Archive for April, 2010

How is thyroid cancer diagnosed?

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. The doctor also may order laboratory tests and imaging tests to produce pictures of the thyroid and other areas.

The exams and tests may include the following:
- Larger and more anteriorly (front) located nodules can be felt by the examiner.
- A physician will ask about any other medical history and any risk factors for thyroid nodules or cancer, including family history of thyroid cancer or radiation exposure of the head or neck.
- Thyroid stimulating hormone (TSH) levels and levels of thyroid hormone can indicate whether the thyroid is under- or overproducing thyroid hormones.
- Anti-thyroid antibody levels can indicate the presence of autoimmune thyroid inflammation that can be seen with Hashimoto’s thyroiditis.
- Calcitonin levels in the blood can indicate a specific type of thyroid cancer, known as medullary carcinoma of the thyroid.
- Ultrasound : This is a test that uses sound waves to take a picture of the thyroid. An ultrasound can reveal which thyroid nodules are larger than 1-1.5 centimeters, requiring further evaluation for cancer. It includes number of nodules, location of nodules, distinctness of borders, fluid versus solid contents, other nodule contents, such as calcium deposits, or the amount of blood flow.
- Radionuclide scanning : The doctor may order a nuclear medicine scan that uses a very small amount of radioactive material to make thyroid nodules show up on a picture.
- Biopsy : The removal of tissue to look for cancer cells is called a biopsy. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to know whether a nodule is cancerous.

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What Is a Thyroid Cancer Prognosis?

A thyroid cancer prognosis is a medical opinion as to the likely course and outcome of the disease. Factors that can affect a prognosis for a person with thyroid cancer include such things as the type and location of the cancer, the stage of the disease, its grade; and the patient’s age and general health.
People facing thyroid cancer are naturally concerned about what the future holds. Understanding thyroid cancer and what to expect can help patients and their loved ones:
- Plan thyroid cancer treatment.
- Think about lifestyle changes.
- Make decisions about their quality of life and finances.

A prognosis is a medical opinion as to the likely course and outcome of a disease. In other words, the prognosis is the chance that a patient will recover or have a recurrence (return of the cancer). There are many factors that can affect a person’s prognosis, which include:
- The type and location of the cancer.
- The stage of the disease (the extent to which the cancer has metastasized, or spread).
- Its grade (how abnormal the cancer cells look, and how quickly the cancer is likely to grow and spread).
- The person’s age, general health, and response to treatment.

Most thyroid cancers are very curable. In fact, the most common types of thyroid cancer, papillary and follicular, are the most curable. In younger patients, both papillary and follicular cancers have a more than 97% cure rate if treated appropriately. Both papillary and follicular cancers are typically treated with complete removal of the lobe of the thyroid that harbors the cancer, in addition to the removal of most or all of the other side.
The bottom line is that most thyroid cancers are papillary thyroid cancer, and this is one of the most curable cancers of all cancers that humans get. Treated correctly, the cure rate is extremely high.
Medullary cancer of the thyroid is significantly less common, but has a worse prognosis. Medullary cancers tend to spread to large numbers of lymph nodes very early on, and therefore require a much more aggressive operation than the more localized thyroid cancers, such as papillary and follicular. This cancer requires complete thyroid removal plus a dissection to remove the lymph nodes of the front and sides of the neck.
The least common type of thyroid cancer is anaplastic which has a very poor prognosis. Anaplastic thyroid cancer tends to be found after it has spread and is incurable in most cases.

What is thyroid cancer and its causes ?

The thyroid is a gland in the neck. It has two kinds of cells that make hormones. The thyroid is shaped like a butterfly and lies at the front of the neck, beneath the voice box (larynx).

The thyroid gland contains mainly 2 types of cells — thyroid follicular cells and C cells (also called parafollicular cells). The follicular cells use iodine from the blood to make thyroid hormone, which helps regulate a person’s metabolism. C cells (parafollicular cells) make calcitonin, a hormone that helps regulate how the body uses calcium.

Different cancers develop from each kind of cell. The differences are important because they affect how serious the cancer is and what type of treatment is needed.
A healthy thyroid is a little larger than a quarter. It usually cannot be felt through the skin. A swollen thyroid is called a goiter. Most goiters are caused by not enough iodine in the diet.
Lumps or bumps in the thyroid gland are called thyroid nodules. Most thyroid nodules are benign, but about 1 in 20 is cancerous. People can develop thyroid nodules at any age, but they are most common in older adults.

Thyroid nodules can be benign or malignant:

- Benign nodules are not cancer. Cells from benign nodules do not spread to other parts of the body.
- Malignant nodules are cancer. They are generally more serious and may sometimes be life threatening. Cancer cells can invade and damage nearby tissues and organs.

Causes of Thyroid Cancer

The following conditions have been cited in various sources as potentially causal risk factors related to Thyroid cancer:
- Cancer begins with an alteration to the structure of DNA that is found in all human cells. This is known as a genetic mutation.
- Age : most people are over 40.
- Gender : women 3 times more than men.
- Race : Caucasians are more likely than African Americans.
- Iodine deficiency.
- Radiation exposure.