Thyroid Cancer

Thyroid cancer (cancer of the thyroid gland) comes in four forms: papillary, follicular, medullary and anaplastic. Papillary and medullary are slow-growing and occasionally return, but respond well to treatment in patients under middle age.

Medullary also reacts well to therapy, if it has not already spread. Anaplastic grows rapidly and reacts badly to therapy. The extent of these types of cancer is not uniform throughout the world, but is roughly: 78% for papillary; 17% for follicular; 4% for medullary and 1% for anaplastic.

Normally, the first symptom of a problem is the growth of a nodule or nodules in the neck near the thyroid gland. However, only 5% of these are malignant. Sometimes an early warning sign is discomfort or even pain; sometimes, the lymph nodes swell, the voice changes or there is hypo- or hyper- thyroidism.

Diagnosis normally takes place after a nodule is found during a (routine) physical examination. The patient is then referred to an endocrinologist or a thyroidologist, who will arrange an ultrasound test or a biopsy. Using a thin needle enough cells can be taken to do an accurate test on the exact condition of the thyroid and whether the nodules are cancerous.

Papillary thyroid cancer more frequently takes place in women and frequently in the 30-40 year old age group and is frequently characterized by bulging eyes. If the growth is less than 1cm in size a partial thyroidectomy or hemithyroidectomy would almost certainly be recommended.

Greater than 1cm and a full thyroidectomy is favoured. Some surgeons would rather a full thyroidectomy anyway because the cancer cannot recur then.

Follicular thyroid cancer is more common in women more than 50 years of age. Therapy is most frequently full thyroidectomy as the threat of recurrence of this aggressive kind is too big for partial surgery.

Medullary thyroid cancer (MTC) starts in the cells that produce the hormone calcitonin. Higher levels of calcitonin in the blood are a realistic indication of MTC, although these increased degrees of calcitonin are almost certainly not injurious in themselves.

Mutations in the DNA concerned in cell growth and development are responsible for nearly all cases of hereditary or familial medullary thyroid carcinoma. Hereditary medullary thyroid cancer is inherited as a 50/50 probability from every affected parent. DNA analysis makes it feasible to identify children who carry the mutant gene.

Surgical removal of the thyroid in children who bear the mutant gene is effective if the whole thyroid gland is removed at an early age, before there is a spread of the tumor. Hereditary MTC accounts for about 25% of all cases of MTC. The other 75% of cases are called sporadic MTC and usually occur in older patients.

Often the disease is well advanced in these cases as there has been no screening as in hereditary MTC. The first sign is frequently diarhoea. The chances of surviving MTC seem to be linked to the incidence at which the patient’s post operative calcitonin levels double.

Anaplastic thyroid cancer is highly aggressive and chances of survival are virtually nil. It is resilient to all known cancer medications and invades nearby tissue early.

Owen Jones, the author of this piece, writes on a number of topics, but is now concerned with the stages of ovarian cancer. If you want to know more, please visit our site at Signs and Symptoms of Ovarian Cancer