Thyroid Carcinoma (Thyroid Cancer)

Thyroid Carcinoma
Body Parts: Neck
Medical Subjects: Women's Health Tumor

What Is Thyroid Cancer

The thyroid is an endocrine gland under the laryngeal tubercle, shaped like a butterfly and generally unable to be touched. The thyroid gland produces thyroxine T4 and triiodothyronine T3, hormones that play an important role in maintaining heat production (body temperature) and metabolic balance in humans.

Thyroid cancer is a malignant tumor that occurs in the thyroid, and it is also the most common malignant tumor in the endocrine system.

Thyroid cancer generally does not affect the secretion of T3 and T4. The main manifestation is a mass on the front of the neck, or a nodule found during B-ultrasound examination of the thyroid. A few patients may also experience symptoms such as hoarseness and difficulty swallowing.

Most thyroid cancers are less malignant and rarely life-threatening. Better therapeutic effects can usually be obtained through surgery, postoperative radioactive 131I therapy, and TSH inhibition therapy.


What Is The Cause Of Thyroid Cancer

The etiology of thyroid cancer is still unclear. The possible risk factors include:

  • History of radiation exposure to head and neck or exposure to radioactive dust in childhood.
  • Have a history of whole body radiotherapy
  • Past or family history of thyroid cancer
  • Female
  • Age less 14 years old or more than 70 years old

If you have the above-mentioned risk factors, and there is an increasing lump in your neck that is hard in texture, you need to suspect thyroid cancer and seek medical attention as soon as possible.

Is thyroid cancer related to iodine intake?

Some data show that excessive intake of iodine may be related to certain types of thyroid cancer, but it does not prove that there is a direct causal relationship between the two. Therefore, thyroid cancer patients are generally not required to limit iodine intake.

For the onset of other thyroid diseases, although too much or too little iodine intake may be related, in daily life, healthy people with a balanced diet should use iodized salt rationally and do not have to worry too much about iodine intake.

Can thyroid cancer be inherited?

With the development of science and technology, it has been found that the occurrence and development of thyroid cancer is related to genetics, especially some specific types of thyroid cancer (such as medullary thyroid cancer), which have certain heritability.


The Symptoms Of Thyroid Cancer

The Types of Thyroid Cancer

Thyroid cancer can be classified as differentiated and undifferentiated, differentiated thyroid cancer can be classified as papillary carcinoma, follicular carcinoma, medullary carcinoma:

  • Papillary cancer: It accounts for 80% of all thyroid cancers. It usually occurs between 30 and 60 years old. It is more common in women and may have a family history. Patients who are young, with small tumors, and have not metastasized, have good treatment results.
  • Follicular carcinoma: It accounts for 15% of all thyroid cancers and is more common in the elderly and people in iodine-deficient areas. The degree of malignancy is slightly higher than that of papillary carcinoma.
  • Medullary carcinoma: accounting for 3% of all thyroid cancers, produces calcitonin, which is detectable in blood, may have a family history, and may be part of multiple endocrine neoplasia (MEN). The degree of malignancy is higher.
  • Undifferentiated cancer: It accounts for 2% of all thyroid cancers. It is more common in the elderly and slightly more in women. It is characterized by rapid growth with pain and high degree of malignancy. About 80% of patients die within 1 year after diagnosis.

What are The Manifestations of Thyroid Cancer?

  • Thyroid cancer does not manifest itself in the early stages and is often presented as a painless neck mass or nodule.
  • However, with the increase of thyroid cancer, it may cause hoarseness, neck and laryngeal pain, dysphagia, cervical lymph node enlargement, and may be accompanied by facial flushing, tachycardia and intractable diarrhea.
  • When thyroid cancer metastasizes, a series of symptoms may appear in other systems of the human body, such as headache, decreased vision, cough, hemoptysis, chest pain, abdominal pain, jaundice (yellow eyes, skin, and urine), bone pain, etc.

Where does thyroid cancer often metastasize if it metastasizes?

Lymph node, lung, liver, bone.


Diagnosis Of Thyroid Cancer

Is thyroid cancer and thyroid nodules the same disease?

Thyroid nodule refers to a lump in the thyroid gland. It is one of the common manifestations of thyroid disease, not a specific disease. Only about 5-15% of thyroid nodules are clinically malignant and thyroid cancer. Thyroid nodules that exclude thyroid cancer are all benign.

How to screen for thyroid cancer?

The screening of the thyroid gland is mainly based on previous medical history, family history, radiation exposure history, thyroid palpation, and thyroid function as preliminary risk factors assessment, and cervical color Doppler ultrasound screening is performed for high-risk patients.

How is thyroid cancer diagnosed?

The diagnosis of thyroid cancer depends on the pathological evidence (especially the postoperative pathological examination). The preoperative diagnosis is mainly based on ultrasound-guided fine needle aspiration or thick needle aspiration. However, thyroid fine needle aspiration still has a certain probability that it does not conform to the postoperative pathology and is not the gold standard for diagnosis.

What is thyroid fine needle aspiration?

Fine needle aspiration of the thyroid is totally called fine needle aspiration cytology of the thyroid. It is an examination technique of performing pathological examination after aspiration of part of the cells in the lesion site through the puncture of thyroid tissue with a thinner needle. Usually, fine needle aspiration should be performed under the guidance of imaging techniques (e.g., ultrasound).


Can Thyroid Cancer Be Prevented?

It's hard to prevent because the exact cause of thyroid cancer hasn't been studied yet. Many of the risk factors studied are not avoidable.

The only thing that can be done is probably to minimize unnecessary ionizing radiation in the neck. For example, when conducting X-ray, CT and other radioactive examinations, you should ask your doctor to take good care of your neck protection.

How can thyroid cancer just discover as soon as possible?

In addition to regular physical examination, learn to thyroid self-examination, also conducive to early detection of thyroid abnormalities.

Stand in front of the mirror, raise your neck slightly and lean back so that your neck is fully exposed in front of the mirror. You can also put one hand behind your neck, hold your neck to help you lean back, or lean against a wall. Look at the mirror to see if the thyroid gland is enlarged, if both sides are symmetrical, and if one side is too large. The index finger, middle finger, ring finger, three fingers together, from the middle of the neck along the sides, from top to bottom gently touch, look for nodules, swelling. Then do the swallowing and feel which part of the neck moves up and down with the swallowing. After locating, look in the mirror to see if there is a lump near the location that will move up and down with the swallowing motion.Touch the thyroid gland around your neck to see if you can touch the hard small nodules, or the soft small drum bag or lump. If any abnormality is found, consult a professional doctor as soon as possible.


What Treatment Method Does Thyroid Cancer Have?

  • Surgical treatment
  • TSH inhibition therapy and thyroxine replacement therapy
  • Radioactive 131I therapy
  • Targeted drug therapy, etc

Must thyroid cancer do operation to treat?

Surgical resection is recommended for all thyroid cancers once diagnosed. Through surgery, not only the primary lesion can be removed, but also the tissue type and stage of cancer as well as the lymph node metastasis can be accurately judged, which is of positive significance for future prognosis.

What are the types of thyroid cancer surgery?

Thyroid surgery is mainly divided into two categories:

  • Total/near total thyroidectomy with or without lymph node dissection
  • Lobectomy of thyroid gland.

At present, in order to prevent the recurrence of thyroid cancer, the former operation method is often adopted.

Does thyroid cancer still need to take medicine for a long time after operation?

Because a small or large portion of the thyroid gland is surgically removed, resulting in a decrease in thyroxine secretion, it is generally necessary to take thyroxine for life. Sometimes thyroxine, or TSH-suppression therapy, is given in larger doses to prevent cancer recurrence.

In addition, calcium supplement is also required for hypoparathyroidism after surgery.

What is TSH suppression therapy?

For patients with differentiated thyroid cancer, long-term thyroid hormone suppression (TSH) treatment is required after surgery.

The aim was to meet the body's physiological need for thyroxine while presumably reducing the risk of tumor recurrence.

What complications or sequelae may arise after thyroid surgery?

Common ones include: hoarse voice, difficulty in speaking, hypoparathyroidism, hemorrhage, infection, and trachea/esophagus injury.

How to treat complications after thyroid cancer surgery?

The treatment of patients with postoperative complications is mainly divided into the following categories:

  • Hypoparathyroidism: It can be divided into temporary and permanent, and their clinical manifestations are all hypocalcemia. For temporary hypocalcemia, calcium supplements can be given symptomatically. For patients with permanent hypoparathyroidism, long-term use of vitamin D and calcium is required. Those who cannot be corrected may need to supplement with parathyroid hormone (PTH) or undergo parathyroid transplantation.
  • Hoarseness and difficulty speaking: Generally, patients are caused by the stimulation of the recurrent laryngeal nerve that controls the vocalization during the operation, and temporary hoarseness and difficulty in speech caused by neuroedema, which can be recovered after the edema is eliminated.

Do I still need chemotherapy after thyroid cancer surgery?

Differentiated thyroid cancer is insensitive to chemotherapy and can be used for palliative treatment of advanced patients who are not sensitive to other treatments. Myeloid thyroid cancer has a more obvious effect on targeted therapy.

What is radioactive 131I therapy?

131I is a radioisotope of elemental iodine that emits radiation that kills cells.

As the thyroid gland is the organ with the highest absorption rate of iodine in the body, differentiated thyroid cancer also has a high uptake rate of iodine, and iodine is basically not used and absorbed in other parts of the body. Therefore, 131I ingested by the thyroid can quickly and accurately kill the differentiated thyroid cancer cells in and metastasis from the thyroid, which is an important treatment method for differentiated thyroid cancer.

Radiation 131I therapy after surgery can destroy the residual small tumor lesions and treat distant metastases. At the same time, it can also increase the sensitivity of the whole body iodine scan in the future.

Can thyroid cancer be completely cured?

Most patients with early differentiated thyroid cancer have good prognosis and long survival period. However, once distant metastasis occurs, the survival of patients will be seriously affected. The earlier treatment is given, the greater the likelihood of a cure.

How long does thyroid cancer patient reexamine after treatment?

After surgery (for at least five years), serum TSH and Tg (thyroglobulin) should be tested every 3–6 months, and B-scan or CT/MRI examination can be conducted regularly if necessary, as well as whole-body radioiodine scanning and tracking.


What Should Be Noticed In The Life Of Thyroid Cancer Patients?

We should cultivate good living habits, such as healthy diet, more exercise, smoking cessation, maintain a good state of mind, etc.

In addition, some patients need to take large doses of thyroxine for a long time after operation. To guard against its side effects, including heart disease and osteoporosis, we should follow the doctor's advice and conduct regular re-examination, and evaluate the heart function and bone mineral density on a regular basis.

What precautions does patient of thyroid cancer have on food?

If radioactive 131I therapy is not required after surgery, there is no special taboo regarding diet, and a healthy and balanced diet is enough:

  • When cooking, pay attention to less salt, less oil, less spices with high salt content, and less pickled vegetables and bacon.
  • Reasonable collocation of meat and vegetable, meat preferred chicken, duck and fish, eat less fat. Eggs, milk are an important source of protein and other nutrients.
  • If you are a vegetarian, you can eat more beans and soy products to supplement protein.
  • Eat more fruits and vegetables.
  • Try not to drink.

If radioactive 131I treatment is needed after the operation, iodine diet should be avoided for at least 1–2 weeks before the treatment, including not eating iodized salt and not eating seafood including kelp and laver.

Can thyroid cancer patient be pregnant give birth to a child?

Sure. There is no evidence that pregnancy increases the risk of thyroid cancer recurrence. However, it is important to note that radioactive 131I therapy for differentiated thyroid cancer may cause teratogenicity, so patients who have received radioactive 131I therapy should use contraception for 6–12 months before becoming pregnant.

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