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Thyroid Cancer

The thyroid is an organ at the base of the throat that makes hormones that help control heart rate, blood pressure, body temperature, and weight. Four main types of thyroid cancer are papillary, follicular, medullary, and anaplastic thyroid cancer. The four types are based on how the cancer cells look under a microscope.

Papillary and follicular thyroid cancers account for 80-90% of all thyroid cancers. Both types begin in the follicular cells of the thyroid. Most of this type tends to grow slowly and if detected early, most can be treated successfully.

Medullary thyroid cancer accounts for 5-10% of thyroid cancer cases and it arises in C cells not follicular cells. Medullary thyroid cancer is easier to control if it is found and treated before it spreads to other parts of the body. Anaplastic cancer is least common with only 1-2% of cases. It arises in follicular cells and the cells are highly abnormal and difficult to recognize. This type of cancer is usually very hard to control because the cancer cells tend to grow and spread very quickly.

The exact cause of thyroid cancer is unknown however; certain risk factors are more likely to contribute to thyroid cancer in one individual versus another. The risk factors associated with an increased chance of developing thyroid cancer are radiation, family history, being female, age, race, and not enough iodine in the diet. Early thyroid cancer does not cause symptoms. As cancer grows symptoms may include a lump or nodule in the front of the neck near the Adam’s apple, hoarseness or difficulty speaking in a normal voice, swollen lymph nodes, especially in the neck, difficulty swallowing or breathing or pain in the throat or neck. If a person has symptoms that suggest thyroid cancer the doctor may perform a physical exam and ask about the patient’s personal and family medical history. Lab tests and imaging including ultrasound, radionuclide scanning, and a biopsy may also be performed. A biopsy is the removal of tissue to look for cancer cells and is the only sure way to know whether a nodule is cancerous. The tissue is examined under a microscope by a pathologist for diagnosis.

If the diagnosis is thyroid cancer, the doctor then needs to know the extent or stage of the disease. Additional testing including ultrasound, MRI, CT scan, and radiounuclide scan may be done to see whether the cancer has spread to the lymph nodes or other areas within the neck. After testing and staging are complete treatment options are discussed. Treatment options are surgery, radioactive iodine therapy, hormone treatment, external radiation therapy, and chemotherapy.

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