Thyroid Cancer

Thyroid Cancer

What is the thyroid gland?
The thyroid gland is a small butterfly-shaped gland located in the neck just below the Adam's apple.  It produces thyroid hormones (T3, T4) necessary for physical and mental growth and development.  It also regulates the body's metabolism

What is thyroid cancer?
It is a malignant growth or tumor within the thyroid gland

Risks factors of thyroid cancer:

• Gender – thyroid disorders are generally more common among females but once a thyroid mass/ nodule is present in a male the risk of malignancy doubles than in females
• Age – the young (< 20 years old) and the old (>70 years old) have the highest incidence of thyroid cancer in a palpable nodule
• (+) family history of thyroid cancer
• history of head and neck irradiation

What are the signs and symptoms of thyroid cancer?

• hard,  irregular and fixed nodule/ mass in front of the neck
• presence of cervical lymph nodes
• vocal cord paralysis
• difficulty in swallowing
• hoarseness

Diagnosis
After a thorough history and physical examination,  your physician will request for laboratory examinations which include:  blood  tests  for  thyroid  hormones,  thyroid  ultrasound to determine the size, number and characteristic of the thyroid nodule and fine needle aspiration biopsy to determine if the mass is benign or malignant (cancerous).

Treatment
Treatment for most type of thyroid cancer is surgery (thyroidectomy) with removal of involved lymph nodes if present. Four weeks after surgery, radioactive iodine therapy in liquid or capsule form to be swallowed will be given to destroy remaining thyroid tissues or spread in other parts of the body.   This will require patients to be admitted in an isolation room for at least 3-4 days. After which, thyroid hormone replacement therapy will be initiated.  Regular follow-up with your doctor is necessary to adjust thyroid hormone dose and determine if there is recurrence of the cancer.

What are possible complications?

• hoarseness ( transient or permanent )
• hypocalcemia – resolved thru intake of calcium or intravenous calcium in severe cases

How do we monitor for possible recurrence or metastasis of thyroid cancer? 

• Regular follow up with the physicians for through physical examination
• Neck ultrasound or CT scan if indicated
• Measurement of thyroid stimulating hormone and thyroglobulin every 6 months
• Total body scan if  with  significantly  elevated thyroglobulin levels.

In TMC, what are the related services available?

• Laboratory tests for the evaluation,  management and monitoring of patients with thyroid disorders
• Blood tests:  TSH,  FT4,  FT3,  anti-TPO,  anti-Tg,thyroglobulin, TSHRAb
• Imaging:  Ultrasound/ CT scan of the thyroid and neck
• Nuclear med:  Thyroid scan/ uptake,  radioactive iodine therapy, total body scan
• Fine needle aspiration biopsy of thyroid nodules
• Thyroid lay forum

How can The Medical City help you? 
The Medical City offers a team of competent ENT-Head and Neck Surgeon and Endocrinologists who will evaluate and treat people with thyroid cancer.

For any inquiries please call:

HEAD AND NECK UNIT, CANCER CENTER
Tel. No. (632) 988-1000 / (632) 988-7000 Ext. 6214

CENTER FOR PATIENT PARTNERSHIP

Tel. No. (632) 988-1000 / (632) 988-7000 Ext. 6444

References:
William's Textbook of Endocrinology, 10th edition
Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer (The American Thyroid Association Taskforce, 2006) TMC Head and Neck Unit - Cancer Center TMC- Department of Medicine – Section of Endocrinology, Diabetes and Metabolism

Note:   This information is not intended to be used as a substitute for professional medical advise, diagnosis or treatment.   If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.