Causes And Symptoms Of Thyroid Cancer

The causes of thyroid cancer are not always known. There are factors that increase the risk.

• An irradiation in the neck area, especially during childhood. The tumor can emerge decades later.
• An infection by radioactive iodine . Attention: the administration of small doses of radioactive products to make a diagnosis (eg a scintigraphy) does not pose a particular risk.

Symptoms of thyroid cancer
Thyroid cancer is suspected when the following appears:

• a nodule at the bottom of the neck
• a lymph gland
• a goiter that suddenly gets bigger
• a persistent hoarseness due to the paralysis of a vocal cord

It sometimes happens that a thyroid tumor is discovered during examinations for another reason, such as an ultrasound.



Thyroid cancer: diagnostic studies
The diagnosis is mainly based on ultrasound and scintigraphy.

• The ultrasound determines the size of the lump and its nature ( hard, liquid or mixed).
• In a scintigraphy radioactive iodine is injected to study its adhesion through the nodule. One speaks of a cold lump when the bond is weak, and of a warm lump when the bond is strong.

Every nodule that is cold at the ultrasound and scintigraphy is suspect, even though in most cases it is not ultimately cancer. To confirm the diagnosis, another research is being done:

• a cytop function of the nodule, followed by a microscopic analysis of the removed cells. The cytop function is a painless examination that is simply done during the consultation.

The treatment of invasive cancer requires close coordination between different medical and paramedical disciplines. Depending on the needs, there are different medical and non-medical concerns involved. The therapeutic strategy is therefore never decided by one doctor. Every cancer patient must be discussed in a Multidisciplinary Oncology Consultation (MOC). In doing so, doctors from different disciplines are involved together with experts from other fields (such as nurses, psychologists, dietitians, etc.).

In this way, the treatment is always adjusted as much as possible to the individual. The doctors will propose a treatment tailored to your specific situation, including the following elements:

• the type of cancer
• the stage (the extent) of cancer;
• the general state of health of the patient.

The treatments for thyroid cancer
Also for this cancer, the MOC will outline the best route, yet we give below an overview of the most used options.



Surgery
Depending on the number of tumor foci, one half or the entire thyroid gland is surgically removed (thyroidectomy). The glands surrounding the thyroid gland can then also be removed (gland clearing) to check whether they have been affected by cancer cells from the tumor.

Radioactive iodine 
In case of a local expansion or metastases, tests are carried out to check whether the tumor cells hold the iodine. If so, they can be destroyed by injecting a high dose of iodine 131.

Radiotherapy and/or chemotherapy
In certain cases, a classic radiography or chemotherapy is possible.

Life after thyroid cancer
As a result of the treatment, there is often a shortage of thyroid hormone during the rest of life. The intake of the thyroid hormone, adjusted according to blood dosages, compensates for the absent or inadequate production by the thyroid gland of this hormone, which is indispensable for the proper functioning of the body. A lifelong follow-up is therefore necessary.

*Image source : Mayo Clinic

References :

1. National Cancer Institute
2. Stichting tegen Kanker
3. American Cancer Society