Thyroid Cancer (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
In this Article
- Thyroid cancer facts*
- What is the thyroid?
- What is the thyroid cancer?
- What causes thyroid cancer?
- What are the risk factors for thyroid cancer?
- What are the symptoms and signs of thyroid cancer?
- What are thyroid nodules?
- What are the different types of thyroid cancer?
- How is thyroid cancer diagnosed?
- How is thyroid cancer staging determined?
- What kinds of specialists treat thyroid cancer?
- What is the treatment for thyroid cancer?
- Thyroid hormone
- Radioactive iodine
- What kind of support is available for those with thyroid cancer?
- What is the prognosis for patients with thyroid cancer?
- Can thyroid cancer be prevented?
- Thyroid Conditions Slideshow
- Take the Quiz on Thyroid Disorders
- Thyroid Medical Anatomy
- Find a local Oncologist in your town
What is the treatment for thyroid cancer?
Thyroid cancer is treated with a variety of therapies depending on the type and extent of cancer and the health of the patient.
Most thyroid cancers require surgery to remove the tumor. Two options are available and decisions as to which option to pursue depend upon the clinical situation.
- Lobectomy: The thyroid has two lobes joined in the middle with a fibrous tissue bridge. If the tumor is confined to only a small area, the surgeon may just remove the affected lobe.
- Thyroidectomy: This is the most common surgery for thyroid cancer and the goal is to completely remove the thyroid gland and hopefully ensure that the cancer will not recur.
- Lymph node resection: Thyroid cancer can spread to local lymph nodes, and these nodes often are removed. Affected lymph nodes may only be recognized at the time of surgery.
- Open biopsy: Sometimes, the cancerous nature of a thyroid nodule is unclear, even after fine needle aspiration. A surgeon may operate to remove the nodule and make the diagnosis of cancer.
Once the thyroid has been removed, the body will no longer be able to make thyroid hormone, and daily thyroid hormone replacement will be necessary. Routine thyroid hormone blood tests will need to be performed to ensure there is an adequate amount of thyroid hormone to allow the body to function properly. Thyroid hormone replacement will be lifelong in total thyroidectomy patients.
Iodine is routinely absorbed by thyroid tissue. Radioactive iodine may be administered after surgery to destroy any remnant thyroid tissue remaining after thyroidectomy. The decision to use this treatment depends upon the type and extent of the thyroid cancer and the levels of thyroid stimulating hormone (TSH) produced by the pituitary gland.
In certain thyroid cancers, where the tumor does not take up iodine, radiation therapy may be considered in place of radioactive iodine. Radioactive iodine update tests performed before surgery can assess whether or not iodine is taken up by the thyroid gland.
Chemotherapy is not commonly used for most thyroid cancers but may be used in certain clinical situations when the thyroid cancer does not respond to other treatments.
What kind of support is available for those with thyroid cancer?
Patients, families, and friends are all affected when the diagnosis of cancer is made. Support is available not only for the patient but for all those who are close to the patient. Hospitals, clinics, and health care professionals' offices often have specially trained staff to help patients and families address their physical, emotional, and spiritual needs.
It is important for the patient and family to understand the disease, the treatment options, the expected outcomes, and the journey that will occur with cancer. It is important for all involved to advocate for the patient since there is so much information to understand and absorb; it can be overwhelming.
There are many community resources available as well. The American Cancer Society is a good place to begin. They have local offices and may be contacted online.
What is the prognosis for patients with thyroid cancer?
There are many types of thyroid cancer, and outcome depends upon the type of thyroid cancer and its stage.
Patients who have papillary or follicular cancer that is confined to the thyroid gland may expect a normal life expectancy with treatment. Prognosis may be better for women who are younger than 40 years of age.
Patients with anaplastic cancer do poorly, with many surviving only a few months after diagnosis. The 5-year survival rate for this cancer is less than 10%.
Can thyroid cancer be prevented?
There is little one can do to prevent thyroid cancer aside from avoiding excessive exposure to radiation.
Cibas, E. S. and S. Z. Ali. "The Bethesda System for Reporting Thyroid Cytopathology." American Journal of Clinical Pathology. 132:2 (2009): 658-665.
br /> Lentsch, E. J., et al. "Thyroid Cancer Staging." Medscape. 6 Sept. 2013.
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