As the longest-running clinic in Louisville, the Multidisciplinary Head and Neck Cancer Clinic at UofL Health - Brown Cancer Center you receive customized care for thyroid cancer from a team of renowned experts. Our level of experience and expertise in treating thyroid cancer increases your chance for successful treatment.
Your personal medical team is made up of experts from several specialties. They work together, communicating and collaborating with each other and with you, to ensure you receive seamless, coordinated care.
If your treatment for thyroid cancer includes surgery, our talented surgeons use the most advanced techniques that are proven to have good results. In some cases, video-assisted or robotic surgery may be used, while minimizing or eliminating a neck scar.
We are at the forefront of research on how to better treat and prevent thyroid cancer, and are able to offer a number of clinical trials of innovative therapies.
According to the American Cancer Society, more than 50,000 people are diagnosed with thyroid cancer each year in the United States. About 75% of these are women. Thyroid cancer is seen most often in adults, with two-thirds of the cases occurring between ages 20 and 55.
Although thyroid cancer accounts for about 1% of all cancers, it is becoming more common. At least 450,000 people in the United States have completed treatment or are living with thyroid cancer.
Thyroid cancer is usually a slow-growing cancer, and the five-year survival rate for thyroid cancer is 98%.
Thyroid gland anatomy
Thyroid cancer begins in the thyroid gland, which is a small butterfly-shaped gland in the front of the neck at the base of the throat, near the windpipe. The thyroid has two halves, or lobes, one on each side of the neck. It wraps around the trachea (windpipe) just under the larynx (Adam's apple). A thin strip of tissue known as the isthmus connects the two halves.
The thyroid is part of the body's endocrine system, a system of glands that control hormones in the body that help control metabolism, heart rate, body temperature and blood pressure.
Thyroid gland cells are the only cells in the body that absorb and retain iodine. Iodine is needed to make thyroid hormones.
Types of thyroid cancer
Papillary, the most common type of thyroid cancer, is cancer that forms in follicular cells and grows in small finger-like shapes. It grows slowly and is more common in women. It often occurs before age 45, and accounts for 80% of thyroid cancers.
Follicular thyroid cancer accounts for about 10% of thyroid cancers. Like papillary thyroid cancer, follicular thyroid cancer usually grows slowly and is highly treatable.
Medullary thyroid cancer (MTC) is the only type of thyroid cancer that develops in the C cells of the thyroid gland. C cells are responsible for making the hormone, calcitonin, which helps maintain a healthy level of calcium in the blood. It accounts for 3 to 10 percent of thyroid cancers.
Anaplastic thyroid cancer is a rare, aggressive form of thyroid cancer. It makes up only 1% of thyroid cancers.
What causes thyroid cancer?
Although the exact cause of thyroid cancer has not been identified, certain risk factors have been identified. Anything that increases your chance of getting thyroid cancer is a risk factor. They include:
- Age: Two-thirds of thyroid cancer cases occur between ages 20 and 55.
- Gender: Women are three times as likely as men to develop thyroid cancer.
- Exposure to radiation, including X-rays, especially during childhood
- Family history of thyroid cancer or thyroid disease
- History of an enlarged thyroid
- Being Asian
- Certain genetic conditions including familial medullary thyroid cancer, multiple endocrine neoplasia type 2A syndrome and multiple endocrine neoplasia type 2B syndrome
Not everyone with these risk factors gets thyroid cancer. However, if you have risk factors, it’s a good idea to discuss them with your doctor.
When thyroid cancer is found early, you have a higher chance of successful treatment. Thyroid cancer often has few signs or symptoms. When it does have symptoms, they vary from person to person.
If you do have signs or symptoms of thyroid cancer, they may include:
- Lump or nodule in the neck
- Enlargement of the thyroid or swelling in the neck
- Pain in the front of the neck that may stretch to the ears
- Change in voice or hoarseness
- Trouble breathing
- Swallowing problems
These symptoms do not always mean you have thyroid cancer. However, it is important to discuss any signs or symptoms with your doctor, since they may signal other health problems.
Research shows that many cancers can be prevented if people applied everything known about cancer prevention to their lives.
If you have signs or symptoms of thyroid cancer, your doctor will examine your neck and throat, feeling for lumps or swelling. Your doctor will also complete a medical history. This involves asking questions about your symptoms, other health problems and health problems in other members of your family. If anyone in your family has had thyroid cancer, parathyroid disease or adrenal tumors, be sure to tell your doctor.
One or more of the following tests may be used to find out if you have cancer and if it has spread. These tests also may be used to find out if treatment is working.
Laryngoscopy: A procedure in which the doctor checks the larynx (voice box) with a mirror or with a laryngoscope. A laryngoscope is a thin, tube-like instrument with a light and a lens for viewing. A thyroid tumor may press on vocal cords. The laryngoscopy is done to see if the vocal cords are moving normally.
Blood hormone studies: A procedure in which a blood sample is checked to measure the amounts of certain hormones released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. The blood may be checked for abnormal levels of thyroid-stimulating hormone (TSH). TSH is made by the pituitary gland in the brain. It stimulates the release of thyroid hormone and controls how fast follicular thyroid cells grow. The blood may also be checked for high levels of the hormone calcitonin and antithyroid antibodies.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as calcium, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs in the neck and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later. This procedure can show the size of a thyroid nodule and whether it is solid or a fluid-filled cyst. Ultrasound may be used to guide a fine-needle aspiration biopsy.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the neck, taken from different angles. The pictures are made by a computer linked to an X-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography or computerized axial tomography.
If you are diagnosed with thyroid cancer, your doctor will discuss the best options to treat it. This depends on several factors, including:
- Type of thyroid cancer
- Size of the nodule
- Your age and health
- Stage of cancer
Your thyroid cancer treatment will be customized to your particular needs.
Surgery is the most common treatment for thyroid cancer. Your physician will discuss the best option for your type of cancer:
- Lobectomy: Removal of the lobe where the cancer is found.
- Near-total thyroidectomy: Removal of all but a small part of the thyroid.
- Total thyroidectomy: Removal of the entire thyroid.
- Tracheostomy: Surgery to create an opening into the windpipe to help you breathe.
Your physician may decide to also remove lymph nodes near where the cancer was found in order to do additional testing.
If your entire thyroid gland is removed, you will take thyroid hormone replacement pills daily for the rest of your life.
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or to prevent them from growing. Radiation therapy is determined by your physician and depends on the type of thyroid cancer and its stage. Thyroid cancer can be treated with:
- Radioactive iodine: You drink a liquid or swallow a pill that contains radioactive iodine, which collects in thyroid tissue and destroys cancer cells. This method also is used to eliminate any thyroid cells in other parts of the body remaining after thyroidectomy or thyroid cancer.
- External beam radiation: This type of therapy is most effective for thyroid cancers that do not absorb iodine, including anaplastic thyroid cancer. It may be used to fight thyroid cancer cells remaining after surgery or if cancer spreads to the bones.
Thyroid hormone therapy
This treatment uses thyroid hormone pills to stop the growth of cancer cells. In papillary or follicular thyroid cancer, hormone treatment may be used to lower the level of thyroid-stimulating hormone (TSH), which may help stop the cancer from coming back. In other thyroid cancers, it may be used to keep thyroid hormone levels normal.
Chemotherapy often is used in combination with external beam radiation therapy to treat anaplastic thyroid cancer. It is usually not effective in other types of thyroid cancer.