The thyroid is a butterfly-shaped gland located at the base of the neck. It produces thyroid hormone, which controls our bodies’ overall metabolism.
Thyroid cancer is increasingly common in the United States, particularly in women. It is now one of the most common cancers found in women. While thyroid nodules are very common, only approximately 5% of thyroid nodules are found to be cancerous. In most patients thyroid cancer does not cause any symptoms, though it sometimes can lead to difficulty swallowing, voice changes or a lump in the neck. Often thyroid cancers are found within nodules that are either felt by the patient or their doctor. These nodules are also frequently found incidentally, when the patient has a radiology test not related to thyroid.
If based on the physical exam and ultrasound a nodule has a certain size and appearance a biopsy may be performed. The most common biopsy is called a fine needle aspiration (FNA) biopsy. In FNAs a small needle is used to remove cells from the nodule to try to determine if it is cancer or not. In some patients, a biopsy may show a cancer before surgery and in others a cancer may only be found after surgery is completed.
There are several types of thyroid cancer. The vast majority of thyroid cancers are not aggressive and have an excellent prognosis. While most patients with thyroid cancer do extremely well, it is critical to be treated appropriately.
There are different types of thyroid cancer, which may need to be treated differently, including:
- Papillary: The most common form of thyroid cancer. This type of cancer, which tends to grow slowly, has an excellent prognosis. It is treated with thyroid surgery and, in some cases, radioactive iodine.
- Follicular: This type of thyroid cancer also has an excellent overall prognosis. It is treated similarly to papillary carcinoma, with thyroid surgery and radioactive iodine.
- Medullary: This form of thyroid cancer develops from cells in the thyroid gland that are different from papillary and follicular thyroid cancers. While the prognosis with medullary cancer is not as good as with those types of thyroid cancers, it is also much less common (between 5-10 percent of all thyroid cancers). Medullary thyroid carcinoma can be associated with several inherited syndromes but most cases happen in patients without any family history. Treatment for medullary thyroid cancer is primarily surgery.
- Anaplastic: This is the least common type of thyroid cancer but is very aggressive. This cancer often grows very quickly and cause a firm neck mass. It needs to be treated very quickly.
The main treatment for most thyroid cancer is surgery. This surgery will involve removing the thyroid and in some patients lymph nodes that may have cancer in them. After thyroid surgery for cancer, some patients may need additional therapy with radioactive iodine and thyroid hormone medication to complete their treatment.
Dr. Joshua Lubek works alongside a team of other thyroid experts including Endocrinologists, Radiation Oncologists, and Medical Oncologists to evaluate and treat your thyroid gland cancer.
After treatment for thyroid cancer, it is important to be followed by a physician to be certain that the disease does not return. Different tools may be used to monitor patients for signs of recurrence, including: blood tests, physical examinations, and radiology tests.
If it is determined that thyroid cancer has returned more tests are performed to determine what additional treatment, if any, should be done.
As with all diseases, the proper treatment for recurrent thyroid cancer is one that is customized or tailored to each individual patient.