The thyroid is a butterfly shaped gland at the base of the throat, near the windpipe. It produces hormones that help control heart rate, blood pressure, body temperature and weight. There are four types of thyroid cancer - papillary, follicular, medullary and anaplastic thyroid cancer. Papillary is the most common while anaplastic is the most aggressive and difficult to cure. Other types of thyroid cancers are usually curable if detected early.
The most common symptom of thyroid cancer is a neck lump or nodule. If the tumor is large, it may cause other symptoms which would include:
- Neck or facial pain
- Shortness of breath
- Difficulty in swallowing
- Cough unrelated to cold
- Hoarseness or voice change
Having any of these symptoms does not mean it is cancer, but if one or more of them is noticed for more than two weeks, then a doctor must be seen and an immediate health screening is a must.
Thyroid cancer is diagnosed by a physical examination of the neck for nodules, thyroid gland function test, blood calcitonin and calcium levels in some cases.
Ultrasound done by an expert sonologist is the investigation of choice. It helps to characterize the nodule (benign or malignant). It can also be used to target a biopsy (FNAC). Ultrasound is used in the follow–up of benign nodules as well. It helps to confirm the diagnosis and plan the treatment.
Molecular testing (gene expression classification) can also be performed to confirm the diagnosis before surgery. Different types of imaging techniques like X-ray, CT scan, MRI and PET scan can also be performed for accurate diagnosis.
The thyroid tumor is staged in order to develop the most effective treatment plan. The two types of surgeries which can be performed are Hemi thyroidectomy and Total thyroidectomy. Surgery may be followed by systemic radioactive iodine therapy to destroy cancerous thyroid tissue which is not surgically removed. External radiation or external-beam therapy can also be used. Chemotherapy plays a very little role in thyroid cancer except for very aggressive cancers such as anaplastic thyroid cancer.
An integrated approach with a multidisciplinary team of Onco Surgeons, Radiation Oncologists & Medical Oncologists exponentially increases the chances of a positive outcome.