Thyroid Cancer - Causes, Symptoms, Diagnosis, and Treatment

Thyroid Gland:

The thyroid is an endocrine gland that is located below Adam's apple. It is butterfly-shaped. When the gland is in normal size, it is difficult to feel the thyroid. In abnormal conditions, it enlarges in size and can be felt with fingers. Multiple blood vessels supply the gland, and the important nerves which determine the quality of voice lie around this gland. Thyroid glands play a vital role in the secretion of many hormones. The growth and development of an individual and the metabolism of the body are greatly influenced by the thyroid gland.

What Is Thyroid Cancer?

Thyroid cancer is a cancerous condition that affects the thyroid gland. In the initial stages, symptoms are not obvious. A fast progression of this condition might result in aggressive stages of thyroid cancer. Recently, an increase in the number of patients with thyroid cancer has been noted. There are several variants of thyroid cancer. Out of which, four types of thyroid cancer are deeply studied and noted. Since the thyroid gland is associated with the body's hormonal balance, the condition of thyroid cancer might result in several alterations in the hormones of the body.

What Are the Causes of Thyroid Cancer?

Genetic mutations are thought to cause thyroid cancer. The exact cause is not identified yet. But the abnormal cells developed in the thyroid gland have the ability to spread to different parts of the body. Deficiency in the level of iodine can also be a causative factor. Abnormally excessive exposure to radiation can serve as a predisposing factor for thyroid cancer.

What Are the Signs and Symptoms of Thyroid Cancer?

The various signs and symptoms associated with thyroid cancer are:

• Difficulty in speaking.

• Cough.

• Lump in the throat.

• Pain in the throat and neck.

• Hoarseness of voice.

• Swollen lymph nodes in the neck.

• Difficulty in swallowing.

What Are the Types of Thyroid Cancer?

The malignancy occurring in the thyroid gland is categorized into six types.

• Papillary Carcinomas: This type of carcinoma is the most common type of thyroid malignancy. About 80% of people with thyroid cancer exhibit papillary carcinoma.

• Follicular Carcinomas: This is the second most common type of carcinoma occurring in the thyroid gland. Only ten percent of the population are affected by follicular carcinoma.

• Medullary Thyroid Carcinomas: It affects nearly five to ten percent of the population.

• Anaplastic Carcinomas: Anaplastic carcinoma is known to affect only one to two percent of the population with thyroid cancer.

• Primary Thyroid Lymphomas: Primary thyroid lymphoma is a rare variant of thyroid cancer.

• Primary Thyroid Sarcomas: It is also another rare type of carcinoma of the thyroid gland.

What Are the Features of Thyroid Cancer?

Thyroid cancer has the highest possibilities for malignancy only in patients who are more than sixty years of age. In a few cases, people who are less than thirty years of age are also affected. In general, though, thyroid problems are found at a greater level in females due to puberty and its effects, thyroid cancer is detected more in the male gender. A rare variant of follicular carcinoma called Hürthle cell carcinoma is known to affect women. This is particularly noted in females below the age of 40.

How Is Thyroid Cancer Diagnosed?

The diagnosis of thyroid cancer involves thyroid gland function tests.

• Thyroid Ultrasound: In thyroid ultrasound, a probe is used to detect the thyroid gland's abnormal structures. Sound waves that are reflected from the tissues of the thyroid gland are recorded and interpreted. This method requires recommendations from your doctor.

• Thyroid Scan: Radioactive iodine is used in this procedure. A pill containing radioactive iodine will be given to be swallowed, after which the radioactive iodine gets accumulated in the thyroid gland. This iodine helps in visualizing the images of the thyroid gland.

• Thyroid Biopsy: Biopsy is the procedure of removing a small tissue from the suspected site. In a thyroid biopsy, a considerable amount of tissue is removed with the help of a needle and sent for laboratory diagnosis.

• Thyroid Stimulating Hormone (TSH) Test: The thyroid-stimulating hormone levels are tested. These hormones are secreted from the brain, which helps in regulating the release of thyroid hormone. Hyperthyroidism or hypothyroidism due to thyroid cancer can be detected by estimating the levels of thyroid-stimulating hormone.

• T3 (Triiodothyronine) and T4 (Thyroxine): The levels of T3 and T4 are checked to understand the thyroid gland's functioning.

• Serum Calcitonin: Elevated levels of serum calcitonin might indicate the presence of medullary thyroid carcinoma.

• Thyroglobulins: Thyroglobulin is a substance (protein) that is secreted by the thyroid gland. It serves as a marker for the cancerous condition of the thyroid. If the levels of thyroglobulin are elevated, it might indicate thyroid cancer.

• Polymerase Chain Reaction (PCR): This is a diagnostic test which detects genetic mutations. It also serves as a tool for diagnosis in medullary thyroid carcinoma that has occurred due to familial causes.

• Laryngoscopy: Laryngoscopy is a procedure that is done to visualize the throat and the larynx. During this procedure, a laryngoscope is inserted into the throat. It is not very painful, but attention should be given if this procedure is carried out in young patients.

• Other Imaging Tests: Other imaging techniques include magnetic resonance imaging (MRI), computed tomography (CT) scan, positron emission tomography (PET) scan, and ultrasound procedures. CT scan helps in evaluating the soft tissue extension of the lesion. The trachea and esophagus are also examined to determine the cancer spread.

What Are the Treatment Options for Thyroid Cancer?

The following treatment options are suggested for patients with thyroid cancer.

• Surgery: The surgery is planned according to the site of involvement. The various surgical options for thyroid cancer patients are:

  • Lobectomy: Lobectomy is a procedure in which one lobe or part of the lobes of the thyroid gland are removed. If there is any involvement of the lymph node in the affected site, those lymph nodes are also removed in this procedure.
  • Near-Total Thyroidectomy: Both the lobes of the thyroid gland are removed in this procedure, leaving a small part of the tissue. The associated lymph nodes are also removed in this procedure.
  • Total Thyroidectomy: In the total thyroidectomy procedure, all the tissues of the thyroid gland are completely removed. There are a lot of complications associated with this surgery.
  • Tracheostomy: Tracheostomy is a surgical procedure that is done to create a small opening in the windpipe to obtain a direct access into the windpipe. It can be either a temporary or permanent procedure.

• Radiation Therapy: In radiation therapy radioactive iodine is used. Radiation therapy uses X-rays with high energy. Radiation therapy can be of two types. They are:

  • Internal Radiation Therapy: In internal radiation therapy, radioactive substances are given with the help of needles, wires, and catheters.

  • External Radiation Therapy: In external radiation therapy, energy beams are sent to the body from an outside source. This type of procedure is called intraoperative radiation therapy.

• Chemotherapy: Chemotherapy is a procedure that uses powerful drugs to kill cancer cells. Chemotherapy has a lot of side-effects associated with it. In some patients, chemotherapy is carried out along with radiation therapy. This is known to produce advantageous results.

• Thyroid Hormone Therapy: If the thyroid hormone levels are very low, they are supplemented along with the naturally produced hormones in the body.

• Targeted Therapy: A specific type of genes are targeted in this therapy. This therapy can be beneficial in destroying the cancer cells.

• Immunotherapy: In immunotherapy, the individual's immune system is boosted so that it can fight cancer.

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