Thyroid Cancer

Key Takeaway

• Thyroid cancer occurs when cells in the thyroid gland grow abnormally, forming a tumor that can spread to other organs if not treated early. There are four main types: Papillary, Follicular, Medullary, and Anaplastic, each with different rates of progression and treatment approaches.
• Treatment usually involves surgery to remove the thyroid gland, and may include radioactive iodine (RAI) therapy, medications, or radiation, depending on the cancer type and stage.
• Thyroid cancer is particularly common in women. Many people may not realize they are at risk, as early symptoms are often subtle. Early detection significantly increases the chances of a complete recovery. Recognizing initial symptoms and undergoing thorough diagnostic tests are key to timely treatment before the disease spreads.

What is Thyroid Cancer?

Thyroid cancer is caused by abnormal growth of cells within the small, butterfly-shaped thyroid gland located in the front of the neck below the Adam’s apple. The thyroid produces hormones—thyroxine (T4) and triiodothyronine (T3)—which regulate metabolism, growth, and overall body functions.

When thyroid cancer develops, cells divide uncontrollably, forming a lump or spreading to lymph nodes or other organs. Without proper diagnosis and treatment, it can affect thyroid function and overall health.

Causes of Thyroid Cancer

Thyroid cancer arises from abnormal cell division or changes in thyroid cells. Some risk factors can be managed, while others cannot:

• Genetics and Family History: A family history of thyroid cancer or certain genetic conditions (e.g., MEN2) increases risk.

• Radiation Exposure: Previous exposure to radiation in the neck or head, such as for childhood cancer treatment, raises the likelihood of thyroid cancer.

• Iodine Deficiency: Iodine is essential for thyroid hormone production; deficiency may disrupt thyroid function and increase risk.

• Female Gender and Hormonal Changes: Women, especially during reproductive years or postpartum, are more prone due to hormonal fluctuations.

• Age: Common in adults aged 30–50, but some types can occur in children or older adults.

• Pre-existing Thyroid Disorders: Individuals with goiter or chronic thyroid inflammation are at higher risk.

Types of Thyroid Cancer

Papillary Thyroid Cancer

The most common type, accounting for 70–80% of cases. It grows slowly and is usually not aggressive initially, but may spread to neck lymph nodes. Treatment involves partial or total thyroidectomy, often followed by radioactive iodine to destroy remaining cancer cells. Prognosis is generally excellent.

Follicular Thyroid Cancer

Less common (10–15%), often spreads via the bloodstream to lungs or bones. Surgery is the primary treatment, sometimes combined with radioactive iodine.

Medullary Thyroid Cancer

Originates from C cells (calcitonin-producing) and may be linked to genetic syndromes like MEN2. Surgery involves total thyroidectomy with lymph node evaluation. Calcitonin levels must be monitored regularly to detect recurrence.

Anaplastic Thyroid Cancer

A rare but highly aggressive type, typically in older adults. Treatment is challenging and may include surgery, chemotherapy, and radiation to control symptoms and prolong life. Complete cure is unlikely.

Symptoms of Thyroid Cancer

Early Signs

• Painless lump in the neck below the Adam’s apple

• Hoarseness or voice changes if the tumor presses on vocal cords

• Difficulty swallowing

• Mild neck discomfort

Advanced Signs

• Breathing difficulties from airway compression

• Swollen lymph nodes in the neck

• Increasing neck pain or tightness

• Unexplained weight loss or fatigue if cancer spreads

Diagnosis

Diagnosis includes multiple methods to assess tumor size, characteristics, and malignancy risk:

• Physical Examination: Palpation of the neck and lymph nodes to detect abnormalities.

• Thyroid Function Tests: Measure TSH, T3, and T4 levels to assess thyroid activity.

• Ultrasound: Uses high-frequency sound waves to visualize the thyroid and detect nodules, cysts, or solid masses.

• Fine Needle Aspiration (FNA) Biopsy: Extracts cells from the tumor for pathological analysis. High accuracy and standard diagnostic tool.

• Advanced Imaging (if needed): CT, MRI, radioactive iodine scan, or PET scan for unclear or high-risk cases.

Diagnosis is individualized based on cancer type, stage, and patient symptoms.

Treatment Options

Thyroidectomy

Surgical removal of the tumor, part, or all of the thyroid gland depending on tumor size and location. Post-surgery care includes monitoring complications, voice changes, calcium levels, and thyroid hormone replacement.

Radioactive Iodine (RAI) Therapy

Used for cancers that absorb iodine. Radioactive iodine destroys remaining cancer cells and reduces recurrence risk.

Thyroid Hormone Therapy

Post-surgery hormone replacement (levothyroxine) maintains hormone balance and suppresses TSH to prevent cancer cell growth.

External Beam Radiation Therapy

High-energy radiation targets cancer cells, especially if surgery is incomplete or cancer has spread.

Chemotherapy

Used for aggressive or treatment-resistant cancers. Administered orally or intravenously under close supervision.

Targeted Therapy

Drugs act specifically on cancer cells with genetic or molecular abnormalities, with fewer side effects than conventional chemotherapy.

Thyroid Cancer vs. Normal Thyroid

Thyroid cancer involves abnormal cell growth that may spread to other tissues, while normal thyroid cells function to regulate metabolism. Cancer may present with hard lumps, hoarseness, or difficulty swallowing, which are absent in a healthy thyroid.

Prevention and Risk Reduction

• Consume adequate iodine (iodized salt, seafood)

• Avoid unnecessary radiation exposure

• Regular thyroid check-ups (ultrasound and clinical exams)

• Maintain healthy lifestyle (diet, exercise, no smoking/alcohol abuse)

• Monitor for early signs (neck lumps, persistent sore throat, hoarseness)

Treatment at Vibhavadi Hospital

The Vibhavadi Cancer Center provides detailed diagnosis and treatment, including neck ultrasound, FNA biopsy, thyroidectomy, radioactive iodine therapy, and hormone replacement, all under experienced specialists.