Thyroid cancer facts*
*Thyroid cancer facts medical author: Melissa Conrad Stöppler, MD
What is the thyroid?
The thyroid is a gland at the front of your neck beneath your voice box (larynx). A healthy thyroid is a little larger than a quarter. It usually can't be felt through the skin.
The thyroid has two parts (lobes). A thin piece of tissue (the isthmus) connects the two lobes.
The thyroid makes hormones:
Four or more tiny parathyroid glands are on the back of the thyroid. These glands make parathyroid hormone. This hormone plays a big role in helping the body maintain a healthy level of calcium.
Picture of the front and the back of the thyroid.What is cancer?
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the thyroid and other organs of the body.
Normal thyroid cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when the body does not need them, and old or damaged cells do not die as they should. The buildup of extra cells often forms a mass of tissue called a nodule. It may also be called a growth or tumor.
Most thyroid nodules are benign. Benign nodules are not cancer (malignant):
Thyroid cancer cells can spread by breaking away from the thyroid tumor. They can travel through lymph vessels to nearby lymph nodes. They can also spread through blood vessels to the lungs, liver, or bones. After spreading, cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.
See the Staging section for information about thyroid cancer that has spread.
What are the different types of thyroid cancer?
There are several types of thyroid cancer:
Medullary thyroid cancer sometimes runs in families.
A change in a gene called RET can be passed from parent to child. Nearly everyone with a changed RET gene develops medullary thyroid cancer. The disease occurs alone, as familial medullary thyroid cancer, or with other cancers, as multiple endocrine neoplasia (MEN) syndrome.
A blood test can usually detect a changed RET gene. If it's found in a person with medullary thyroid cancer, the doctor may suggest that family members also be tested. For those who have a changed gene, the doctor may recommend frequent lab tests or surgery to remove the thyroid before cancer develops.
Tests and treatment options depend on the type of thyroid cancer.
Thyroid cancer symptoms*
*Thyroid cancer symptoms medical author: Melissa Conrad Stöppler, MD
Not all thyroid cancers produce symptoms. When symptoms do occur they may consist of:
How is thyroid cancer diagnosed?
If your doctor thinks that you may have thyroid cancer, you'll have one or more of the following tests:
Your doctor may take tissue for a biopsy in one of two ways:
You may want to ask the doctor these questions before having a biopsy:
How is staging determined for thyroid cancer?
If the biopsy shows that you have cancer, your doctor will need to learn the extent (stage) of the disease to help you choose the best treatment.
The stage is based on the size of the nodule and whether the cancer has invaded nearby tissues or spread to other parts of the body. Thyroid cancer spreads most often to nearby tissues in the neck or to lymph nodes. It may also spread to the lungs and bones.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of cancer cells and the same name as the original tumor. For example, if thyroid cancer spreads to the lungs, the cancer cells in the lungs are actually thyroid cancer cells. The disease is metastatic thyroid cancer, not lung cancer. It's treated as thyroid cancer, not as lung cancer. Doctors sometimes call the new tumor in the lung “distant” disease.
Staging may involve one or more of these tests:
What is the treatment for thyroid cancer?
Treatment options for people with thyroid cancer are …
You'll probably receive more than one type of treatment. For example, the usual treatment for papillary thyroid cancer is surgery, thyroid hormone treatment, and radioactive iodine therapy. External radiation therapy and chemotherapy are not often used for people with papillary thyroid cancer.
The treatment that's right for you depends mainly on the type of thyroid cancer (papillary, follicular, medullary, or anaplastic). It also depends on the size of the nodule, your age, and whether the cancer has spread. You and your doctor can work together to develop a treatment plan that meets your needs.
Your doctor may refer you to a specialist who has experience treating thyroid cancer, or you may ask for a referral. You may have a team of specialists:
An oncology nurse and a registered dietitian may also be part of your team.
Your health care team can describe your treatment choices, the expected results of each treatment, and the possible side effects. Because cancer treatments often damage healthy cells and tissues, side effects are common. These side effects depend on many factors, including the type of treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities.
At any stage of the disease, supportive care is available to control pain and other symptoms, to relieve the side effects of treatment, and to ease emotional concerns. You can get information about coping on NCI's website at http://www.cancer.gov/cancertopics/coping.
Also, you can get information about supportive care from NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). Or, chat using LiveHelp, NCI's instant messaging service, at https://livehelp.cancer.gov.
You may want to talk with your doctor about taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of thyroid cancer. See the section on Taking Part in Cancer Research.
You may want to ask the doctor these questions before treatment begins:
Surgery
Most people with thyroid cancer have surgery. The surgeon removes all or part of the thyroid.
You and your surgeon can talk about the types of surgery and which may be right for you:
The surgeon may also remove nearby lymph nodes. If cancer has invaded tissue within the neck, the surgeon may remove as much of that tissue as possible. If cancer has spread outside the neck, treatment of those areas may involve surgery, radioactive iodine therapy, and external radiation therapy.
Some people who have a lobe removed have a second surgery later on to remove the rest of the thyroid. Less often, the remaining thyroid tissue is destroyed by radioactive iodine therapy.
It's common to feel tired or weak for a while after surgery for thyroid cancer. The time it takes to heal is different for each person.
You may have pain or discomfort for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your health care team. After surgery, they can adjust the plan if you need more pain control.
Surgery for thyroid cancer removes the cells that make thyroid hormone. After surgery, most people need to take pills to replace the natural thyroid hormone. You'll probably need to take thyroid hormone pills for the rest of your life. See the Thyroid Hormone Treatment section.
If the surgeon removes the parathyroid glands, you may need to take calcium and vitamin D pills for the rest of your life.
In a few people, surgery may damage certain nerves or muscles. If this happens, a person may have voice problems or one shoulder may be lower than the other.
You may want to ask the doctor these questions before having surgery:
Thyroid hormone treatment
After surgery to remove part or all of the thyroid, most people need to take pills to replace the natural thyroid hormone. However, thyroid hormone pills are also used as part of the treatment for papillary or follicular thyroid cancer. Thyroid hormone slows the growth of thyroid cancer cells left in the body after surgery.
Although thyroid hormone pills seldom cause side effects, too much thyroid hormone may cause you to lose weight and to feel hot and sweaty. Too much thyroid hormone may also cause a fast heart rate, chest pain, cramps, and diarrhea. Too little thyroid hormone may cause you to gain weight, feel cold and tired, and have dry skin and hair. If you have side effects, tell your doctor. Your doctor can give you a blood test to make sure you're getting the right dose of thyroid hormone.
You may want to ask the doctor these questions before taking thyroid hormone:
Radioactive iodine therapy
Radioactive iodine therapy with I-131 is a treatment for papillary or follicular thyroid cancer. It kills thyroid cancer cells and normal thyroid cells that remain in the body after surgery.
People with medullary or anaplastic thyroid cancer usually do not receive I-131 therapy. These types of thyroid cancer rarely respond to I-131 therapy.
For one or two weeks before treatment, you will need to be on a special diet. Avoid fish (especially shellfish), seaweed, iodized salt, milk, yogurt, ice cream, bacon, ham, and other foods with iodine. Do not take vitamin pills or drugs that have iodine.
Because some imaging tests (such as CT scans) use iodine in the contrast material, tell your doctor if you had a CT scan or other imaging test in the past 6 months.
For the treatment, you will swallow one or more capsules or a liquid that contains I-131. Even people who are allergic to iodine can take I-131 therapy safely. I-131 goes into the bloodstream and travels to thyroid cancer cells throughout the body. When thyroid cancer cells take in enough I-131, they die.
Many people get I-131 therapy in a clinic or in the outpatient area of a hospital and can go home afterward. Other people have to stay in the hospital for one day or longer.
Most radiation from I-131 is gone in about one week. Within three weeks, only traces of radiation remain in the body.
During treatment, you can help protect your bladder and other healthy tissues by drinking a lot of fluids. Drinking fluids helps I-131 pass out of the body faster.
Some people have mild nausea the first day of I-131 therapy. A few people have swelling and pain in the neck where thyroid cells remain. If thyroid cancer cells have spread outside the neck, those areas may be painful too.
You may have a dry mouth or lose your sense of taste or smell for a short time after I-131 therapy. Gum or hard candy may help.
A rare side effect in men who receive a high dose of I-131 is loss of fertility. In women, I-131 may not cause loss of fertility, but some doctors advise women to avoid getting pregnant for one year after a high dose of I-131.
Researchers have reported that a very small number of patients may develop a second cancer years after treatment with a high dose of I-131. See the Follow-up Care section for information about checkups after treatment.
Because a high dose of I-131 also kills normal thyroid cells, you'll need to take thyroid hormone pills after this treatment to replace the natural hormone.
You may want to ask the doctor these questions before having I-131 therapy:
External radiation therapy
External radiation therapy is a treatment for any type of thyroid cancer that can't be treated with surgery or I-131 therapy. It's also sometimes used for cancer that returns after treatment or to relieve bone pain from cancer that has spread.
External radiation therapy uses high-energy rays to kill cancer cells. A large machine directs radiation at the neck or other tissues where cancer has spread.
The treatment usually is given in a hospital or clinic. You may receive external radiation therapy 5 days a week for several weeks. Each treatment takes only a few minutes.
Although radiation therapy is painless, it may cause side effects. The side effects depend mainly on how much radiation is given and which part of your body is treated. Radiation to the neck may cause a sore throat and trouble swallowing. Also, the skin on your neck may become red, dry, and tender.
You are likely to become tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.
Although the side effects of radiation therapy can be upsetting, they can usually be treated or controlled. Talk with your doctor or nurse about ways to relieve discomfort. Most side effects go away when treatment ends.
You may find it helpful to read the NCI booklet Radiation Therapy and You.
You may want to ask the doctor these questions before having radiation therapy:
What is the thyroid?
The thyroid is a gland at the front of your neck beneath your voice box (larynx). A healthy thyroid is a little larger than a quarter. It usually can't be felt through the skin.
The thyroid has two parts (lobes). A thin piece of tissue (the isthmus) connects the two lobes.
The thyroid makes hormones:
Four or more tiny parathyroid glands are on the back of the thyroid. These glands make parathyroid hormone. This hormone plays a big role in helping the body maintain a healthy level of calcium.
Picture of the front and the back of the thyroid.What is cancer?
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the thyroid and other organs of the body.
Normal thyroid cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when the body does not need them, and old or damaged cells do not die as they should. The buildup of extra cells often forms a mass of tissue called a nodule. It may also be called a growth or tumor.
Most thyroid nodules are benign. Benign nodules are not cancer (malignant):
Thyroid cancer cells can spread by breaking away from the thyroid tumor. They can travel through lymph vessels to nearby lymph nodes. They can also spread through blood vessels to the lungs, liver, or bones. After spreading, cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.
See the Staging section for information about thyroid cancer that has spread.
What are the different types of thyroid cancer?
There are several types of thyroid cancer:
Medullary thyroid cancer sometimes runs in families.
A change in a gene called RET can be passed from parent to child. Nearly everyone with a changed RET gene develops medullary thyroid cancer. The disease occurs alone, as familial medullary thyroid cancer, or with other cancers, as multiple endocrine neoplasia (MEN) syndrome.
A blood test can usually detect a changed RET gene. If it's found in a person with medullary thyroid cancer, the doctor may suggest that family members also be tested. For those who have a changed gene, the doctor may recommend frequent lab tests or surgery to remove the thyroid before cancer develops.
Tests and treatment options depend on the type of thyroid cancer.
Thyroid cancer symptoms*
*Thyroid cancer symptoms medical author: Melissa Conrad Stöppler, MD
Not all thyroid cancers produce symptoms. When symptoms do occur they may consist of:
How is thyroid cancer diagnosed?
If your doctor thinks that you may have thyroid cancer, you'll have one or more of the following tests:
Your doctor may take tissue for a biopsy in one of two ways:
You may want to ask the doctor these questions before having a biopsy:
How is staging determined for thyroid cancer?
If the biopsy shows that you have cancer, your doctor will need to learn the extent (stage) of the disease to help you choose the best treatment.
The stage is based on the size of the nodule and whether the cancer has invaded nearby tissues or spread to other parts of the body. Thyroid cancer spreads most often to nearby tissues in the neck or to lymph nodes. It may also spread to the lungs and bones.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of cancer cells and the same name as the original tumor. For example, if thyroid cancer spreads to the lungs, the cancer cells in the lungs are actually thyroid cancer cells. The disease is metastatic thyroid cancer, not lung cancer. It's treated as thyroid cancer, not as lung cancer. Doctors sometimes call the new tumor in the lung “distant” disease.
Staging may involve one or more of these tests:
What is the treatment for thyroid cancer?
Treatment options for people with thyroid cancer are …
You'll probably receive more than one type of treatment. For example, the usual treatment for papillary thyroid cancer is surgery, thyroid hormone treatment, and radioactive iodine therapy. External radiation therapy and chemotherapy are not often used for people with papillary thyroid cancer.
The treatment that's right for you depends mainly on the type of thyroid cancer (papillary, follicular, medullary, or anaplastic). It also depends on the size of the nodule, your age, and whether the cancer has spread. You and your doctor can work together to develop a treatment plan that meets your needs.
Your doctor may refer you to a specialist who has experience treating thyroid cancer, or you may ask for a referral. You may have a team of specialists:
An oncology nurse and a registered dietitian may also be part of your team.
Your health care team can describe your treatment choices, the expected results of each treatment, and the possible side effects. Because cancer treatments often damage healthy cells and tissues, side effects are common. These side effects depend on many factors, including the type of treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities.
At any stage of the disease, supportive care is available to control pain and other symptoms, to relieve the side effects of treatment, and to ease emotional concerns. You can get information about coping on NCI's website at http://www.cancer.gov/cancertopics/coping.
Also, you can get information about supportive care from NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). Or, chat using LiveHelp, NCI's instant messaging service, at https://livehelp.cancer.gov.
You may want to talk with your doctor about taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of thyroid cancer. See the section on Taking Part in Cancer Research.
You may want to ask the doctor these questions before treatment begins:
External radiation therapy
External radiation therapy is a treatment for any type of thyroid cancer that can't be treated with surgery or I-131 therapy. It's also sometimes used for cancer that returns after treatment or to relieve bone pain from cancer that has spread.
External radiation therapy uses high-energy rays to kill cancer cells. A large machine directs radiation at the neck or other tissues where cancer has spread.
The treatment usually is given in a hospital or clinic. You may receive external radiation therapy 5 days a week for several weeks. Each treatment takes only a few minutes.
Although radiation therapy is painless, it may cause side effects. The side effects depend mainly on how much radiation is given and which part of your body is treated. Radiation to the neck may cause a sore throat and trouble swallowing. Also, the skin on your neck may become red, dry, and tender.
You are likely to become tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.
Although the side effects of radiation therapy can be upsetting, they can usually be treated or controlled. Talk with your doctor or nurse about ways to relieve discomfort. Most side effects go away when treatment ends.
You may find it helpful to read the NCI booklet Radiation Therapy and You.
You may want to ask the doctor these questions before having radiation therapy:
Source: http://www.rxlist.com
Not all thyroid cancers produce symptoms. When symptoms do occur they may consist of:
Source: http://www.rxlist.com
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