Thyroid cancer is a rare malignancy that affects the thyroid gland.
Thyroid cancer is generally noticed as a painless, distinct, solitary nodule in the thyroid region (lower) of the throat externally. Solitary nodules have a much higher chance of turning out to be malignant in older patients beyond 60 years of age or in patients younger than 30 years.
Thyroid nodules when present in males have higher chances of being malignant. Enlargement of lymph nodes situated in the neck region can also be a sign of malignancy. Patients with family history of thyroid carcinoma must be checked thoroughly.
The ultimate goal of workup is to differentiate the nodule into malignant or benign. Following are the means of tests used to determine this:
Following are the different ways of treating thyroid cancer:
Papillary and follicular thyroid cancers are the most common types of the thyroid cancer. Both these carcinomas have very good prognosis i.e. they are most curable ones. These carcinomas have 97% cure rate in younger patients when treated properly.
Anaplastic thyroid cancer is rarely seen and has the worst prognosis. It is diagnosed after the spread has taken place and patient is almost incurable. It is rare to survive this cancer as many a times even the surgery cannot remove the tumor entirely.
The risk of developing thyroid cancer increases with benign thyroid conditions like thyroiditis or goitre. Exposure to radiation in childhood can increase the risk of developing thyroid malignancies, mainly papillary thyroid carcinoma. Exposure to radiations during medical procedures may also lead to thyroid cancer.
Inherited genetic mutations are responsible for a small number of medullary thyroid carcinomas. Low dietary intake of trace element iodine has higher chances of developing follicular or anaplastic carcinoma.
In 2010, thyroid cancer resulted in 36,000 deaths around the world as compared to 24,000 in 1990 . Yearly, 1% new cases of thyroid cancer are diagnosed. The incidence of thyroid cancer is 3 folds more in females as compared to males. The prevalence of this disease is maximum in third and fourth decades of life.
The pathophysiology of thyroid cancer is not completely defined. Transformation of various molecular factors has been linked with thyroid malignancy. These include proliferative factors like growth hormones and oncogenes, and apoptotic and cell-cycle hindering factors such as tumor suppressors .
Physiological behavior of the cancer depends upon the type of tumor. Thyroid cancer is thought to follow a continuity from well differentiated to anaplastic, distinguished by early and late genetic events . Many patients suffering from differentiated thyroid cancer experience loss of thyroid-specific functions such as iodine aggregation .
Papillary carcinoma arises from follicular cells, that produce and store thyroid hormones, have a tendency of spreading to local lymph nodes. Follicular carcinoma also arises from the follicular cells and Hurthle cell carcinoma is a rare type of follicular carcinoma that spread hematogenously.
Medullary thyroid cancer begins in thyroid cells called C cells that produce the hormone calcitonin. Anaplastic thyroid cancer is a rare, aggressive, undifferentiated carcinoma that is inclined to local invasion and metastatic spread.
Exposure to radiation in early childhood is a known risk of thyroid cancer hence it is advised that children should not have any tests involving exposure to radiation unless it is absolutely essential.
Blood tests can be performed to look out for genetic mutations that are seen in familial medullary carcinoma as MTC can be treated early by removing the gland. Once the disease is discovered in the family, all the other family members should be tested for this mutated gene for prevention of cancer.
Thyroid gland is an essential gland for the normal functioning of the body and hence prompt treatment of the thyroid cancer is needed. Like any other cancer the exact cause is known but childhood radiation has shown to be a risk factor and should be studiously avoided. Being diagnosed as a patient of thyroid cancer can be frightening, but thyroid cancer is curable most of the times.
The cancer is diagnosed by thyroid hormone tests, ultrasound of the neck and maybe CT or MRI scans too. There are various line of treatments that are available now a days to cure this disease.
Depending on the type and stage of cancer the physician guides you to the best mode of treatment that is appropriate for you. After the treatment you will have to take a pill to replace the thyroid hormone in your body for life time.