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Thyroid Cancer Diagnosis and Treatment

What are thyroid tumors?

The thyroid gland is located in the front of the neck at the base of the throat. Thyroid tumors are either benign (noncancerous) or malignant (cancerous) growths. Examples of benign tumors are adenomas, which secrete thyroid hormone. Malignant tumors are more rare and are more common in women than in men. According to the American Cancer Society (ACS), about 30,180 cases of thyroid cancer will be diagnosed in the US in 2006.

What are thyroid adenomas?

Thyroid adenomas grow from the cell layer that lines the inner surface of the thyroid gland. The adenoma itself secretes thyroid hormone. If the adenoma secretes enough thyroid hormone, it may cause hyperthyroidism. Thyroid adenomas may be treated if they cause hyperthyroidism. Treatment may include surgery to remove part of the thyroid (the overactive nodule).

What are cancerous thyroid tumors?

Cancer of the thyroid occurs more often in people who have undergone radiation to the head, neck, or chest. However, most thyroid cancer can be cured with appropriate treatment. Thyroid cancer usually appears as small growths (nodules) within the thyroid gland. Some signs that a nodule may be cancerous include:

  • presence of a single nodule rather than multiple nodules
  • thyroid scan reveals the nodule is not functioning
  • nodule is solid instead of filled with fluid (cyst)
  • nodule is hard
  • nodule grows fast

What are the symptoms of thyroid cancer?

The first sign of a cancerous nodule in the thyroid gland is a painless lump in the neck.

However, each individual may experience symptoms differently. Other symptoms may include:

  • hoarseness or loss of voice as the cancer presses on the nerves to the voice box
  • difficulty swallowing as the cancer presses on the throat

Most thyroid cancers are diagnosed with imaging and do not cause any symptoms because they are too small. When present, the symptoms of thyroid cancer may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Diagnosis of thyroid cancer:

In addition to a complete medical history and medical examination, diagnostic procedures for thyroid cancer may include:

  • thyroid scan
  • ultrasound
  • biopsy - taking a sample of the nodule with a needle for examination under a microscope

Thyroid cancer comes in four forms:

papillary thyroid cancer

Papillary thyroid cancer is the most common form of thyroid cancer, accounting for about 60 to 70 percent of all cases. This form of thyroid cancer affects more women than men.

Treatment for papillary cancer usually involves:

  • surgery - to remove part or all of the thyroid (called a thyroidectomy)
  • thyroid hormone therapy - to suppress the pituitary gland from secreting more thyroid-stimulating hormone, which may stimulate a recurrence of papillary cancer
  • administration of radioactive iodine - to destroy any remaining thyroid tissue

follicular thyroid cancer

Follicular thyroid cancer occurs most often among elderly patients and accounts for about 15 percent of thyroid cancer cases. This type of thyroid cancer is more aggressive and tends to spread through the bloodstream to other parts of the body.

Treatment for follicular cancer may include:

  • surgery - to remove the thyroid gland (thyroidectomy)
  • administration of radioactive iodine - to destroy any remaining thyroid tissue

anaplastic thyroid cancer

Anaplastic thyroid cancer tends to occur most often among elderly women and accounts for less than 10 percent of thyroid cancer cases. This quick-growing cancer usually results in a large growth in the neck. Approximately 80 percent of patients diagnosed with anaplastic thyroid cancer die within one year of diagnosis.

Treatment for anaplastic thyroid cancer may include:

  • surgery - to remove the thyroid gland (thyroidectomy)
  • medication (i.e., anticancer drugs)
  • radiation therapy

medullary thyroid cancer

Medullary thyroid cancer tends to spread through the lymphatic system (which is part of the immune system and consists of a system of vessels that connect lymphs throughout the body) and the bloodstream to other parts of the body. This type of cancer produces excessive amounts of calcitonin, a hormone also produced by the thyroid gland itself.
  • surgery - to remove the thyroid gland (thyroidectomy)

Additional surgery may be necessary if the cancer has spread.

Because medullary cancer tends to run in families, screening tests for genetic abnormalities in the blood cells may be conducted.

What is radioactive iodine treatment?

The thyroid needs iodine to properly produce the thyroid hormones. By administering radioactive iodine to a patient, the thyroid tissue will absorb the altered iodine, which then destroys that thyroid tissue.

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