Thyroid Cancer: Symptoms, Causes, Diagnosis and Treatment

Thyroid cancer is an endocrine cancer that develops in the thyroid gland, a small butterfly-shaped gland located in the neck. The thyroid gland manages the production of hormones that are crucial in regulating the body's metabolism.

It also releases hormones that direct several bodily functions, like controlling body temperature, heart rate, and blood pressure. It also releases hormones that direct several bodily functions, like controlling body temperature, heart rate, and blood pressure. 

Thyroid cancer can develop when the cells in the thyroid gland mutate and grow uncontrollably, forming a tumour. But is thyroid cancer curable? Yes! If diagnosed early, thyroid cancer is one of the most treatable forms of cancer. 

Thyroid cancer is of four types based on the kind of cells from which the cancer developed. Understanding the type of thyroid cancer is crucial as it helps the healthcare professional in determining the appropriate treatment and prognosis. 

The four significant types of thyroid cancer are:

1. Papillary Thyroid Cancer: It is the most common thyroid cancer, accounting for about 80% of cases. It develops from the follicular cells that produce thyroid hormones.
   Even if papillary thyroid cancer spreads to lymph nodes in the neck, the disease responds well to treatment and is rarely fatal. 

2. Follicular Thyroid Cancer: This type of cancer arises from the follicular cells of the thyroid gland. Follicular thyroid cancer accounts for about 15% of cases.
   It is less common than papillary thyroid cancer but has a higher risk of spreading to bones and organs like the lungs. It can be more challenging to treat. 

3. Medullary Thyroid Cancer: It develops from the C cells of the thyroid gland, which produce a hormone called calcitonin. Accounting for about 2% of thyroid cancers, medullary thyroid cancer is less common than papillary or follicular thyroid cancer.
   Unlike other types, it can run in families and be found at an early stage. 

4. Anaplastic Thyroid Cancer: Accounting for about 2% of cases, anaplastic thyroid cancer is the rarest and most aggressive form of thyroid cancer.
   It grows quickly, often spreading to other parts of the body. This type of thyroid cancer is the hardest to treat. 

Thyroid Cancer Stages

Thyroid cancer is generally classified into four stages (I to IV) based on the size of the tumour and the spread extension. Healthcare providers generally use the TNM staging system, which stands for Tumor, Nodes, and Metastasis, to determine how large is the primary tumour and far it has spread. 

Here are the stages of thyroid cancer according to this system:

1. Stage I: In stage, I, the tumour is small and confined to the thyroid gland. It has not spread to nearby lymph nodes or distant sites.

2. Stage II: Stage II is divided into IIA and IIB. 

1. In stage IIA, the tumour may be larger than in stage I but is still confined to the thyroid gland. It has not spread to nearby lymph nodes or distant sites. 

2. In stage IIB, the tumor has spread to nearby lymph nodes but has not metastasized to distant organs.

3. Stage III: Stage III is divided into IIIA, IIIB, and IIIC. In stage IIIA, the tumour may be any size and may have spread to nearby tissues or structures outside the thyroid gland. 

1. It may or may not have spread to nearby lymph nodes. 

2. In stage IIIB, the tumour has spread to nearby tissues or structures outside the thyroid gland and has spread to lymph nodes. 

3. In stage IIIC, the tumour may be any size and has spread to lymph nodes located above the collarbone.

4. Stage IV: Stage IV is divided into IVA, IVB, and IVC. 

1. In stage IVA, the tumour has spread to tissues or structures outside the thyroid gland and may or may not have spread to lymph nodes. 

2. In stage IVB, the tumour has spread to distant organs or distant lymph nodes. 

3. Stage IVC is the most advanced stage where the cancer has spread to distant organs and distant lymph nodes.

The treatment and prognosis for thyroid cancer significantly depend on the thyroid cancer stages.

Thyroid cancer may not cause any noticeable symptoms in its early stages, and it is often detected incidentally during a routine physical exam or imaging test. However, as the cancer grows, it may result in the following thyroid cancer symptoms:

1. A lump or swelling in the neck

2. Hoarseness or other changes in voice quality that persist for more than a few weeks

3. Difficulty swallowing or breathing

4. Pain in the neck, ears, or throat that does not go away

5. Swollen lymph nodes in the neck

6. A persistent cough

7. Fatigue or weakness

8. Unexplained weight loss

In addition to the above symptoms, thyroid cancer symptoms in females may include changes in bowel habits or menstrual periods. 

Thyroid cancer causes include a change in the DNA inside the thyroid cells. The DNA instructs the cell what to do. The changes in the DNA make the cells grow uncontrollably, forming a tumour. For most thyroid cancers, experts are not sure what causes changes in the DNA of these cells. 

Thyroid Cancer Risk Factors

While the cause of thyroid cancer may not be clear, certain factors can increase the risk of developing the disease. However, these risk factors do not necessarily mean an individual will develop thyroid cancer. Possible risk factors include:

1. Gender: Women are three times more likely than men to develop thyroid cancer.

2. Age: The risk of thyroid cancer increases with age, and it is most commonly diagnosed in individuals between the ages of 30 and 60. However, it can occur at any age, including in children and older adults.

3. Family History: Having a family history of thyroid cancer or other thyroid conditions, such as goiter or thyroid nodules, can increase the risk of developing thyroid cancer.

4. Radiation Exposure: Exposure to high radiation levels (during radiation therapy for head and neck cancers), especially during childhood, can increase the risk of thyroid cancer.

5. Genetic Mutations: Changes in certain genes, such as the RET and BRAF genes, may increase the risk of developing thyroid cancer.

6. Certain Medical Conditions: Certain medical conditions, like Hashimoto’s thyroiditis and Cowden syndrome, are associated with an increased risk of developing thyroid cancer.

7. Iodine Deficiency: A diet low in iodine may increase the risk of developing thyroid cancer.

Several people develop thyroid cancer due to no known cause. Therefore, there is no way to prevent thyroid cancer. However, individuals can reduce the risk of the disease by taking the following steps:

1. Avoiding Radiation Exposure: Try to limit radiation exposure as much as possible, especially during childhood.

2. Prophylactic Surgery: Genetic tests can help determine if a person carries an altered gene that increases their risk of medullary thyroid cancer.
   If they have the faulty gene, they may consider prophylactic thyroidectomy (a preventive surgery to remove the thyroid gland before cancer develops). 

3. Maintain a Healthy Diet: Eating a balanced diet that includes a variety of fruits, vegetables, whole grains, and lean proteins can support overall health and reduce the risk of cancer. 

1. Some studies suggest that a diet rich in fruits and vegetables, particularly those high in antioxidants, may help protect against thyroid cancer.

4. Protect Your Neck from Radiation: If you receive radiation therapy to the head, neck, or chest area for other medical conditions, talk to your doctor about ways to protect your thyroid from radiation. 

1. Shielding the thyroid during such treatments can help reduce the risk of developing thyroid cancer.

5. Be Mindful of Environmental Exposures: Although the link between environmental factors and thyroid cancer is not fully understood, it is advisable to minimize exposure to potential carcinogens. 

1. Avoid prolonged exposure to toxic substances, such as asbestos and certain chemicals, and follow safety guidelines in your workplace or community.

6. Regular Self-Exams and Check-ups: Regularly examine your neck for any unusual lumps or swelling, and promptly report any abnormalities to your healthcare provider. 

1. Routine check-ups with your doctor can help detect any changes in your thyroid gland and facilitate early diagnosis and treatment if necessary.

Not all thyroid nodules or abnormalities are cancerous, and some may not require immediate treatment. A healthcare provider can help diagnose thyroid cancer through physical exams, medical history, imaging tests, and biopsy.

The following are some common diagnostic tests used to diagnose thyroid cancer:

1. Physical Examination: A doctor may examine the neck to observe for lumps or swelling in the thyroid gland. They may also ask the patient about their risk factors, such as radiation exposure in the past and a family history of thyroid cancers. 

2. Blood Tests: Blood tests can help to evaluate thyroid function and detect any abnormal levels of thyroid hormones.

3. Imaging Tests: Imaging tests like ultrasound, CT scan, MRI, or PET scan can help to visualise the thyroid gland and detect thyroid cancer and cancer spread. 

4. Radioiodine Scan: The test is used to detect thyroid cancer and determine if the cancer has spread. 

1. During the test, the patient is told to swallow a pill with a safe amount of radioactive iodine. 

2. The thyroid gland absorbs the iodine over a few hours. 

3. The doctor uses a special device to measure the radiation in the thyroid gland. Areas with less radioactivity require more testing to confirm cancer presence. 

5. Biopsy: A fine needle aspiration (FNA) biopsy uses a thin needle to extract a small tissue sample from the thyroid gland for examination under a microscope. 

1. This can help determine whether the nodule is cancerous or noncancerous. 

2. A sentinel node biopsy helps determine if cancer cells have spread to lymph nodes.

How to Prepare for the Doctor Consultation?

Preparing for a doctor consultation for thyroid cancer can help patients ensure they get the most out of their appointment. Here are a few things to prepare:

1. Write Down the Symptoms: The individual undergoing hyperpigmentation laser treatment should document any symptoms they have encountered, noting their onset and how they have evolved over time.

2. Make a List of Medications and Supplements: They must write down their medications or supplements and any allergies.

3. Write Down Questions: They should enlist any questions about thyroid cancer, such as the diagnostic process, treatment options, and potential side effects.

4. Bring Medical Records: If they have had any previous thyroid tests or treatment, they should bring copies of the results to the appointment.

5. Bring a Support Person: It is advisable to have a trusted companion during the consultation to provide emotional support and aid in recalling crucial details.

What to Expect from the Doctor?

During a thyroid cancer consultation appointment, a healthcare provider may ask various questions to understand better the individual’s medical history, symptoms, and overall health. Some questions that may be asked include:

1. What symptoms have you been experiencing, and when did they start?

2. How severe are the symptoms, and are they occasional or continuous?

3. Does anything improve or worsen your symptoms?

4. Have you noticed changes in your voice or difficulty swallowing?

5. Have you had any previous thyroid tests or treatments? If so, what were the results?

6. Do you have family members with a history of thyroid cancer or other thyroid conditions?

7. Have you ever been exposed to radiation through medical treatments or environmental factors?

8. What medications and supplements are you currently taking?

9. Have you experienced any other medical conditions or undergone any surgeries in the past?

10. Are you currently experiencing any other symptoms or health concerns?

What Questions to Ask the Doctor?

During a thyroid cancer consultation, patients should feel empowered to ask their healthcare provider any questions about their diagnosis, treatment options, and overall health. Here are some questions patients may consider asking:

1. Which thyroid cancer do I have, and what stage is it in?

2. What treatment options are available to me, and which do you recommend?

3. What are the potential benefits and risks of each treatment option?

4. What are the expected outcomes of treatment, and what are the chances of recurrence?

5. Are there any lifestyle changes or modifications I can make to improve my health or reduce my risk of recurrence?

6. Am I at risk for any other types of cancer?

7. Should I seek a second opinion?

8. How quickly do I need to decide about the next step? Can I take some time to consider the options?

9. Can I decide to have regular check-ups but not have cancer treatment?

10. What follow-up care will I need after treatment, and how frequently should I be monitored?

11. Will I be able to work and engage in my normal activities during thyroid cancer treatment?

12. Are there any clinical trials or new treatment options I should know about?

13. How can I manage any side effects or complications from treatment?

14. Is my family at risk of developing thyroid cancer? Should we get genetic tests?

15. What support resources are available to me, such as support groups or counselling? 

Thyroid cancer is highly curable. The treatment for the disease depends on various factors, like the cancer type and the stage of cancer, the patient’s overall health, and their preferences. Thyroid cancer treatment options include:

1. Surgery: Surgery to remove the thyroid gland is the most common thyroid cancer treatment. The extent of the thyroid cancer surgery may depend on the location, size, and spread of the cancer to the nearby lymph nodes. 

1. The surgeon may perform a thyroidectomy to remove all or most of the thyroid or a lobectomy to remove a portion of the thyroid. 

2. The surgeon may also perform a lymph node dissection to remove nearby lymph nodes where cancer cells have spread. 

2. Radioactive Iodine Therapy: After thyroid cancer surgery, the patient may be given a liquid or pill with a higher dose of radioactive iodine that destroy any remaining thyroid tissue or cancer cells. 

1. The thyroid gland absorbs the radioiodine with minimal radiation exposure to the rest of the body. As a result, the treatment is considered very safe. 

3. External Beam Radiation Therapy: The treatment uses high-energy radiation, such as X-rays and protons, at precise points in the body to kill cancer cells and stop them from growing. 

1. Radiation therapy is generally recommended when cancer does not respond to other treatments or when it returns. 

4. Chemotherapy: The treatment uses drugs to kill cancer cells and is typically reserved for advanced or aggressive cases of thyroid cancer, such as anaplastic thyroid cancer. However, only a few people diagnosed with thyroid cancer will ever need to undergo chemotherapy. 

5. Targeted Therapy: This thyroid cancer treatment uses drugs to target specific proteins or genes in cancer cells. By blocking these proteins or chemicals, the targeted drug can cause cancer cells to die and stop their growth.

6. Hormone Therapy: The treatment replaces or blocks the release of hormones produced in the thyroid that can cause cancer to spread or return. Thyroid hormone therapy medication is generally administered in pill form. 

7. Palliative Care: Palliative care for thyroid cancer is specialised medical care that focuses on relieving the symptoms, pain, and stress of serious illnesses. Palliative care aims to improve the patient’s quality of life and support the patient and their family.

Please Note: The choice of thyroid cancer treatment and its duration will depend on the type and stage of cancer, the individual’s overall health, preferences, and the doctor’s opinion. 

Cost of Thyroid Cancer Treatment

The cost of thyroid cancer treatment depends on several factors including the stage of the cancer, the type of the cancer, the treatment method used, location of the hospital, type of the hospital or clinic, the patient’s age, the patient’s comorbidities, and much more.

To get the cost of thyroid cancer treatment, one must consult their doctor. The table below provides the approximate cost for various thyroid cancer treatments available in India.

Thyroid Cancer Survival Rate

The thyroid cancer survival rate depends on several factors, including the type of thyroid cancer, the stage at which it was diagnosed, and the individual’s age and overall health. The five-year survival rates for different types of thyroid cancer for localised (within the thyroid gland) and metastatic (cancer that spreads) cancer include:

While most people with thyroid cancer are successfully treated and have good outcomes, there can be potential complications from cancer and its treatment. Some of the complications of thyroid cancer may include:

1. Recurrence: Thyroid cancer can recur even after successful treatment, especially in more aggressive types of thyroid cancer. Recurrence happens in about 30% of all thyroid cancer cases. 

2. Metastasis: If cancer has spread beyond the thyroid gland, it can metastasise (spread) to other body parts, such as the lungs, bones, or brain.

3. Hypothyroidism: If the entire thyroid gland is removed, the patient must take thyroid hormone replacement therapy for the rest of their life to maintain normal thyroid function.

4. Voice Changes or Hoarseness: Surgery to remove the thyroid gland can damage the vocal cords, causing changes in voice quality.

5. Difficulty Swallowing or Breathing: If cancer has grown large or spread to nearby tissues, it can cause difficulty swallowing or breathing.

6. Radiation Therapy Complications: Radiation therapy can cause side effects such as fatigue, skin irritation, or damage to the salivary glands.

When to See a Doctor?

Individuals need to consult a doctor if they experience any symptoms or signs of thyroid cancer or if they have any risk factors for the disease. Patients must call their healthcare provider if they have thyroid cancer and experience the following:

1. Lump in the neck

2. Extreme fatigue

3. Unexplained weight loss or gain

4. Rapid heart rate

Doctors prescribe a low-iodine diet to patients with thyroid cancer. Low-iodine diet is recommended to increase the effectiveness of radioactive iodine therapy. Iodine is found in various foods and beverages. A person with thyroid cancer can eat and avoid the following foods to decrease their iodine intake. 

Foods to Avoid

1. Iodised salt

2. Vitamins and supplements containing iodine

3. Seafood, such as fish, shellfish, sushi, etc. 

4. Milk or other dairy products, like cheese, yoghurt, ice cream, and butter

5. Egg yolks and whole eggs

6. Herbal supplements

Foods to Eat

1. Non-iodised salt

2. Fresh fruits and vegetables

3. Frozen vegetables

4. Canned fruits

5. Egg whites

6. Grain, cereal products, and pasta

7. Natural unsalted nuts

8. Lemonade, fruit juices, sodas

9. Coffee or tea (without milk or cream)

10. Sugar, honey maple syrup, jam, and jelly

11. Fresh or dried herbs and spices

Thyroid cancer is a relatively rare cancer affecting the thyroid gland. While thyroid cancer causes are not fully understood, several risk factors may increase the possibility of developing the disease. However, with early detection and treatment, many people with thyroid cancer can achieve a positive outcome and lead normal, healthy lives. You must seek prompt medical attention if you notice any symptoms or risk factors associated with thyroid gland cancer

If you experience thyroid cancer symptoms or have any concerns regarding the disease, you can contact an expert at HexaHealth. Our team of professionals will help you manage your symptoms, track medication and appointments, and connect you with healthcare providers and support networks. We will help you throughout your thyroid cancer journey at every step of the way. Get in touch with us TODAY! 

Suggested Reads