An Overview of Thyroid Cancer

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Thyroid cancer is one of the least deadly and most survivable cancers. It's more common in younger people than other cancers, is around three times more likely in women than men, and is typically diagnosed between the ages of 45 and 54.

Finding a lump or swelling in your neck can prompt a diagnosis, as can a nodule found during a routine physical examination or an ultrasound of a structure near your thyroid. Some people have no symptoms, while others have pain, enlarged lymph nodes, and others. Surgery and hormone replacement medication to treat it is likely, though other options may also be used.

Prevalence

According to the American Cancer Society, approximately 54 thousand people will develop thyroid cancer in the United States this year, and this number has risen in recent years. In fact, thyroid cancer is the most rapidly increasing cancer in the United States.

The "why" behind the rise of thyroid cancer is most likely due to the increased use of thyroid ultrasound, which can detect smaller thyroid nodules that may not have been detected in the past, according to a study in JAMA.

In other words, over-diagnosis is a problem, as imaging techniques (like ultrasound) and fine-needle aspiration biopsies have begun to detect small thyroid tumors (less than 2 centimeters) that aren't causing any immediate symptoms or need for treatment.

Types

The thyroid is a butterfly-shaped gland at the base of your neck that makes hormones that help regulate your blood pressure, temperature, heart rate, and weight.

There are four main types of thyroid cancer, including:

  • Papillary or mixed papillary-follicular thyroid cancer (about 80 percent of cases)
  • Follicular or Hurthle cell thyroid cancer (about 13 percent of cases) 
  • Medullary thyroid cancer (about 4 percent of cases) 
  • Anaplastic thyroid cancer (about 2 percent of cases)

Less common thyroid cancers include thyroid lymphoma, thyroid sarcoma, and other rare tumors.

Symptoms

Some people with thyroid cancer do not develop any symptoms, while others may notice they have developed a lump at the base of the front of their neck. Other symptoms may include: 

  • Pain in the neck
  • Enlarged lymph nodes 
  • Swelling
  • Thyroid nodules 
  • Hoarse voice

If thyroid cancer runs in your family, you may want to check your neck for lumps periodically. The older you are, the more likely you are to have a nodule on your thyroid, but few of these nodules are cancerous. If you feel a lump in the area of your thyroid, make an appointment to see your doctor.

Causes

No one knows exactly what causes thyroid cancer, but some cases may be attributed to inherited conditions such as familial medullary thyroid carcinoma, familial adenomatous polyposis, Cowden disease, Carney complex type 1, and nonfamilial medullary thyroid carcinoma. Other cases occur due to mutations in your genes that happen over time.

Low iodine levels and radiation exposure are important risk factors.

Diagnosis

You can check for thyroid nodules, or lumps, at home, but many are too small to be felt or seen. Thyroid cancer is usually diagnosed through a series of tests and labs that help rule out other thyroid issues too.

Depending on your situation, your doctor may do blood tests, a fine needle aspiration biopsy, genetic testing, or certain types of imaging like ultrasound, computed tomography (CT) scan, radioiodine scan, or a magnetic resonance imaging (MRI) scan.

These tests also indicate which stage the thyroid cancer is. In stages 1 and 2, the tumor is located within the thyroid gland. Stage 2 tumors are usually double the size of stage 1 tumors. Stage 3 tumors may spread to nearby neck lymph nodes and extrude onto the thyroid gland's surface. Stage 4 tumors spread to distant lymph nodes, bones, and other organs.

Five-year survival rates for thyroid cancer are over 98 percent. That said, the older you are, the more likely cancer will be aggressive.

Treatment

Treatment for thyroid cancer depends on the kind of cancer you have, how large it is if it has spread, and your overall health. Surgery to remove all or part of your thyroid is common, as is thyroid hormone replacement medication afterward. You may also have treatments such as radioactive iodine therapy, radiation, chemotherapy, alcohol ablation, active surveillance, or targeted drug therapy.

Coping

Coping with a cancer diagnosis involves emotional, physical, social, and practical aspects. You may want to think about making some lifestyle changes such as diet and exercise. It's also good to educate yourself about thyroid cancer so you can be your own best advocate (or one for a loved one with the diagnosis). Support groups, whether online, in-person or otherwise, can be instrumental in helping you and your loved ones cope as well.

A Word From Verywell

While it's alarming to see the rising incidence of thyroid cancer, it's important to understand that much of this can be attributed to increased use of diagnostic strategies. If you've found a lump in your neck, it's very likely not cancer at all. But if it is, your chance of recovery is excellent. Stay proactive in your care, learn everything you can, and ask a lot of questions as you and your doctor come up with a treatment plan.

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