In most cases, thyroid cancer is the result of an abnormal gene that you get from one of your parents. Other causes include radiation exposure and iodine deficiency.
Your healthcare provider will want to take blood tests and do a biopsy of your thyroid nodule or enlarged lymph node to check for cancer cells. A doctor who specializes in examining blood and body tissue (pathologist) looks at the samples under a microscope to make a diagnosis.
Thyroid cancer occurs when cells develop changes (mutations) in their DNA that cause them to grow and multiply quickly. This process can lead to the formation of a mass called a tumor. The cancer may also spread to lymph nodes in the neck or other parts of the body. Thyroid cancer is one of the few head and neck cancers that has a high five-year survival rate (97%).
The first step in diagnosing thyroid cancer is getting a blood test that checks your thyroid hormone levels. A fine needle aspiration biopsy may also be done to confirm a suspected thyroid nodule. In this procedure, a healthcare provider inserts a thin needle into the nodule, often using ultrasound to guide the needle. This allows healthcare providers to collect a sample of the nodule tissue and evaluate it under a microscope for signs of cancer.
A CT scan may be used to provide a more detailed look at the nodule and nearby structures. A sentinel node biopsy can help determine if cancer cells have spread to nearby lymph nodes. These procedures are usually performed under local anesthesia and do not cause any significant discomfort.
Your doctor will use the results of these tests to determine the type of thyroid cancer you have and whether it has spread. Your diagnosis will also affect what kind of treatment you receive.
If the cancer is in the neck near your larynx, trachea or esophagus, surgery may be needed to control symptoms. The surgeon can remove part or all of the thyroid gland. They can also create an opening (stoma) in the windpipe to make it easier to breathe if the thyroid is removed completely.
If the cancer has not spread, your doctor may recommend closely monitoring it with regular ultrasounds and physical exams. This is called active surveillance and it may be appropriate for some papillary thyroid cancers that are small and have not spread. If you choose active surveillance, you will need regular follow-up appointments and a CT scan every six to 12 months.
Your doctor will take a history of your symptoms and do a physical exam. They will check your neck, including the thyroid gland and lymph nodes. They will also examine your throat, using a tool called a laryngoscope. This is done to see if the tumor presses on your vocal cords and causes hoarseness or difficulty swallowing. A CT scan or an MRI may be used to help find the size and shape of the tumor, as well as its location within the thyroid. Your provider will ask whether you have any other health problems or if you’ve had radiation therapy of the head or neck.
Your healthcare team will do a needle biopsy of the nodule if the imaging tests show that it’s solid or has calcium and doesn’t have clear borders. This procedure takes about half an hour. Your provider will clean the area and then insert a thin needle into the nodule or goiter. You’ll feel a little pressure when the needle goes in, but it should not be painful. Then your provider will pull out the needle and put a small bandage over the site. They may have to do this a few times to get samples from different parts of the nodule or goiter. They might also need to do a core needle biopsy, which uses a larger needle.
If the biopsy shows that the cancer has spread beyond the thyroid, your provider will discuss treatment options with you. They might recommend radioactive iodine treatment, which works by making cancer cells more sensitive to iodine and blocking their growth.
Another option is surgery to remove the thyroid tumor and part or all of your parathyroid. This is usually an outpatient surgery. You’ll have to take a daily manmade hormone (thyroid replacement) to replace the hormones your thyroid made before it was removed. You’ll also need to take calcium supplements to keep your bones strong. Your provider might suggest other treatments, such as chemotherapy or immunotherapy, if they think the cancer is very aggressive. These are experimental and might not be available in your area.
You will have follow-up appointments to check whether cancer has returned. These may be every few months to begin with, then every 6 months or yearly. These appointments give you the chance to discuss any problems or concerns you have. They also allow the doctor to examine you and take blood tests.
For most people with papillary thyroid cancer, the best way to detect recurrence is by checking the neck lymph nodes regularly. This can be done with routine cervical ultrasonography or thyroglobulin (Tg) blood testing. In some cases, the doctor may recommend a radioiodine scan. This test is used to check for any remaining thyroid tissue and for recurrence in the gland that was removed. It is less often used now, because the ultrasound and Tg tests are more effective at detecting recurrence.
People who have had thyroid cancer are also at risk for developing another cancer, usually a different type of tumour in the same part of the body or a new, unrelated cancer elsewhere in the body. This is called a second cancer or a metastatic tumour.
To help keep cancer from coming back, you can follow a healthy lifestyle, get enough exercise and eat a balanced diet with plenty of fruit, vegetables, and whole grains. You can also try to avoid foods high in saturated fat, trans fats, and sugary drinks. You should also drink alcohol in moderation.
Taking hormone replacement therapy, which includes levothyroxine and rhTSH, can also lower your chances of cancer returning. But your doses of these drugs will need to be checked and adjusted regularly by a doctor who specialises in endocrinology, and your thyroid function tested.
For people who have had medullary thyroid cancer, doctors can monitor the blood for high levels of a protein called carcinoembryonic antigen, which is very low in people without cancer. They can then use this information to check whether you are at increased risk of developing a new cancer or if your medullary thyroid cancer has come back after treatment. It is important to talk with a specialist about any feelings you have, such as depression or anxiety. You can also ask for help from family and friends, support groups, religious groups, or professional counselors.
While you can’t prevent thyroid cancer, most types are treatable. Early detection and surgery can prevent the cancer from spreading or growing. The thyroid is a butterfly-shaped gland in the front of the neck just above the larynx (voice box).
There are two lobes, one on each side of the windpipe (trachea), connected by a band of tissue called the isthmus. The thyroid produces hormones that control the body’s metabolism. The most common types of thyroid cancer are papillary and follicular thyroid cancer, which start in the cells of the thyroid gland. The less common type is medullary thyroid carcinoma, which starts in the C cells of the thyroid and spreads faster than other types of thyroid cancer. Medullary thyroid cancer is more likely to be inherited, and can be tested for in families with a history of the disease.
You can protect your health by having regular checkups with a doctor. This includes a routine exam of the thyroid, as well as examination of nearby lymph nodes in the sides of the neck. The doctor may also order blood tests or ultrasound to check for thyroid cancer and other conditions.
If you have a small papillary or follicular cancer, your doctor might recommend close monitoring with frequent blood tests and ultrasound examination of the thyroid to see if the tumor is growing or spreading. This is known as active surveillance and can be done for several years. Treatment can be started at any time if the doctor decides it is necessary.
Women are more likely to be diagnosed with thyroid cancer than men, due to a combination of factors, including differences in hormone levels and certain inherited genetic mutations. Radiation exposure, whether from medical procedures or from high-dose radiation used in childhood cancer treatments, is another major risk factor for thyroid cancer.
A healthy diet is important to help lower your risk of many diseases, including thyroid cancer. Choose a diet rich in fruits and vegetables, whole grains, and lean protein. Avoid excessive amounts of salt and foods containing saturated fats, which are linked to obesity and poor health outcomes. In addition, get enough iodine to support the thyroid.
If a thyroid nodule is suspicious, doctors can use a fine-needle aspiration biopsy to see if it’s cancer. This involves numbing the area with medicine, then putting a thin needle into the nodule and pulling out a sample of cells to test for cancer.
Some people with small papillary thyroid cancers choose to have them watched closely with regular ultrasounds, rather than having treatment straight away. This is known as active surveillance.
Fatigue is a common early sign of thyroid cancer, and can also be a symptom that the cancer has spread to other parts of your body. If you notice unexplained fatigue, it’s important to see your health care provider. He or she will take a history of your symptoms and do a physical exam. They will check your neck for any lumps or nodules and look for swelling in the front of your throat (larynx) and lymph nodes in the neck area. They may also use a tool called a laryngoscope to view your vocal cords to make sure they are moving normally and not being affected by a tumor.
A doctor may recommend some treatments, depending on the type of thyroid cancer you have and its location. Treatments may include radiation or surgery to remove the thyroid, medication to reduce hormone production or to block its effects, or therapy to control the growth of cancer cells. Some people have a better chance of beating cancer with early diagnosis and treatment.
Fatigue is very common in survivors of thyroid cancer and can affect their quality of life. Fatigue is difficult to treat and is not always relieved by medications, but there are some things that you can do to help reduce it. Getting enough sleep, eating well and exercising regularly can all help to ease your fatigue. It’s also important to manage stress, if possible. In addition to making lifestyle changes, you may be prescribed medications to improve your energy and reduce your fatigue. These medicines can be taken as tablets or liquids and are usually taken in the morning before breakfast. You might also be given a vitamin B12 shot to boost your energy levels.
Thyroid cancer usually starts in the thyroid gland, a butterfly-shaped structure at the base of your neck that makes hormones and controls how your body uses energy. It’s part of your endocrine system, which also includes the pancreas and adrenal glands. Thyroid cancers are rare. They occur about 53,000 times a year in the United States, according to the American Thyroid Association (ATA). Most people with thyroid cancer don’t have any symptoms. They’re diagnosed when a lump or nodule is felt or seen on ultrasound or another imaging study. The most common type of thyroid cancer is papillary (pah-PIL-ee-rul) tumors. The other types are follicular (fuh-LIK-uh-cul-ray) or medullary (moo-DUH-lee) tumors.
Many people with papillary cancer are under 40 when they get the diagnosis. The cause of this trend isn’t clear. It may be that people are becoming more aware of and discussing their health. It’s also possible that more doctors are finding these small thyroid cancers.
Symptoms of thyroid cancer often start slowly and can be difficult to recognize. They can be caused by a wide range of things, including aging, diet, stress or other medical problems. The cancer itself can also produce these symptoms.
If you have any of these symptoms, it’s important to see your doctor. Your doctor will order blood tests to check your thyroid hormone levels and to see if your thyroid is functioning properly. He or she will also probably do an ultrasound exam of your thyroid and any enlarged lymph nodes in your neck. A fine needle aspiration biopsy may be done if you have a nodule. This involves inserting a needle into the nodule using ultrasound to guide it, then drawing out a sample of cells for testing.
Thyroid cancer starts in the thyroid gland, a butterfly-shaped organ in your neck that makes hormones and is part of the endocrine system. The thyroid controls your body’s metabolic functions, including energy levels, temperature control, heart rate and digestion. Thyroid cancer usually affects the cells of the thyroid, but it can also spread to nearby tissues and lymph nodes.
Tissue changes in the thyroid often cause weight loss, fatigue and a change in appetite. Other symptoms include a hoarse voice, difficulty swallowing or a lump in the neck. Lymph nodes in the neck may become enlarged and feel hard to touch and/or press against the esophagus or windpipe (trachea). These nodules can be benign or malignant, so a health care provider will do an exam to check your thyroid and neck, and take a history of your family’s medical history.
Depending on the size of your thyroid nodule and whether it has signs and symptoms, your health care provider may recommend further tests. This can include an ultrasound, a fine-needle aspiration or a sentinel node biopsy. A MRI or CT scan might be done to help assess the nodule and determine how far it has spread.
If you have a small papillary thyroid cancer, your doctor may suggest active monitoring, with frequent blood tests and an ultrasound exam of your neck to look for any changes. If the cancer does grow, your health care provider will talk to you about treatment options.
Your health care team might recommend a surgery to remove the thyroid, parathyroid glands or some or all of your lymph nodes. They might also recommend radiation therapy to help prevent the cancer from returning. You’ll have regular follow-up appointments. During your follow-up visits, tell your doctor if you have any new symptoms.
The thyroid is a butterfly-shaped gland that makes hormones and controls metabolism, or how the body uses energy. It’s located in the front of the neck, in a small space below where your collar bones meet. Thyroid cancer can be caused by abnormal cells that grow in the thyroid and spread to other parts of the body. Most thyroid cancers are slow-growing and usually don’t cause symptoms. But a few types of cancer can cause pain, swelling, or changes in the voice.
The most common type of thyroid cancer is papillary (pah-PIB-uli) carcinoma. This cancer starts in thyroid hormone-producing cells and can spread to lymph nodes in the neck. It most often affects people ages 30 to 50. Another type of thyroid cancer is follicular (fuh-LIK-uli) carcinoma. This cancer also starts in thyroid hormone-producing cells, but it’s less common than papillary carcinoma.
If you have pain in the neck or throat that doesn’t go away, see your doctor. Your doctor will examine your neck and may order blood tests, an ultrasound, or a biopsy to check for cancer cells. A doctor can also use radioactive iodine, or RAI, to destroy thyroid cells that have cancerous mutations.
The type of treatment you get depends on the type of thyroid cancer you have and how far it has spread. For example, you might need chemotherapy with drugs that block chemicals that cancer cells need to grow. These drugs can come in pill form or be given through a vein. They can be used alone or with radiation therapy. You might also need other types of treatments, such as surgery or radiation to the head and neck.
Swollen lymph nodes can be a symptom of thyroid cancer, but they also may be caused by infections, or by conditions that affect the immune system. More than 600 small, kidney bean-shaped lymph nodes are clustered throughout your body — under your neck, in your armpits and groin, and in the middle of your chest and belly. They store immune cells and act as filters, removing germs, dead tissues and waste from your blood.
Lymph nodes in the front of the neck (cervical lymph nodes) and near the trachea (windpipe) often enlarge when thyroid cancer spreads to these areas of the throat. Located under the skin on both sides of the neck, these lymph nodes are part of the lymphatic system and connect to the esophagus on one side and the trachea on the other.
The lymphatic system is a network of vessels that transports fluid and white blood cells to and from your lungs, heart, and intestines. It also carries hormones, such as growth hormones and testosterone.
A weakened immune system, which can be caused by infection or certain medicines, increases the risk of swollen lymph nodes. If swollen lymph nodes are related to an infection, and are not treated, they may become infected and form a pus-filled cavity called an abscess. An abscess requires drainage and antibiotic treatment.
If you have swollen lymph nodes in your neck, your doctor will want to run tests and imaging to see what’s causing them. These may include a physical exam, an ultrasound of the neck, and CT or MRI scans. These can show if the enlarged nodule is a tumor or is another type of thyroid problem, such as a goiter.
Your doctor may ask if you would like to take part in a clinical trial to improve treatment options for thyroid cancer.
The most common treatment for thyroid cancer is surgery to remove part or all of the thyroid gland (thyroidectomy) and nearby lymph nodes. This is followed by radioactive iodine therapy to destroy any remaining thyroid tissue and any cancer cells that have spread.
Your doctor will do tests to check for thyroid cancer or find out how far it has spread. These include:
Ultrasound scan – this uses sound waves to make pictures of parts of your body. Your doctor may use this to check a nodule or lump in your neck and to help decide whether to take a sample of the nodule for further testing (biopsy).
Fine needle aspiration – this involves inserting a thin needle into a nodule to get a small sample of cells for diagnosis. This is the most common test used to see if a thyroid nodule is cancerous. A sample of the nodule is sent to a laboratory to be examined under a microscope. The results can be definitive (showing cancer), uncertain (not sure if the nodule is cancerous) or indeterminate (cancer but not certain). Indeterminate biopsies are often sent for additional tests to look for specific gene changes that can help to predict if a nodule is likely to be cancerous.
CT scan or MRI of your thyroid and neck – these tests also use x-rays to make pictures of the nodule or lumps in your neck. These can be very helpful if there are signs the nodule could be cancerous, such as a tight feeling in your throat or difficulty breathing, swallowing or hoarseness. A CT or MRI scan can also show if the cancer has spread to nearby lymph nodes in your neck.
SPECT or MUGA scan – these can be done to measure how much thyroid-stimulating hormone, or TSH, is being produced. They can also be useful in helping to diagnose papillary or follicular thyroid cancer that has spread to the lungs or bones. They are sometimes done with a radioactive tracer to look for areas of cancer that might be producing more TSH than normal.
Your doctor may recommend lobectomy (surgery to remove one side, or lobe) of the thyroid for some low-risk cancers, such as papillary thyroid cancer that has not spread outside the thyroid. This can be particularly helpful if you haven’t had radiation to your neck and the nodule is only 1 to 4 cm in size.
Most people with thyroid cancer are diagnosed because of a lump (nodule) that is felt or seen, or by the results of imaging tests like ultrasound or CT scan. If the doctor thinks you have thyroid cancer, you will have a biopsy to confirm it. Then, your doctor can decide what treatment to recommend.
Surgery is the most common treatment for thyroid cancer. Surgery can be used alone or in combination with other treatments. Some doctors may also use radioactive iodine to destroy any remaining cancer cells. This is called RAI therapy.
Your doctor will make an incision in the front of your neck. Depending on the type of surgery you have, your doctor might remove part or all of your thyroid gland. Lobectomy is the removal of one part, or lobe, of your thyroid. This might be done for low-risk papillary thyroid cancers or for follicular carcinoma with vascular invasion that has not spread beyond the thyroid gland.
If your cancer has spread to lymph nodes in the neck, your doctor might also remove these lymph nodes. This is called a neck dissection. Your surgeon might do a central compartment neck dissection or a modified radical neck dissection. Which one your doctor does will depend on the results of your biopsy, which lymph nodes are involved, and the results of your imaging tests.
After surgery, you will need hormone therapy to prevent your body from making too much thyroid hormone. You might have to take pills or receive a shot. If your thyroid cancer was removed completely, you will need to have regular blood tests to check your thyroid function.
Most of the time, surgery and radioactive iodine treatment do not affect your ability to have children. But it is important to talk with your doctor about this if you want to try to have children in the future. Your doctor can give you advice about fertility options and other sources of support if needed. Follow-up tests and check-ups help your doctor find out whether your cancer has come back or is still growing. These might include physical exams, imaging tests, and blood tests to check your hormone levels and calcitonin.
Radiation therapy uses high-energy rays to destroy cancer cells. It is often used in combination with other treatments, such as surgery and targeted drug therapy.
The type of radiation your doctor gives you depends on your medical history, the size and location of your thyroid tumor, and other factors. Your treatment plan will be carefully outlined by your healthcare team before you undergo radiation therapy.
For tumors in the area of the thyroid gland or nearby lymph nodes, doctors often use external beam radiation therapy. This treatment is usually done in the hospital. You might receive treatment five days a week for several weeks. This treatment can be combined with a surgical procedure called thyroidectomy to remove the entire thyroid and nearby lymph nodes.
In some cases, doctors might also use a surgery called a lobectomy to remove only the part of the thyroid where the cancer is found. During this procedure, lymph nodes might also be removed and checked under a microscope for signs of cancer. If the doctor discovers that the cancer has spread beyond the thyroid, they might recommend an additional surgery to remove lymph nodes from the neck and treat them with radiation or drug therapy.
Some types of cancer are more likely to come back after surgery than others. For these cancers, doctors might also use a procedure called radioactive iodine (RAI) treatment. During RAI treatment, you receive a special pill that contains radioactive iodine. The iodine enters your bloodstream and travels to the tissues that need it, such as the thyroid cancer cells. The cancer cells absorb the iodine and are destroyed.
Your body might be radioactive for a few days after this treatment. Your healthcare team will tell you how long you should stay away from other people and what safety precautions to take. The radioactive iodine will leave your body through your urine and sweat.
Some people with thyroid cancer may benefit from targeted drug therapy, which is a type of chemotherapy. Targeted drug treatments block certain chemicals that help cancer cells grow. These drugs are taken in pill form or injected into a vein. The medicines crizotinib (Xalkori) and ceritinib (Zykadia) might be options for some patients with follicular, papillary, or poorly differentiated thyroid cancer with ALK gene changes.
Your healthcare provider may ask you if you want to take part in a clinical trial to help make existing treatments better and develop new ones. Clinical trials test whether an experimental treatment is safe and effective in people. Your doctor can explain what is involved in a clinical trial and answer any questions you have.
You may have blood tests to check hormone levels and your thyroid function. You might also have a fine-needle aspiration biopsy or a sentinel node biopsy to find out if cancer has spread from your thyroid to other parts of your body. Imaging tests include CT scans (which use x-rays to make detailed pictures of the inside of your body) and a PET scan, which uses an injection of a glucose solution to help cancer cells show up better.
Surgery to remove your thyroid is the most common treatment for thyroid cancer. If you have papillary thyroid cancer that hasn’t spread, surgery might be all you need. If it has spread, you might need to have additional treatment with radiation or targeted drug therapy. You might also need hormone therapy to control your thyroid hormone levels.
A few weeks after surgery, you might get radioactive iodine (RAI) treatment. This destroys any remaining thyroid tissue and any cancer cells that have spread to other parts of your body. RAI is usually used for follicular and papillary cancers that are more likely to come back after surgery or have a higher chance of spreading. A small test dose is first given to see if the thyroid tissue takes up the iodine.
Chemotherapy isn’t often used to treat thyroid cancer, but it might be needed if your cancer has spread to other parts of your body. It might also be helpful for people with a type of thyroid cancer called anaplastic thyroid cancer that grows fast. Your doctor might give you chemotherapy pills or liquid drugs that are taken through a vein (intravenously). They can help kill cancer cells and control their growth. The medications can have side effects, including nausea and vomiting.
