MEDICAL SECOND OPINION

Thyroid Cancer

Overview

The thyroid gland is a small organ with a bridge-like structure called the isthmus, which connects two lobes at the anterior neck's base.
The thyroid gland produces hormones that regulate your body's metabolism. The elevation of thyroid hormones (hyperthyroidism) is manifested by high heart rate, excessive sweating, heat intolerance, muscle weakness, overactive bowel, and accelerated metabolism, such as tremors. Hypothyroidism, characterized by low thyroid hormones, is, as can be expected, characterized by a slowed-down metabolism. While the thyroid gland regulates the body's metabolism, the pituitary gland in our brain produces and secretes hormones that regulate the amount of hormones secreted by the thyroid gland.

Risk Factors:

The etiology of thyroid cancer is not entirely understood. Factors that increase the risk of thyroid cancer include being a woman, exposure to high radiation, and certain inherited genetic diseases.

Types:

Papillary cancer:

Papillary cancer accounts for a substantial part of all thyroid cancers. They originate from follicular cells that produce hormones in the thyroid gland. It is usually benign in nature, and the prognosis becomes poor when it spreads to other body organs.

Follicular cancer:

It is the second most common type of thyroid cancer. Quicker spread and higher risk of recurrence are remarkable properties.

Medullar cancer:

This type of thyroid cancer originates from C cells that secrete the hormone calcitonin in the thyroid gland. It can be detected at an early stage due to the elevation of calcitonin in blood. This cancer requires the removal of the thyroid gland.

Anaplastic cancer:

Although it is the least common type of thyroid cancer, it proliferates, and the treatment is challenging. It is mainly seen in people aged 60 or older, and removal of the gland may be necessary, as its quick growth makes breathing difficult.

Symptoms:

Thyroid cancer may not show any symptoms at an early stage. The following symptoms can be manifested at advanced stages:
•    A lump on neck
•    Pain in throat and neck
•    Hoarseness
•    Difficulty swallowing
•    Difficulty in breathing
•    Enlarged lymph nodes in neck
•    Prevention:

As is the case for all other cancers, prevention of thyroid cancer is also to eliminate or minimize manageable risks. Excluding radiation and genetic factors, the primary approach includes healthy lifestyle recommendations, healthy nutrition, regular exercise, etc.), as the causes of thyroid cancer are not precisely known.
Thyroid cancer may develop in a part of thyroid nodules, and therefore, thyroid examinations and screening are essential. In the presence of these nodules, one should consult an endocrinologist as soon as possible.

Diagnosis:

If the physical examination and the imaging studies (CT, MRI, PET) that are ordered to investigate findings suspicious for thyroid cancer show a mass, a provisional diagnosis is made. If a family history is notable for thyroid cancer, genetic tests may be required to determine the risk of cancer. Blood tests may also give clues about the irregularities in the thyroid gland. The definitive diagnosis of thyroid cancer requires a biopsy.

Treatment:

After the diagnosis of thyroid cancer is made, the next step is to determine the stage. Your doctor will determine the stage (I to IV) of your cancer based on a set of stringent criteria. You may think thyroid cancer is broadly staged as local, limited, regional, and distant.

Generally, cancer phases are symbolized by the Roman numbers I to IV. Phase IV is the last phase and the most severe cancer. Each patient's treatment is planned by considering stage, age, general health status, and personal preferences.

For thyroid cancer, the treatment options include chemotherapy, hormone therapy, iodine therapy, radiotherapy, targeted therapy, and surgery. While these treatments cure the tumor, they can increase the quality of life and ease the severity of the symptoms in advanced stages. Moreover, the treatment options can be used together or alone.

Chemotherapy

Chemotherapy uses drugs to cure cancer. The active ingredients in these drugs kill cancer cells. Chemotherapy drugs can be administered intravenously or by mouth. If the drug is administrated through a vein, a thin tube, called a catheter, is inserted into a large vein, and the chemotherapy drug is delivered from this catheter throughout the treatment.
One or more chemotherapy medicines may be administered according to the response of the cancer to the treatment and the type of cancer. After chemotherapy is given for a certain period, treatment is paused. After the completion of this defined "break" period, treatment resumes. Each of these periods is called a cycle.

Targeted Therapy

Targeted therapies are newer anti-cancer treatments compared to chemotherapy. These medicines target specific abnormalities that are present in cancerous cells. Before these medicines are started, cancer cells are analyzed in laboratories to determine whether they have particular mutations.

Radiotherapy

Radiation therapy aims to kill cancer cells by using high-powered energy beams.
If the radiation source is out of the body and beams are directed to the cancer, this treatment is called external radiotherapy. On the other hand, if the radioactive agent is put into the area where cancer is present by a needle or catheter, the method is called internal radiotherapy (brachytherapy).

Although radiation therapy can also be used as first-order therapy for cancer, generally, it is used to kill cells that are not removed by surgery. In the first-line treatment, mostly radiotherapy and chemotherapy are administered together, and this treatment is also known as chemoradiotherapy. It plays a vital role in relieving or removing the symptoms of advanced-stage cancers.

Surgery:

As a result of your surgeon's evaluation, your thyroid gland can be entirely removed (total thyroidectomy), or one lobe of the thyroid gland can be removed (lobectomy).
When the entire thyroid gland is removed (total thyroidectomy), you will need to use thyroid hormone pills for the rest of your life.

Your surgeon makes an incision on the neck base to expose the thyroid gland. Total thyroidectomy or lobectomy is performed according to the preoperative planning. In total lobectomy, thyroid tissue surrounding the parathyroid glands may not be removed. This approach is commonly referred to as near-total thyroidectomy. No matter how much of the thyroid gland is removed, your surgeon removes the enlarged lymph nodes in the neck.

Asking your questions about the treatment of thyroid cancer, your life after treatment, rehabilitation, pain management, clinical studies, and all the questions in your mind about thyroid cancer, your doctor will help you participate in your treatment and alleviate your concerns.

Created at 11.10.2023 03:43
Updated at 27.05.2024 01:06

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