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 developes quickly and responds badly to therapy. The extent of these kinds of cancer is not uniform throughout the world, but is roughly: 78% for papillary; 17% for follicular; 4% for medullary and 1% for anaplastic.

Usually, the first symptom of difficulty is the growth of a nodule or nodules in the neck in close proximity to the thyroid gland. However, only 5% of these are malignant. Occasionally an early warning sign is discomfort or even pain; sometimes, the lymph nodes swell, the voice alters or there is hypo- or hyper- thyroidism.

Discovery normally takes place after a nodule is discovered 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 fine needle enough cells can be taken to do an accurate test on the exact condition of the thyroid and whether the nodules are malignant.

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.

Above 1cm and a full thyroidectomy is preferred. Some surgeons prefer a full thyroidectomy anyway because the cancer cannot come back then.

Follicular thyroid cancer is more widespread in women over 50 years of age. Therapy is most frequently full thyroidectomy as the threat of recurrence of this aggressive form is quite great for partial surgery.

Medullary thyroid cancer (MTC) starts in the cells that produce the hormone calcitonin. Increased levels of calcitonin in the blood are a realistic indication of MTC, although these increased levels of calcitonin are probably not harmful in themselves.

Changes 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 likelihood from each affected parent. DNA analysis makes it feasible to identify children who carry the mutant gene.

Surgical removal of the thyroid in children who carry the mutant gene is effective if the entire 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 normally occur in older patients.

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

Anaplastic thyroid cancer is extremely aggressive and chances of survival are almost zero. It is resistant to all known cancer treatments and invades nearby tissue early.

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