The thyroid is a butterfly-shaped gland found in the lower part of the neck that controls multiple organs in the body as well as metabolism and development of the human body. In the last three decades, the cases of thyroid cancer have skyrocketed and it is now the fastest growing cancer among women. Just in the last decade thyroid cancer has gone from hundreds to approximately 56,870 cases in the US alone each year. Although thyroid cancer affects both men and women, women are more prone to it. Sitting at the 9th place with a global percentage of 3.3%, it is one of the most common cancers in the world and the 5th most common cancer in the United States and the sixth most common in women. According to the National Cancer Institute, there are approximately 56,000 new cases diagnosed each year in the U.S. and 436,444 new cases globally. Thyroid cancer isn’t rare anymore, in fact the number of cases among women and men is expected to grow in the coming years.
A study carried out by the American Thyroid Association further alludes to the fact that thyroid cancer is on the rise, but the main cause remains unclear. It is believed that the increase in imaging studies of the neck where abnormal growth of thyroid cells (thyroid nodules) are discovered before they become visible on physical examination may be the major cause for this increase.
What is thyroid cancer?
This is a type of cancer that attacks the thyroid gland. There are many types of thyroid cancer, while some are more difficult to treat, others are not.
Types of thyroid cancer
It should be noted that the type of thyroid cancer determines the type of treatment and prognosis that a patient will receive.
● Papillary thyroid cancer: The most common type of thyroid cancer that represents 80% of all cases with a peak onset of 30 to 50 years old, but children and teens are also prone to it.
● Follicular thyroid cancer: Second most common type, and often referred to as “well differentiated” thyroid cancer is more aggressive than papillary carcinoma.
● Hurthle Cell: A rare, variant, of follicular thyroid cancer and has a lower cure rate than other well differentiated thyroid cancers.
● Anaplastic thyroid cancer: This is a rare and serious type of thyroid cancer that is fast growing in popularity, and very hard to treat due to its aggressive nature. Typically occurs in adults 60 years and older.
● Medullary thyroid cancer: This type starts in the cells and is easier to detect because it produces a hormone called calcitonin which can be detected in a blood test. Typically affects adults ages 20 to 50.
● Thyroid Lymphoma: Is a non-Hodgkin’s lymphoma that starts in the thyroid and is highly curable with correct treatment. This type usually affects adults 60 years and older.
The main cause of thyroid cancer is not clear but certain factors, like these, may play a role:
● Radiation (especially from nuclear reactor accidents)
● Latent tumor
● Medical imaging equipment
● Inherited gene
● Iodine deficiency
● A previous case of breast cancer
● Race (more present in Caucasian and Asians)
● Swollen glands in the neck
● Excessive hair shedding
● Enlarged cervical lymph nodes in the neck
● Hoarseness and sore throat
● Breathing and swallowing difficulty
● Throat or neck pain.
(N.B. it is important to note that sometimes, there are no symptoms)
Treatment of thyroid cancer depends on the type and the cancer stage, the possible side effects, patient preferences, and health history. Some options include:
● Surgical removal of the thyroid gland, lobectomy, removal of the cancerous nodule, and total thyroidectomy.
● After surgery, patients require thyroid hormone replacement. If cancer is found, higher doses of thyroid hormone are administered to suppress the TSH and any possibility of cancer recurrence.
● Radioactive Iodine (RAI): Thyroid cells love iodine, so patients are placed on a low iodine diet
● (LID) to starve the remaining thyroid cells of iodine. Once the radioactive iodine Is introduced the remaining cells absorb the RAI abating any remaining cancer.
● External-beam radiation: A type of radiation therapy whereby high energy x-rays are used to target specific areas to destroy the cancer
● Systemic Therapy: The introduction of medications through the bloodstream to find and destroy cancerous cells.
Even though thyroid cancer is more common in women, it is manageable and treatable even if it is in the advanced stages. In all, the main cause of thyroid cancer remains unclear, but it is recommended by the American Thyroid Association that fine needle biopsy of thyroid nodules should be less than 1cm in size and furthermore, patients with low-risk-cancer should be put under surveillance rather than undergo surgery. As stated previously, the mortality rate of thyroid cancer is low, so if you notice any changes in your thyroid, voice or if you notice any symptoms, always consult your physician.
● World Cancer Research Fund International
● National Cancer Institute
● American Thyroid Association
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