TREATMENTS AND
PROCEDURES

Cancer care

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The thyroid is a butterfly shaped gland at the base of the throat, near the windpipe. The thyroid gland produces thyroid hormones which are important in the normal regulation of the metabolism of the body. It produces hormones that help control heart rate, blood pressure, body temperature and weight. Thyroid cancer is more common in women than in men.

Types

  • Papillary
  • Follicular
  • Medullary
  • Anaplastic

Papillary is the most common while anaplastic is the most aggressive and difficult to cure. Other types of thyroid cancers are usually curable, if detected early.

Risk factors

  • Family history of Goitre
  • Exposure to high levels of radiation
  • Certain hereditary syndromes
  • Diets low in iodine may increase the risk of thyroid cancer

Symptoms

The most common symptom of thyroid cancer is a neck lump or nodule. If the tumour is large, it may cause other symptoms which would include:

  • Neck or facial pain
  • Shortness of breath
  • Difficulty in swallowing
  • Cough unrelated to cold
  • Hoarseness or voice change
  • A lump or nodule in the lower front of the neck where the thyroid is located. It is most often painless and found incidentally

Having any of these symptoms does not mean it is cancer, but if one or more of them is noticed for more than two weeks, then a doctor must be seen and an immediate health screening is a must.

Diagnosis

Thyroid cancer is diagnosed by a physical examination of the neck for nodules, thyroid gland function test, blood calcitonin and calcium levels in some cases.

Ultrasound done by an expert sonologist is the investigation of choice. It helps to characterize the nodule (benign or malignant). It can also be used to target a biopsy (FNAC). Ultrasound is used in the follow–up of benign nodules as well. It helps to confirm the diagnosis and plan the treatment.

Molecular testing (gene expression classification) can also be performed to confirm the diagnosis before surgery. Different types of imaging techniques like X-ray, CT scan, MRI and PET scan can also be performed for accurate diagnosis.

The thyroid tumour is staged in order to develop the most effective treatment plan.

Treatment

The two types of surgeries which can be performed are

  • Hemi thyroidectomy
  • Total thyroidectomy

Surgery may be followed by systemic radioactive iodine therapy to destroy cancerous thyroid tissue which is not surgically removed. External radiation or external-beam therapy can also be used. Chemotherapy plays a very little role in thyroid cancer except for very aggressive cancers such as anaplastic thyroid cancer.

The survival rate and prognosis of thyroid cancer depends upon a few factors, including the individual's age, the size of the tumour, and whether there is metastasis or spread of the tumour.