Thyroid Cancer

WHAT YOU SHOULD KNOW

Like all forms of cancer, this variety is the result of unrestrained multiplication of cells. Normal cells divide in a planned way, creating more cells only when needed. Cancerous cells reproduce without order or limits, often creating excess tissue that becomes a tumor. As the disease progresses, cancer often spreads to nearby organs, or even other parts of the body. Thyroid cancer, however, is generally slow to spread and can usually be eliminated when treated promptly.

Thyroid cancer strikes women twice as often as men, and tends to be seen more frequently in people over 40. The rarer and more dangerous types are more likely to be found in the elderly.

Causes

Thyroid cancer is sometimes linked to radiation treatments, such as those given for leukemia, that the patient received during infancy or childhood. Although the radiation may have caused no immediate problem, a tumor may still develop 30 or 40 years later. A deficiency of iodine in the diet could also be at fault, and some cases of thyroid cancer follow cancer in other glands. In many cases, however, no cause can be found.

Signs/Symptoms

The most common sign of thyroid cancer is a lump in the neck. A few people also notice enlarged lymph nodes in the neck. You may have difficulty swallowing and, at a later stage in the illness, may suffer from hoarseness and have difficulty breathing.

Care

To confirm the diagnosis and determine the type and stage of the cancer, the doctor will order some specialized blood tests and take pictures of the thyroid with a thyroid scan or ultrasound (a technique that produces images by bouncing sound waves off the organ). CT (computed tomography) and MRI (magnetic resonance imaging) scans may also be ordered to provide the doctor with a cross-sectional view of the gland. A sample of thyroid tissue drawn out through a needle may be sent to a lab for study (a procedure call biopsy).

Treatment usually starts with surgery and continues with long-term hormone therapy. For large cancers, treatment with radioactive iodine may also be prescribed.

• Surgery: Depending upon the stage and type of tumor, your doctor will perform one of the following types of thyroid surgery:
• • Lobectomy. Removal of only the side of the thyroid where the cancer is found.
  • Near-total thyroidectomy. Removal of the entire thyroid except for a small part.
  • Total thyroidectomy. Removal of the entire gland.

Nearby lymph nodes may also be removed if there's a chance the cancer has reached them. If the cancer has not spread, the surgery almost always cures the disease. After the operation, you will need to take thyroid hormone replacement supplements daily for the rest of your life.

• Radiation Therapy: X-rays or gamma rays can kill cancer and help prevent it from spreading. They can also be effective in reducing pain, controlling bleeding, and shrinking cancerous tumors. Radiation is often used after surgery to kill any cancer cells that might have been missed during the operation.
      For people who have had a total thyroidectomy, radiation is usually administered in the form of radioactive iodine, which collects in any remaining thyroid tissue and destroys the cells. The iodine is given in liquid or capsule form. It generally passes from the body within 48 to 72 hours.
• Hormone Therapy: When the body's level of thyroid hormone drops following removal of the gland, it triggers an increase in the production of thyroid stimulating hormone (TSH), a substance that promotes the growth of the thyroid gland and in some cases, the growth of thyroid cancer cells. To hold down the level of TSH, your doctor will prescribe thyroid hormone replacement therapy with a drug such as Synthroid. The replacement is taken in tablet form on a daily basis.

Risks

Most types of thyroid cancer are among the most curable forms of the disease. Left untreated, however, the cancer will eventually spread and prove fatal. It's important to undergo treatment as soon as you can.

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