Symptoms Of Thyroid Cancer, Diagnosis And Prognosis
What Is Thyroid Cancer?
The thyroid is located at the front of your neck, between that dimple and your larynx. It surrounds the windpipe like a shield. This butterfly-shaped organ produces hormones that play an important role in the energy management of your body. They stimulate the metabolism and encourage body cells to do their work.
When cells in the thyroid gland malignantly derail, thyroid cancer develops. The characteristic of cancer cells is that they share unrestrained and form a growth. The larger it gets, the more likely it is to invade surrounding tissue and/or cancer cells to detach from it and spread through the body via lymph nodes or blood. For example, new tumors can develop in other organs. These are metastases or metastases.
Four types of thyroid cancer
There are four main types of thyroid cancer.
- Papillary thyroid carcinoma. About 75-80 percent of all thyroid cancer cases are tumors of this type. Papillary thyroid carcinoma is the least aggressive form. These tumors grow slowly. They can spread to the lymph nodes and lungs. However, this rarely happens.
- Follicular thyroid carcinoma. About 15-20 percent of thyroid cancer patients have this form. Follicular tumors are slightly more aggressive. They also grow slowly, but metastases to the lungs, liver and bones are more common.
- Medullary thyroid carcinoma. This type of thyroid cancer affects 5-10 percent of all people with thyroid cancer. Medullary tumors are moderately aggressive. They can metastasize.
- Anaplastic thyroid carcinoma. This very aggressive type of thyroid cancer accounts for 5-10 percent of all thyroid cancers. An anaplastic tumor grows quickly, penetrates quickly into surrounding tissue and spreads quickly. Once the disease has been diagnosed, there are often metastases to the lymph nodes.
It is not known what causes thyroid cancer. There are several risk factors:
- Irradiation of the neck. Especially in young people, this gives an increased risk of thyroid cancer. We are not talking here about the radiation used to make an X-ray or to treat an overactive thyroid gland. The dose of radiation is too small for this.
- Genetic predisposition. There are indications that hereditary predisposition increases the risk of thyroid cancer. However, this risk is very small.
- Exposure to high doses of radioactive radiation, such as from nuclear power plant disasters. Children are extra sensitive to radioactive iodine that is released and accumulates in the thyroid gland. For example, years after the nuclear disasters in Chernobyl (Russia) and Fukushima (Japan), there appeared to be many more children with thyroid cancer.
The main symptom of thyroid cancer is a lump in the neck that moves with swallowing. This does not necessarily indicate a malignant growth. On the contrary, more than 95 percent of thyroid swellings are benign. Nevertheless, it is wise to go to the doctor with this. After all, without further investigation it is not possible to determine whether it is a benign or malignant tumor.
Other complaints that occur with thyroid cancer are:
- The rapid growth of the lump or new lumps in the thyroid gland.
- Inexplicable hoarseness.
- Swollen lymph nodes in the neck.
- Shortness of breath.
- Swallowing complaints. You have the feeling that there is a permanent lump in your throat or that the food is difficult to sink.
- Sore throat.
- Tickling cough.
- Head and neck pain, intestinal complaints, a lot of mucus, muscle weakness, extreme fatigue, sweating, tremors and chest pain or palpitations are uncommon. These complaints arise when the tumor leads to an overactive thyroid gland.
If the doctor thinks that you may have thyroid cancer based on your complaints, he will first have blood tests done. Blood tests can show whether your thyroid is working too slowly or too fast. With abnormal amounts of thyroid hormone in your blood, it is more likely that your thyroid does not work properly than there is a tumor here. In thyroid cancer, the thyroid gland usually functions normally, so that the production of thyroid hormone is also normal.
The doctor can also have an ultrasound scan of your neck. The images were taken by this device show any thyroid abnormalities.
Thyroid Cancer Treatment
In thyroid cancer, it is almost always necessary to surgically remove the thyroid gland. Sometimes (part) of nearby lymph nodes must also be removed. Because it is practically impossible to remove all thyroid tissue and all cancer cells, additional treatments usually follow after surgery to completely heal the patient. It's about:
- Treatment with radioactive iodine (I-131) (ablation therapy): the patient swallows a capsule containing radioactive iodine. This substance is absorbed by the thyroid gland and destroys any remaining cancer cells. This treatment may need to be repeated after six months.
- Radiotherapy. Radiation is rarely used in thyroid cancer. This only happens to treat:
- Medullary and anaplastic tumors.
- In very extensive papillary and follicular tumors, which do not respond well to treatment with radioactive iodine.
- With metastases in the brain and bones. The treatment is then no longer aimed at healing, but at inhibiting the disease as much as possible and reducing the symptoms. This is called palliative care.
- Chemotherapy. Chemotherapy consists of administering a medication that has a cell killing and cell division inhibiting effect (cytostatics). This form of treatment is mainly used in anaplastic thyroid carcinoma because these tumors do not always respond to other possible forms of treatment. Sometimes doctors also apply this therapy as an adjunct treatment to radiotherapy or before surgery to shrink the tumor. With advanced thyroid cancer, chemotherapy can help to reduce the symptoms.
The outlook for thyroid cancer depends on the type of tumor and the stage at which the disease is discovered.
In papillary carcinoma, the chance of a cure and survival is good. After surgery, the 10-year survival rate is about 95 percent. The chance of being alive for 10 years after surgery for follicular carcinoma is approximately 70 percent. In medullary carcinoma, the average chance of surviving this disease for 10 years is 50-70 percent. Less than 5 percent of people with anaplastic carcinoma is still alive 10 years after diagnosis.
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