September Is Thyroid Cancer Awareness Month

Thyroid Cancer Awareness Month promotes thyroid cancer awareness for early detection, as well as care based on expert standards, and increased research to achieve cures for all thyroid cancer.

Thyroid cancer occurs in the cells of the thyroid — a butterfly-shaped gland located at the base of your neck, just below your Adam's apple. Your thyroid produces hormones that regulate your heart rate, blood pressure, body temperature and weight.

Thyroid cancer might not cause any symptoms at first. But as it grows, it can cause pain and swelling in your neck. 

Several types of thyroid cancer exist. Some grow very slowly and others can be very aggressive. Most cases of thyroid cancer can be cured with treatment.

Thyroid cancer rates seem to be increasing. Some doctors think this is because new technology is allowing them to find small thyroid cancers that may not have been found in the past.

Symptoms

Thyroid cancer typically doesn't cause any signs or symptoms early in the disease. As thyroid cancer grows, it may cause:

• A lump (nodule) that can be felt through the skin on your neck
• Changes to your voice, including increasing hoarseness
• Difficulty swallowing
• Pain in your neck and throat
• Swollen lymph nodes in your neck

When to see a doctor

If you experience any signs or symptoms that worry you, make an appointment with your doctor.

Causes

It's not clear what causes thyroid cancer.

Thyroid cancer occurs when cells in your thyroid undergo genetic changes (mutations). The mutations allow the cells to grow and multiply rapidly. The cells also lose the ability to die, as normal cells would. The accumulating abnormal thyroid cells form a tumor. The abnormal cells can invade nearby tissue and can spread (metastasize) to other parts of the body.

Risk factors

Factors that may increase the risk of thyroid cancer include:

• Female sex. Thyroid cancer occurs more often in women than in men.
• Exposure to high levels of radiation. Radiation therapy treatments to the head and neck increase the risk of thyroid cancer.
• Certain inherited genetic syndromes. Genetic syndromes that increase the risk of thyroid cancer include familial medullary thyroid cancer, multiple endocrine neoplasia, Cowden's syndrome and familial adenomatous polyposis.

Prevention

Doctors aren't sure what causes most cases of thyroid cancer, so there's no way to prevent thyroid cancer in people who have an average risk of the disease.

Prevention for people with a high risk

Adults and children with an inherited gene mutation that increases the risk of medullary thyroid cancer may consider thyroid surgery to prevent cancer (prophylactic thyroidectomy). Discuss your options with a genetic counselor who can explain your risk of thyroid cancer and your treatment options.

Diagnosis

Tests and procedures used to diagnose thyroid cancer include:

• Physical exam. Your doctor will examine your neck to feel for physical changes in your thyroid, such as thyroid nodules. He or she may also ask about your risk factors, such as past exposure to radiation and a family history of thyroid tumors.
• Blood tests. Blood tests help determine if the thyroid gland is functioning normally.
• Ultrasound imaging. Ultrasound uses high-frequency sound waves to create pictures of body structures. To create an image of the thyroid, the ultrasound transducer is placed on your lower neck. The appearance of your thyroid on the ultrasound helps your doctor determine whether a thyroid nodule is likely to be noncancerous (benign) or whether there's a risk that it might be cancerous.
• Removing a sample of thyroid tissue. During a fine-needle aspiration biopsy, your doctor inserts a long, thin needle through your skin and into the thyroid nodule. Ultrasound imaging is typically used to precisely guide the needle into the nodule. Your doctor uses the needle to remove samples of suspicious thyroid tissue. The sample is analyzed in the laboratory to look for cancer cells.
• Other imaging tests. You may have one or more imaging tests to help your doctor determine whether your cancer has spread beyond the thyroid. Imaging tests may include CT, MRI and nuclear imaging tests that use a radioactive form of iodine.
• Genetic testing. Some people with medullary thyroid cancer may have genetic changes that can be associated with other endocrine cancers. Your family history may prompt your doctor to recommend genetic testing to look for genes that increase your risk of cancer.

Coping and support

A diagnosis of thyroid cancer can be frightening. You might feel as if you aren't sure what to do next.

Everyone eventually finds his or her own way of coping with a cancer diagnosis. Until you find what works for you, consider trying to:

• Find out enough about thyroid cancer to make decisions about your care. Write down the details of your thyroid cancer, such as the type, stage and treatment options. Ask your doctor where you can go for more information. Good sources of information to get you started include the National Cancer Institute, the American Cancer Society and the American Thyroid Association.
• Connect with other thyroid cancer survivors. You might find comfort in talking with people in your same situation. Ask your doctor about support groups in your area. Or connect with thyroid cancer survivors online through the American Cancer Society Cancer Survivors Network or the Thyroid Cancer Survivors' Association.
• Control what you can about your health. You can't control whether or not you develop thyroid cancer, but you can take steps to keep your body healthy during and after treatment. For instance, eat a healthy diet full of a variety of fruits and vegetables, get enough sleep each night so that you wake feeling rested, and try to incorporate physical activity into most days of your week.

Complications

Thyroid cancer that comes back

Despite treatment, thyroid cancer can return, even if you've had your thyroid removed. This could happen if microscopic cancer cells spread beyond the thyroid before it's removed.

Thyroid cancer may recur in:

• Lymph nodes in the neck
• Small pieces of thyroid tissue left behind during surgery
• Other areas of the body, such as the lungs and bones

Thyroid cancer that recurs can be treated. Your doctor may recommend periodic blood tests or thyroid scans to check for signs of a thyroid cancer recurrence.

There are different types of thyroid cancer. They are based on what the cells look like under a microscope. Your treatment will depend on which type of thyroid cancer you have.

• Papillary thyroid cancer (PTC). This is the most common type of thyroid cancer. PTC starts in cells called follicular cells and usually is only found in one lobe of the thyroid. Although PTC usually grows very slowly, it often spreads to lymph nodes in the neck. It can also spread to the lungs and bones.
• Follicular thyroid cancer (FTC). This is the second most common type of thyroid cancer. It is usually found in countries where people do not get enough iodine from food. FTC can spread to the lungs.
• Medullary thyroid cancer (MTC). Medullary thyroid cancer is less common. By the time it is diagnosed, it may already have spread to the lymph nodes, liver, or lungs. There are two types of MTC: sporadic and familial.
  • Sporadic MTC occurs mostly in adults, does not occur in families, and usually affects only one lobe of the thyroid gland.
  • Familial MTC can develop during early childhood, occurs in families, and can spread to other parts of the body. There are three types of familial thyroid cancer, called MEN 2a, MEN 2b, and FMTC (familial medullary thyroid cancer). Genetic blood tests can be used to identify people who are at risk for developing familial medullary cancer. If genetic testing shows a gene problem called RET mutation, most experts suggests surgery to remove the thyroid to help prevent future medullary thyroid cancer.
• Anaplastic carcinoma. This is a very rare and aggressive form of thyroid cancer. By the time it is diagnosed, it usually has spread to the neck and other parts of the body. It grows rapidly and is the most fatal form of thyroid cancer.
• Thyroid lymphoma. This very rare type of lymphoma starts in the thyroid gland and causes it to grow larger.

Resources:

https://www.stlukesonline.org/health-services/health-information/healthwise/2017/06/27/13/27/types-of-thyroid-cancer

https://www.mayoclinic.org/diseases-conditions/thyroid-cancer/symptoms-causes/syc-20354161