What are the reasons one can get thyroid cancer?
There is no specific reason why one can get thyroid cancer,Radiation to the neck during childhood is known to increase chances of getting thyroid cancer A small fraction of thyroid cancer is hereditary. This is higher in a type of cancer known as medullary cancer.
What are the symptoms of thyroid cancer?
Most of the thyroid cancers are asymptomatic and just present as a nodule in the neck
Few thyroid cancers may present as lymph nodes in the neck
Very few thyroid cancers, the more aggressive ones, may present with hoarseness of voice and difficulty in swallowing.
How is thyroid cancer diagnosed?
Whenever a patient presents with a thyroid nodule the treating doctor may ask for an ultrasound of the thyroid region
Ultrasound gives additional information about the nodule
Nodules which have the following characteristics on ultrasound are considered more suspicious of cancer.
If there is suspicion of cancer then the next step is to get an FNAC. A needle is inserted into the nodule preferably under ultrasound guidance and the tissue is sent to the pathologist.
What are the various types of thyroid cancer?
The most common type of thyroid cancer is papillary cancer of the thyroid. Fortunately this is the least aggressive.
The next common is follicular cancer The other types are medullary cancer and anaplastic cancer.
How is thyroid cancer treated?
Surgery is the mainstay of thyroid cancer treatment. The removal of the thyroid is known as thyroidectomy.
Following surgery another treatment known as radioiodine therapy is used in which radioactive iodine is administered to ablate any remaining thyroid or metastases
Following this usually a higher than normal dose of thyroxine is given to suppress the TSH
How is thyroid surgery performed?
Removal of the thyroid gland is called thyroidectomy.
Depend on the extent of removal it may be called
Along with the thyroid it may be necessary to remove the lymph nodes in the neck. This procedure is called lymph node dissection.
What are the risks involved?
There are two main risks in thyroid surgery
1. Injury to the nerve supplying the voice box which may lead to hoarseness of voice2. Injury to the parathyroid gland which is located behind the thyroid , two on each side. This leads to decrease in calcium levels which manifests as stiffness of hands and legs
Fortunately these complications are rare and quite low in experienced hands.
What is the usual follow up after thyroid cancer surgery?
Approximately 1 month after the thyroid cancer surgery radioiodine scan is performed to see if there is any residual thyroid or metastases and to check if radioiodine ablation is required. This is true for papillary and follicular carcinoma of the thyroid.
Following this thyroid replacement tablets are started usually in a higher dose
Periodically the tests which are done are thyroid function tests and thyroglobulin
Thyroglobulin is known as a tumour marker and raising values suggest that the cancer might have come back.
Do benign nodules of thyroid need surgery?
Not always. A few thyroid nodules may need surgery especially if
If these indications are not there then observation is an option