenth most common type of cancer. It’s about one-tenth as common as breast cancer, and one-fifth as common as lung cancer.
Thyroid cancers are classified according to the appearance of the cancerous cells. Cancerous cells that look like healthy cells are called well-differentiated cells. Well-differentiated cells grow at a slower rate than undifferentiated cells.
The types of thyroid cancer include:
A. Papillary thyroid cancer
Papillary thyroid cancer is a well-differentiated form of thyroid cancer. It’s the most common type. It’s most often seen in women of childbearing age. Papillary thyroid cancer is less dangerous than the other types. It spreads slower, and it’s very treatable.
B. Medullary thyroid cancer
Medullary thyroid cancer is another well-differentiated form of thyroid cancer. Some cases of medullary thyroid cancer have a genetic component. This can cause it to occur as part of a syndrome of endocrine gland cancers. Cases without a genetic component are said to be “sporadic.”
Medullary thyroid cancer arises in non-thyroid cells located in the thyroid gland. It’s treated differently than other forms of thyroid cancer.
C. Follicular thyroid cancer
Follicular thyroid cancer is the type of thyroid cancer most likely to spread and recur. Hurthle cell cancer is a type of follicular cancer.
D. Anaplastic thyroid cancer
Anaplastic thyroid cancer is the most aggressive form of thyroid cancer. It’s rare and difficult to treat.
E. Thyroid lymphoma
This is a rare type of thyroid cancer. It begins in immune cells located within the thyroid gland.
⇨ Diagnosing thyroid cancer
The results of a physical exam or laboratory test can reveal the presence of thyroid cancer. An examination of the neck may reveal a small or large mass in the thyroid. Lymph nodes may also be enlarged.
Lab tests and procedures used to diagnose thyroid cancer include:
- thyroid function tests
- a thyroglobulin test, which is used for papillary or follicular cancers
- an ultrasound of the thyroid
- a thyroid scan
- a thyroid biopsy
- calcium level in the blood
- phosphorous level in the blood
- calcitonin level in the blood
- laryngoscopy.
What are treatment options for thyroid cancer?
Thyroid cancer treatment usually requires surgery to remove the tumor. Two options are available and decisions as to which option to pursue depend upon the clinical situation.
1.Lobectomy:
The thyroid has two lobes joined in the middle with a fibrous tissue bridge called the isthmus. If the tumor is confined to only a small area, the surgeon may just remove the affected lobe.
2.Total thyroidectomy:
This is the most common surgery for thyroid cancer and the goal is to completely remove the thyroid gland and hopefully ensure that cancer will not recur.3.Lymph node resection:
Thyroid cancer can spread to local lymph nodes, and these nodes often are removed. Affected lymph nodes may only be recognized at the time of surgery.4.Open biopsy:
Sometimes, the cancerous nature of a thyroid nodule is unclear, even after fine-needle aspiration. A surgeon may operate to remove the nodule and send all the tissue for evaluation by a pathologist to make the diagnosis of cancer.
5.Thyroid hormone-
If the thyroid gland has been removed, the body will no longer be able to make thyroid hormone, and daily thyroid hormone replacement will be necessary. Routine thyroid hormone blood tests will need to be performed to ensure there is an adequate amount of thyroid hormone to allow the body to function properly. Thyroid hormone replacement will be lifelong in total thyroidectomy patients.
6.Radioactive iodine (radioiodine, I-131)
Iodine is routinely absorbed by thyroid tissue. Radioiodine may be administered after surgery to destroy any remnant thyroid tissue remaining after thyroidectomy. The decision to use this treatment depends upon the type and extent of the thyroid cancer and the levels of thyroid-stimulating hormone (TSH) produced by the pituitary gland.
7.Radiation
In certain thyroid cancers, where the tumor does not take up iodine, radiation therapy may be considered in place of radioactive iodine. Radioactive iodine update tests performed before surgery can assess whether or not iodine is taken up by the thyroid gland.
8.Chemotherapy
Chemotherapy is not commonly used for most thyroid cancers but may be used in certain clinical situations when thyroid cancer does not respond to other treatments.
What is the long-term outlook for people with thyroid cancer?
People diagnosed in the early stages of thyroid cancer generally respond well to treatment and go into remission. Some types of thyroid cancer have a higher rate of recurrence than others.
Make sure you go to routine follow-up appointments after you’re in remission. Doctors will need to check you for the rest of your life for signs of recurrent cancer. Your doctor will also want to routinely check that the amount of thyroid replacement hormones you’re taking is correct.
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