Thyroid cancer: Understanding diagnosis and treatment

The thyroid, a small gland located in the neck, plays a crucial role in regulating metabolism. Thyroid cancer occurs when abnormal cells begin to grow uncontrollably within the thyroid gland. While it is a relatively rare form of cancer, early detection and treatment are vital for effective management.

Diagnosis of Thyroid Cancer

Thyroid cancer is considered highly treatable, and early diagnosis is key. Symptoms often start with painless swelling or bumps around your throat that you can feel through your skin, and in some cases, voice or swallowing problems.

Several methods are used to detect thyroid cancer:

1. Physical Examination: A healthcare provider may feel for lumps or swelling in the neck.
2. Ultrasound: This imaging test uses sound waves to create a picture of the thyroid gland and can help identify suspicious areas. Ultrasound can also detect abnormal lymph nodes in the neck.
3. CT or MRI Scan: These imaging modalities are often employed when investigating other problems, but they also identify nodules in the thyroid gland.
4. Fine-Needle Aspiration Biopsy (FNA): In this procedure, a thin needle is inserted into the thyroid nodule to extract cells for examination under a microscope.
5. Molecular testing: Sometimes, the diagnosis is not clear on the FNA, so samples obtained can be sent for genetic testing to determine whether a nodule is benign or cancer.
6. Blood Tests: Some blood tests are used to help define the extent of disease, either at diagnosis or while monitoring patients long term.
7. Radioactive Iodine Scan: This test involves ingesting a small amount of radioactive iodine, which is absorbed by thyroid cells. Cancerous cells absorb less iodine, allowing for visualization on a scan.

Treatment of Thyroid Cancer

The treatment for thyroid cancer depends on the type and stage of the disease. Common treatment options include:

1. Surgery: The most common treatment for thyroid cancer is the surgical removal of part or all of the thyroid gland.
2. Radioactive Iodine Therapy: This treatment uses radioactive iodine to destroy any remaining cancerous thyroid cells after surgery.
3. Thyroid Hormone Therapy: Following surgery or radioactive iodine therapy, patients may need to take thyroid hormone replacement medication to maintain normal hormone levels and prevent cancer recurrence.
4. External Radiation Therapy: In rare cases, external beam radiation therapy may be used to target and kill cancer cells, especially if the cancer has spread beyond the thyroid.
5. Chemotherapy: Although also less common for thyroid cancer, chemotherapy may be used if the cancer does not respond to other treatments or has spread to other parts of the body.

Regular check-ups and awareness of thyroid health can lead to early diagnosis, significantly improving the prognosis for those with thyroid cancer.

Written by Dr. Noah Parker, head and neck surgeon at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel