Thyroid Cancer – Causes, Symptoms & Treatment
Thyroid cancer is a malignant disease of the thyroid gland. It is one of the most common endocrine tumors and is highly treatable in most cases.
Things worth knowing about "Thyroid cancer"
Thyroid cancer is a malignant disease of the thyroid gland. It is one of the most common endocrine tumors and is highly treatable in most cases.
What is Thyroid Cancer?
Thyroid cancer (medically known as thyroid carcinoma) is a malignant change in the tissue of the thyroid gland. The thyroid is a butterfly-shaped gland located in the front of the neck that produces hormones regulating metabolism, growth, and many other body functions. Thyroid cancer is the most common malignant tumor of the endocrine system and, in most cases, carries a favorable prognosis.
Types of Thyroid Cancer
There are several types of thyroid carcinoma, differing in their origin, growth behavior, and prognosis:
- Papillary thyroid carcinoma: The most common form, accounting for approximately 70–80% of cases. It grows slowly and has an excellent prognosis.
- Follicular thyroid carcinoma: Represents around 10–15% of cases. It tends to spread through the bloodstream (hematogenous metastasis).
- Medullary thyroid carcinoma: Arises from calcitonin-producing C-cells. It can occur in familial clusters, particularly in association with MEN-2 syndrome.
- Anaplastic thyroid carcinoma: A rare but highly aggressive form with a poor prognosis, primarily affecting older individuals.
Causes and Risk Factors
The exact causes of thyroid cancer are not fully understood. However, several factors are known to increase the risk:
- Radiation exposure: Particularly during childhood, radiation to the head and neck area significantly increases the risk.
- Genetic predisposition: Family history plays a role, especially in medullary carcinoma associated with MEN-2 syndrome.
- Thyroid conditions: Pre-existing benign nodules (adenomas) or Hashimoto thyroiditis may slightly increase risk.
- Iodine deficiency: May increase the risk of follicular carcinoma.
- Sex and age: Women are more frequently affected, and risk increases with age.
Symptoms
In early stages, thyroid cancer often causes no noticeable symptoms. Possible symptoms as the disease progresses include:
- A palpable or visible lump in the neck
- Hoarseness or changes in voice
- Difficulty swallowing
- Breathing difficulties or a feeling of pressure in the throat
- Swollen lymph nodes in the neck
- Persistent neck pain
Most thyroid nodules are benign. However, any new or growing nodule should be evaluated by a physician.
Diagnosis
The diagnosis of thyroid cancer involves several examination steps:
- Ultrasound (sonography): The primary method for evaluating thyroid nodules.
- Fine needle aspiration (FNA): A thin needle extracts cells from the nodule for microscopic analysis.
- Blood tests: Measurement of thyroid hormones (TSH, T3, T4) and specific tumor markers such as thyroglobulin or calcitonin.
- Scintigraphy: A nuclear medicine scan used to assess thyroid activity.
- CT or MRI: Imaging techniques used to evaluate the extent of the tumor and possible metastases.
Treatment
Treatment depends on the type, stage, and individual health status of the patient. The main treatment options include:
Surgery (Thyroidectomy)
In most cases, surgical removal of the thyroid gland (total thyroidectomy) is the primary treatment. Affected lymph nodes may also be removed during the procedure.
Radioiodine Therapy
After surgery, many patients receive radioactive iodine (iodine-131) to destroy any remaining thyroid tissue and metastases. This method is particularly effective for papillary and follicular carcinomas.
Hormone Therapy (TSH Suppression)
Following surgery, thyroid hormone medication (levothyroxine) is taken to suppress TSH levels and inhibit the growth of any remaining tumor cells.
Radiation Therapy and Targeted Therapies
For advanced or therapy-resistant carcinomas, external radiation or modern targeted drugs (e.g., tyrosine kinase inhibitors) may be used.
Prognosis
The prognosis of thyroid cancer depends strongly on the type and stage. Papillary and follicular carcinomas have a very high 10-year survival rate of over 90% when diagnosed and treated early. Anaplastic carcinoma, however, carries a significantly worse prognosis. Regular follow-up examinations are essential for long-term monitoring and early detection of recurrence.
References
- Haugen BR et al.: 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1–133.
- World Health Organization (WHO): Classification of Tumours of Endocrine Organs. 4th Edition. IARC Press, Lyon (2022).
- National Cancer Institute (NCI): Thyroid Cancer Treatment (PDQ) – Health Professional Version. Available at: cancer.gov (2023).
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