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Thyroid Cancer Awareness Month

Thyroid Cancer Awareness Month

Recently you may have read our overview of women's health issues in honor of National Women's Fitness and Health Day, but today we're putting a tighter focus on a health issue affecting women that often goes overlooked: thyroid cancer. The most common endocrine cancer, thyroid cancer manifests as a malignant tumor or growth on the thyroid gland (a butterfly-shaped gland in the front of the neck that produces hormones to regulate metabolism and heart rate). Although it can affect men as well as women, over 70% of people diagnosed with thyroid cancer are women.

September is Thyroid Cancer Awareness Month, and to honor the occasion, here are some facts you should know about this rarely discussed disease:

  • Thyroid cancer diagnoses have increased over the past 15 years, while incidence rates of most other cancers have been steady or declining. This may be due to an increased awareness of the disease and ability to detect it.
  • More than 53,000 people will be diagnosed with thyroid cancer in the U.S. in 2018, and more than 300,000 people worldwide.
  • Thyroid cancer can affect people of any age, but 2 out of 3 people diagnosed are between 30 and 55.
  • Most forms of thyroid cancer are treatable when discovered early.
  • Less than 10% of thyroid nodules are cancerous in adults; 20% to 30% are cancerous in children.

 Thyroid Cancer Awareness Month

Diagnosis

Although the most common forms of thyroid cancer (papillary and follicular, referred to as differentiated thyroid cancer) have a 90% long-term survival rate, this can depend on early detection. Thyroid cancer often has no symptoms, so for many people detection occurs during an unrelated test: a doctor spotting a lump during a physical exam, or a CT or MRI scan of the spine or chest.

Some people do have a physical sign of thyroid cancer, however, in the form of a lump, nodule, or growth in the neck. Signs to watch out for include:

  • A lump in the neck, especially a growing one.
  • Swelling in the neck, such as an abnormally large lymph node that does not shrink over time.
  • Pressure caused by a growth or lump in the neck.
  • Pain in the front of the neck, which may radiate outward, especially up toward the ears.
  • Difficulty breathing.
  • Difficulty swallowing, or a feeling a lump when swallowing.
  • Hoarseness or a changed voice for an extended period with no known cause.
  • Frequent coughing unrelated to a cold.

These symptoms may indicate other conditions than thyroid cancer, and lumps on the thyroid are common and typically benign. However, if you're experiencing any of these symptoms, you should discuss them with your doctor immediately. Early detection and treatment is always vital.

Even if you're not experiencing symptoms, doctors suggest you check yourself for any signs of thyroid cancer twice a year. You can do this at home easily with a "neck check," a simple self-examination that only requires a mirror and a glass of water.

To perform a neck check:
1. Locate your thyroid gland. It's above your collarbone and below your larynx, and also below the Adam's apple on a man's neck.
2. Swallow a drink of water with your head tipped back somewhat.
3. Watch for any bumps or growths in this area of your neck in the mirror as you swallow.

Although this test is important, be sure to ask your doctor to check your thyroid during regular physical exams.

 

Risk Factors

The causes of thyroid cancer are largely unknown. Specific risk factors may include:

  • Women are most likely to be diagnosed, with their period of greatest risk coming earlier (40s and 50) than in men (60s and 70s).
  • Radiation exposure, especially in childhood. This is less common now, as doctors only use radiation to treat serious diseases, but it was once used even for acne.
  • Family history of thyroid cancer.
  • Familial medullary thyroid carcinoma (FMTC), the inheriting of an abnormal gene that can cause medullary thyroid cancer.
  • Multiple Endocrine Neoplasia Type 2 (MEN 2), a condition that causes endocrine tumors, resulting from a mutation in the RET gene.
  • Inherited genetic conditions such as familial adenomatous polyposis (FAP); Cowden disease; Carney complex, type 1; and familial nonmedullary thyroid carcinoma.
  • A low-iodine diet.

If you have a family history of thyroid cancer, genetic testing can indicate the presence of a mutated gene. In addition, thyroid nodules can sometimes produce excessive amounts of thyroid hormone, causing hyperthyroidism. A diagnosis of hyperthyroidism may indicate the presence of these modules and a need to test them for cancer.

 Thyroid Cancer Awareness Month

Treatment

Treating thyroid cancer is dependent on a variety of factors, such as the type of thyroid cancer, whether it has spread, and your age.

Treatments may include:

Surgery: A thyroidectomy, or removal of the thyroid gland, or a lobectomy, a removal of part of the thyroid gland in the case of small cancers that have not spread.
Lymph node removal: If cancer has spread to the lymph nodes, they will also be removed along with the thyroid.
Radioactive iodine therapy: The thyroid absorbs most of the body's iodine, and the gland and the cancer can be destroyed with radiation through this absorption.
External beam radiation therapy: A high-energy, radioactive beam focused on the areas where cancer has spread. Typically used on rarer forms of thyroid cancer that do not respond to thyroid-hormone based treatment like Radioiodine therapy.
Chemotherapy and other targeted drug therapies: Also used on these rarer forms of thyroid cancer. Targeted drug therapy is still in development.

Recovery

Following treatment for thyroid cancer, you will still be in regular communication with your primary doctor and possibly an endocrinologist. Follow-up checks are a normal part of this process. Blood tests and imaging tests such as radioiodine scans and ultrasound scans are a common component of this period. Due to thyroid cancer's very slow growth rate, it's not unusual to have testing done periodically for years after successful treatment.

One of the most important elements of treatment and recovery from thyroid cancer is thyroid hormone therapy. This helps maintain a person's metabolism after the loss of most or all of their thyroid gland. And by lowering thyroid-stimulating hormone (TSH) levels, it can stop remaining cancer cells from growing and may help prevent thyroid cancer from recurring. By replacing the lost TSH, these hormones prevent the pituitary gland from increasing TSH production in a process that can cause thyroid cancer to develop again.

 Thyroid Cancer Awareness Month

Social Support

Although thyroid cancer has been pegged by some as one of the more fortunate cancers to have, due to its high long-term survival prognosis, don't feel like you should diminish your concern if you have been diagnosed with it. It's normal to be anxious, depressed, worried, and frustrated, even after successful treatment. Fortunately, there are a number of options to help you during both the occurrence of cancer and the recovery period, including:

  • Cancer patient and survivor support groups
  • Mental health counseling
  • Your loved ones: help them be a part of your treatment and recovery process!

The Thyroid Cancer Survivors' Association maintains a number of support resources as well as links to support groups and communities. Don't hesitate to make use of these options. A support system is an opportunity to share your experiences and feelings openly in a comfortable setting, as well as a valuable way to gain a clearer understanding about what to expect after a diagnosis. Many survivors are eager to share their thyroid cancer story and to hear yours, and connecting to them can open up a new pathway to recovery.

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