What is thyroid cancer? Thyroid cancer symptoms and treatment
The thyroid gland is an organ located in the midline of the neck, weighing 20-25 grams, and has an endocrine function. The hormone made by the thyroid gland using iodine plays a role in the regulation of the whole body’s metabolism.
Thyroid gland diseases are very common in the community (approximately 3 out of 10 people) and usually do not show symptoms. However, some of the thyroid gland nodules emerge as cancer or later turn into cancer.
What is thyroid cancer?
Thyroid cancers, one of the least common of all cancer types, also show the most positive response to treatment. İt is the most common endocrine cancer after ovarian cancer.
Thyroid cancers account for less than 1 percent of all cancer cases. Although it is rarely seen in children, it is among the top 5 cancers seen after the age of twenties. Thyroid nodule occurs in one out of 1000 people each year, while It occurs in one out of 50,000 people.
Thyroid nodules are more common in women than men, but the incidence of cancer in nodules seen in men is higher than in women. The risk of developing thyroid cancers, with a prevalence of 4.2% in society, is approximately 0.7% in women and 0.25% in men.
They are lumps in the thyroid gland. They can be single or multiple. Those that secrete hormones are called warm nodules, those that do not secrete hormones are called cold nodules. Its distinction is made by thyroid scintigraphy. Good and bad differentiation of nodules is made with a fine needle biopsy. Simple benign nodules can be followed without removal.
Thyroid gland inflammation
Depending on the duration of the disease, they are called acute, transient, and chronic. Acute thyroiditis starts quickly and lasts for a short time. Transient thyroiditis can last up to a year. Subacute thyroiditis, postpartum thyroiditis, and radiation-induced thyroiditis are in this group. In chronic thyroiditis, the best known is Hashimoto thyroiditis. It can continue for life. It occurs due to autoimmune reasons. It is among the biggest causes of hypothyroidism in the community. Sometimes it can be seen with thyroid cancer. Hormone drugs are used in their treatment.
How is thyroid cancer determined?
With the routine application of ultrasonography, the rate of the diagnostic approach to these nodules has increased in parallel with the increasing rate of thyroid nodule detection. More thyroid cancer can be diagnosed with fine-needle aspiration biopsy. In studies, the frequency of thyroid cancer that can be detected by chance in adults is as high as 6 percent.
Another reason why thyroid cancers seem to have increased in frequency is that detailed thin-sectional examination is performed in the pathological examinations of cases operated for benign thyroid diseases. In this way, the probability of developing thyroid cancer increases from 5 percent to 13 percent.
What are the factors causing thyroid cancer?
Radiation exposure of the head and neck region increases the frequency of thyroid cancer. It was found that the incidence of thyroid cancer increased after 20-25 years in individuals who received radiation around 200–700 rad in their childhood. In a study, it was revealed that the frequency of thyroid cancer in people who received around 500 rad radiation was around 2 percent. After the Chernobyl nuclear power plant accident in Russia, there has been a large increase in thyroid cancer among people living in that region. Thyroid cancer is 30 percent more common in cases where radiation was applied years ago for reasons such as acne, scalp problems, tuberculosis in the neck, fungal infections of the scalp, blood vessel tumors of the face, enlarged thymus, tonsillitis, sore throat, chronic cough, and excess hair. These types of treatments are no longer applied today.
In addition, the possibility of thyroid nodule and cancer in patients who have cancer in the head and neck region and receive radiation to this area increases. If this type of treatment has been applied to you in the past, then you should definitely consult your doctor and request an examination of the thyroid gland.
Thyroid cancer symptoms
Cancer of the thyroid gland is usually asymptomatic. It may occur in patients who are followed up for a goiter or incidentally in examinations for another disease. Rarely, a mass in the neck, hoarseness, difficulty swallowing; very rarely, it can occur with bone fractures or hyperthyroidism (toxic goiter). Thirty percent of patients with medullary cancer may experience flushing, diarrhea, and fatigue.
The most effective method used today to determine whether a person has a thyroid nodule is thyroid ultrasonography. The thyroid scintigraphy method, which was used in the past, is now used to determine the activity rather than nodule detection.
Thyroid ultrasonography and fine-needle aspiration biopsy can be performed in many cases due to the advancement of diagnostic methods and the development of technical possibilities in thyroid diseases in recent years. For this reason, the possibility of diagnosing even initial thyroid cancers is very high today. However, it is worth noting that 50 percent of thyroid nodules are detected in autopsy studies. In other words, there are still thyroid nodules in the community that cannot be detected even by ultrasound.
After the nodule is detected in the thyroid gland, if there is any suspicion, a fine needle aspiration biopsy from the nodule reveals whether the thyroid nodules are malignant. Fine needle aspiration is a low-risk, fast and easy-to-apply method in good hands. If the biopsy result is benign and the patient has no other complaints, thyroid nodules can be followed up. If the biopsy result is suspicious or malignant, the treatment phase is started.
Thyroid cancer treatment methods
The most effective method of thyroid cancer treatment is surgery. Although it is thought that removing only a part of the thyroid gland may be sufficient in thyroid cancer in some centers, the most reliable method is the complete removal of the thyroid gland. This method reduces the possibility of recurrence and maximizes the effectiveness of non-surgical treatment methods such as radioactive iodine treatment after surgery. Complications such as hoarseness and low calcium levels, which can be seen in thyroid surgery, are minimized when the operation is performed by an experienced team.
Radioactive iodine treatment can be applied to patients after surgery based on the findings during surgery, pathological data of cancer, and the results of whole-body scans performed after total thyroidectomy.
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