How Long Can You Have Thyroid Cancer Without Knowing?

What Is the Thyroid Gland?

The thyroid, a small endocrine gland, is located in front of the neck, with its two lobes connected by the isthmus (a band of tissues). The thyroid gland's two lobes are located on either side of the windpipe, just below the voice box. The thyroid gland's principal purpose is to create thyroid hormones. The thyroid hormones are important in growth, development, and metabolism. Three thyroid hormones are thyroxine (T4), triiodothyronine (T3), and calcitonin. These hormones are crucial for healthy physical functioning, and an imbalance in their levels can cause thyroiditis, Graves' disease, Hashimoto's disease, hypothyroidism, thyroid nodules, and other problems.

What Is Thyroid Cancer?

Cancer, in general, is a serious medical condition characterized by uncontrolled cell growth. A part of the body's cells grows and bulks up to form a lump abnormally. Malignant (cancer) cells develop in the tissues of the thyroid gland as a result of thyroid cancer. These cells grow abnormally to form a lump. Thyroid cancer is primarily classified into four types:

• Papillary Thyroid Cancer: Papillary thyroid cancer is the most common type of thyroid cancer and is well-differentiated. This type often affects only one lobe of the thyroid gland and grows very slowly. Papillary thyroid cancers frequently spread to the neck lymph nodes despite their slow growth.

• Follicular Thyroid Cancer: It is the second most prevalent type of thyroid cancer. It occurs more frequently in places where the population's diet is deficient in iodine. These malignancies can spread to other body parts, such as the lungs or bones, but they don't typically migrate to the lymph nodes.

• Medullary Thyroid Cancer: Medullary thyroid cancer is a rare type of thyroid cancer. It begins in a class of thyroid cells known as C-cells. These C-cells are responsible for producing the hormone calcitonin.

• Anaplastic Thyroid Cancer: It is the most aggressive type of thyroid carcinoma that rapidly spreads to other body parts. However, this type is also very rare.

What Causes Thyroid Cancer?

Cancer, in general, occurs primarily due to genetic variations. Genes are the basic units of inheritance, and any changes can affect how they grow and function. Genes are formed by strands of tightly packed DNA (deoxyribonucleic acid), known as chromosomes. Therefore, cancer is primarily a genetic disease that occurs due to genetic mutations (variations), and these genetic mutations govern how the cells behave, particularly how they divide and grow.

Moreover, several factors can also increase the chances of developing thyroid cancer in an individual. However, the exact physiology as to why this happens is not clear. These factors include:

• Having other thyroid diseases like thyroiditis (inflammation of the thyroid), goiter (presence of a lump in the neck), hyperthyroidism (overactive thyroid gland), hypothyroidism (underactive thyroid gland), etc.

• Family history of thyroid cancer.

• Undergoing radiation therapy or getting exposed to radiation in childhood.

• Being obese.

• Acromegaly (refers to a condition with excessive growth hormone production in the body).

• Individuals over the age of 60.

Is Thyroid Cancer a Common Condition?

• Thyroid cancer is diagnosed in about 12,000 men and 33,000 women every year.

• Every year, on average, 950 men and 1,100 women die from the disease.

• Thyroid cancer is more common in women as compared to men. It is about 2.9 times more common in women. Other thyroid disorders are also more prevalent in women.

• Most thyroid cancer cases occur in adults in their 30s and people older than 60.

What Are the Symptoms of Thyroid Cancer?

The symptoms of thyroid cancer include:

• Presence of a visible lump or nodule in the neck. This lump can easily be felt through the skin.

• Voice changes and becomes hoarse.

• Difficulty and pain in swallowing and eating.

• Lymph nodes of the neck become swollen.

• Pain in the neck.

• Pain in the throat.

How Long Can You Have Thyroid Cancer Without Knowing?

An individual can have thyroid cancer long before it is diagnosed. There may be no early symptoms or indications of thyroid cancer, and the symptoms often present only after the tumor has grown larger. Thyroid cancer is noticed when the tumor grows large enough to be seen with the naked eye. Moreover, the diagnosis of thyroid cancer is often incidental, which means it is diagnosed during a routine check-up or the diagnosis of any other disease. In addition, the symptoms of thyroid cancer are similar to many other diseases; therefore, early diagnosis becomes more difficult.

How Is Thyroid Cancer Diagnosed?

Thyroid cancer is diagnosed in the following ways:

• Physical Examination: A physical examination of the body may be done to look for general health symptoms, such as lumps or swelling in the neck, pain in the neck, swollen lymph nodes, and anything else that seems abnormal. The patient’s medical history is also recorded for habits, past diseases, and treatment.

• Blood Tests: Blood samples are collected and sent to the laboratory to check the levels of hormones released by the thyroid gland. The levels of thyroid-stimulating hormone, calcitonin, and thyroid antibodies are also checked along with the thyroid hormones. The calcium concentration in the blood is also checked.

• Laryngoscopy: The doctor examines the larynx (voice box) using a mirror or a laryngoscope. The thyroid tumor can compress vocal cords; therefore, a laryngoscopy is performed to check whether the vocal cords are moving normally.

• Ultrasound: This technique can determine a thyroid nodule's size and whether it is a solid nodule or a cyst filled with fluid. Ultrasound may also be used during an ultrasound-guided fine needle aspiration biopsy.

• CT (Computed Tomography) Scan: A CT scan shows more detailed images of the thyroid gland and helps study minute pathologies.

• Radioactive Iodine Scan: A small quantity of radioactive iodine is swallowed or injected into a vein for this test. The thyroid gland gradually absorbs the iodine. The radioactivity is then observed with a specialized camera. Nodules in the thyroid that have less iodine than the surrounding tissue can be cancerous.

• PET (Positron Emission Tomography) Scan: This test may be done in cases where the thyroid gland does not take up the radioactive iodine during a radioactive iodine scan. In this test, the patient is given a special kind of sugar visible inside the body with the help of a camera. This sugar manifests as ‘hot patches’ where the cancer is present.

How Is Thyroid Cancer Treated?

Options for treating thyroid cancer depend on the patient's overall health condition, the type, and stage of cancer, and their personal preferences.

• Active Surveillance: Small papillary thyroid tumors (cancers), which have a minimal risk of developing into larger tumors, may not require immediate treatment. Active surveillance, which involves regular cancer screening, can be considered a replacement for surgery or other treatments. The doctor may advise a blood test and a neck ultrasound examination regularly.

• Surgery: Most patients with thyroid cancer who need treatment will have their thyroid partially or completely removed through surgery. This depends on the type of thyroid cancer, its size, and if it has progressed to the lymph nodes. The types of surgeries done are thyroidectomy (removal of the complete thyroid or most parts of the thyroid gland), thyroid lobectomy (half of the thyroid gland or one of the lobes is removed), and lymph node dissection.

• Thyroid Hormone Therapy: The hormones produced by the thyroid can be replaced or supplemented with the help of thyroid hormone therapy. Medication for thyroid hormone therapy is often administered orally as pills.

• Radioactive Iodine Therapy: A radioactive type of iodine is used in radioactive iodine therapy to destroy thyroid cells and any cancerous thyroid cells that could still be present after surgery. It is most commonly implemented for thyroid tumors at risk of rapidly spreading to other body parts.

Conclusion:

Thyroid cancer is generally present as a slow-growing tumor or lump in the neck. Sometimes, cancer may be present in the body long before the doctor clinically diagnoses it. Therefore, thyroid cancer can be present very long without the patient's awareness. However, thyroid cancer is the safest form of tumor and can be effectively treated. The prognosis is generally good. But several factors influence the prognosis of thyroid cancer, including the stage of cancer, the patient's age, overall health, the type of cancer, etc. Therefore, it is best to seek a doctor’s advice when any abnormal lump or swelling is noticed in the neck.