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Thyroid Cancer: Causes, Symptoms, Risk Factors, Diagnosis, Treatment And Prevention

Thyroid cancer is the cancer of the thyroid gland which is found at the neck's front just below Adam's apple. The thyroid gland is a butterfly-shaped gland with two lobes, one at each side joined by a narrow tissue called the isthmus. It is a hormone-making gland involved in the synthesis of hormones that regulate heart rate, body temperature, metabolism and blood pressure and body weight. [1]

According to the National Cancer Institute, in women, the chances of thyroid cancer are three times more than men. It can occur in any age group: however, the chances are more in people above 30. Take a look at its causes, symptoms and other details.

Types Of Thyroid Cancer

There are three primary types of cancer: differentiated, medullary and anaplastic.

1. Differentiated thyroid cancers: They are mainly found in the thyroid follicular cells which produce and store hormones. They are of two main types:

  • Papillary cancer: It accounts for 8 out of 10 thyroid cancers and regarded as the most common types. Papillary cancer grows slowly and is often symptomatic. The peak onset age is between 30 to 50 years and occurs three times more in women than men. Papillary cancer spreads to lymph nodes in more than 50 per cent cases but still can be curable and rarely fatal. [2]
  • Follicular cancer: It is the next common type of cancer and accounts for 1 out of 10 or 15% of all thyroid cancers. Follicular cancer is more aggressive than papillary cancer and mainly affects adults aged above 40. It is common in iodine-deficient countries. Unlike papillary thyroid cancer, it does not spread to lymph nodes but other body parts such as lungs, brain, bones, skin and bladder. [3]

2. Medullary thyroid cancers (MTC): It accounts for four per cent of the total thyroid cases and is very rare. MTC develops in C cells or parafollicular cells of the thyroid gland which is responsible for the making of calcitonin hormone that regulates the levels of calcium and phosphate in the blood. The two main types of MTC are sporadic MTC and Familial MTC. Sporadic MTC is not inherited while Familial is hereditary. [4]

3. Anaplastic thyroid cancer (ATC): It is also known as undifferentiated carcinoma as the cancerous cells do not look similar to normal thyroid cells. ATC accounts for two per cent of overall thyroid cancers. It grows quickly and spread to other body parts. ATC is very difficult to treat and usually occurs in elders aged above 60.

Causes Of Thyroid Cancer

Thyroid cancer mainly occurs when there's a genetic mutation in the thyroid cells. The exact cause of mutation or change in the DNA factor is still unknown. However, there are certain risk factors which are responsible for the onset of cancer such as radiation or family history.

Symptoms Of Thyroid Cancer

  • Painless lump or nodule in the lower neck
  • Dysphagia (difficulty in swallowing food
  • Abnormal voice change
  • Pain in the throat
  • Swollen glands in the neck region
  • Persistent cough
  • Difficulty in breathing

Note: Lumps or nodule in the neck is common and it is not often a sign of cancer. In children, swollen lumps in the neck are mainly due to throat infection or ear infection. However, it's better to consult a medical expert if you notice other following symptoms. [1]

Risk Factors Of Thyroid Cancer

  • Age
  • Female gender[5]
  • Exposure to radiation as an infant
  • Family history of thyroid cancer [6]
  • Family history of goitre
  • Some genetic medical conditions like multiple endocrine neoplasia (type 2A)
  • Born in an Asian country
  • Smoking
  • Overweight
  • Staying in areas where there's an iodine deficiency in the soil like mountains (Himalayas) [7]

Multiple factors increase the risk of thyroid cancer. Some risk factors cannot be changed such as family history while others can change such as smoking. Having one or more of the aforementioned risk factors does not mean that you will get the disease. Some people have got the disease without any of the above risk factors while some of them didn't get despite the above factors. Timely medical check-up helps you diagnose it at an early stage.

Complications Of Thyroid Cancer

Complications in thyroid cancer occur when it gets metastasized to other body parts and spread there. Another complication is reoccurrence after surgery due to small cancerous cells which are left behind.

Diagnosis Of Thyroid Cancer

The diagnostic methods of thyroid cancer include:

  • Medical history: In this method, questions are asked by the medical experts related to the family history of thyroid cancer, other cancers or any genetic disease running in the family.
  • Physical examination: It includes examining the enlarged nodes.
  • Imaging tests: It is carried out only when the doctor finds that the patient is at increased risk of the disease by evaluating its risk factors like family history. The test is carried out to view the spread of cancer in the thyroid gland and nearby areas.
  • Ultrasound: In this method, several images of the thyroid gland is taken to look for solid or fluid-filled signs in a thyroid nodule. If the nodule is solid, it indicated cancer. Ultrasound also determines the spread of cancer to lymph nodes.
  • Needle biopsy: If the signs of cancer are found after the ultrasound, a needle biopsy is done in which a long thin needle is inserted into the thyroid nodule through the skin to take a sample of thyroid tissues. The ultrasound image helps in guiding the needle to the nodule. The sample is then checked for any cancerous cells. [8]
  • Blood tests: This test does not determine the thyroid cancer. Blood tests are conducted to know the proper functioning of thyroid gland. If any abnormalities are found in its overall functioning, further tests are suggested to identify cancer.

Treatment Of Thyroid Cancer

The treatment methods are as follows:

  • Surgery: Removal of the tumour. It also includes the removal of a small portion or entire thyroid gland according to the severity of the condition. [9]
  • Hormone treatment: This treatment method is for patients who have undergone surgery of thyroid gland.
  • Radioactive iodine: To kill cancerous cells not removed after the surgery.
  • Chemotherapy: Drugs to kill cancerous cells and prevent their proliferation.
  • Targeted therapy: Genes, proteins or tissues which are responsible for cancer is targeted in this method.

How To Prevent Thyroid Cancer

  • Consult a genetic counsellor if thyroid cancer runs in family.
  • If your job demands to live near nuclear or radioactive power plants, talk to a doctor about potassium iodine pills. [10]
  • Keep a check on your symptoms.
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