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Thyroid cancer: Treatment, symptoms, advice and help

About thyroid cancer

Thyroid cancer is a cancerous condition of the thyroid gland which is located in the throat, just below the voice box. It is responsible for production of certain hormones like tri-iodothyronine and thyroxine, which helps in maintaining the electrolyte and metabolic balance of the body. Cancer is defined as an uncontrolled growth of cells, and it may either be benign or malignant. Malignant cancer is more serious than benign cancer, since it may invade or spread to other tissues, resulting in increased morbidity. Thyroid cancer can be of four types, depending upon the affliction of different cells in the gland. Papillary and follicular thyroid cancers are the commonest types of thyroid cancer. Other types include medullary and anaplastic thyroid cancers which are relatively rare.

Thyroid cancer: Incidence, age and sex

The incidence of thyroid cancer is fairly low in the general population and it may commonly affect individuals in their 30s and 40s. Its frequency is more in women as compared to men. Asians have a higher susceptibility to thyroid cancer than individuals of other ethnic origins.

Signs and symptoms of thyroid cancer: Diagnosis

The clinical features of thyroid cancer include presence of painless lump or nodule in the front of the neck. This is mostly diagnosed during clinical examination by the doctor, who may also look for swelling of lymph nodes in the neck. Sometimes the affected individual may also complain of hoarseness of voice, if the cancer has spread to the voice box. The individual may experience difficulty in swallowing if the cancerous tissue enlarges and presses upon the food pipe. Other associated features include low grade temperature, fatigue, or unexplained weight loss.

Thyroid cancer can be diagnosed by a blood test for TSH (thyroid stimulating hormone) measurement which is usually high in such individuals. Moreover radionuclide scanning of the thyroid gland may help in corroborating the diagnosis. Invasive investigation like biopsy (microscopic examination of a specimen of affected tissue) is generally indicated to not only establish diagnosis but also to assess the extent and stage of the cancer.

Causes and prevention of thyroid cancer

The exact cause of thyroid cancer is not known. However, certain factors like positive family history of thyroid cancer or significant exposure to high-level radiation may increase the risk of developing cancer by manifold. A high iodine diet may help may help in preventing the development of thyroid cancer, though there are not much clinical studies in this regard.

Thyroid cancer: Complications

Thyroid cancer, if not detected and treated timely, may spread locally to neighbouring areas like voice box or lymph nodes of the neck. The cancer may also spread in advanced stages, to distant areas like the bones and the lungs by blood stream or by lymphatic channels. This phenomenon is termed as metastasis.

Thyroid cancer: Treatment

The treatment modalities of thyroid cancer include surgery, radiotherapy, and hormonal therapy. The treatment requires a multi-disciplinary approach involving the expertise of an oncologist and an endocrinologist. It is essential to assess the extent and stage of cancer before deciding the treatment plan. Most of the thyroid cancers require surgical excision of the thyroid gland. This is usually followed by radio-iodine scanning and ablation of the remaining cancerous cells. Affected individuals may require hormonal therapy after surgery, wherein T4 may be given to suppress TSH secretion. It is advisable to keep a routine follow-up of the individual to detect any recurrence of cancer.