HYDERABAD: Thyroid Gland – a butterfly shaped gland with two lobes – is a part of the endocrine system. It is present in the front side of the neck below the voice box (larynx). It is an important gland owing to the function it performs. It produces hormones that help to control and influence various functions like breathing, heart rate, body weight, body temperature, muscles strength, menstrual cycles, etc.
Thyroid gland, known as the activity gland, produces two hormones: Thyroxine (T4) and triiodothyronine (T3), which help the body function at normal rate. Thyroid gland needs regular supply of Iodine to function properly. Iodine is present in fish, seafood and dairy. We get iodine from our diet.
Thyroid Cancer
Thyroid cancer associated with the thyroid gland is more common in women than in men, and in women it is diagnosed at age between 35 and 39. Thyroid cancer in men is more likely to occur above age 70; it is rare in children.
Types of Thyroid Cancers
Symptoms
If the tumor is large, it may cause neck or facial pain, shortness of breath, difficulty swallowing, cough unrelated to a cold, hoarseness or voice change. Early stages of thyroid cancers are usually asymptomatic. Hence a thorough examination by a Head & Neck Surgeon for any lump is a must. In most people, thyroid cancer develops very slowly.
Causes of Thyroid Cancer
Although the exact cause of thyroid cancer is unknown, factors such as age, genetics, exposure to radiation and family history of onco gene are likely to result in thyroid cancer.
Diagnosis
Your doctor after taking your complete medical history, considering possible risk factors, other health problems, performs physical examination. Thyroid cancer is suspected if a lump or nodule is detected in the gland. Sometimes, imaging test like ultrasound done for another purpose reveal thyroid tumor incidentally. Accurate diagnosis is ascertained by ultrasound of the neck with a needle test (FNAC- Fine needle aspiration cytology), Thyroid Scans, in certain case PET scan, MRI or CT Scans. Thyroid function tests (Blood tests) are usually performed to detect thyroid cancers.
“To make an accurate diagnosis of thyroid cancer, the thyroid cells need to be closely examined. Since a cancer cell looks different than a normal cell, the type of thyroid cancer is determined by microscopic examination of the thyroid cells found in the nodule (neck lump) or growth.”
Treatment
Early detection and treatment are the prerequisite for a better outcome. A successful treatment plan involves adopting a collaborative approach combining the expertise of head & neck surgeons, endocrinologists and a nuclear physician. Most of the thyroid cancers are treatable with surgery and other associated treatment options.
Surgery
Surgery is the most common treatment option for almost every case of thyroid cancer.
Complete removal of both lobes of Thyroid followed by Radio Iodine scanning/ablation (For Papillary/Follicular/ Hurthle cell cancers) is the treatment of choice. During surgery the nodule or mass is removed and examined by a pathologist to establish the diagnosis.
Radioactive Iodine Therapy
Radioactive Iodine therapy is a procedure in which radioactive iodine is used to selectively destroy any remaining cancer cells. It is usually performed by a nuclear medicine specialist or endocrinologist to destroy cancerous thyroid tissue, which is not removed surgically. Conventional external beam radiation or chemotherapy has little role in the treatment of these types of cancers.
Prognosis
Generally, good prognostic indicators are age (less than 40 yr old males & less than 50 year old females), histological grade of cancers (Papillary/Follicular cancers do well if detected early), size of the tumor & extensiveness of the primary tumor.
Although most thyroid swellings (or goiters) are benign, consult a doctor if you notice any of the above mentioned symptoms. The probability of a male developing a Thyroid lump is low, but if found it should be taken seriously and a Head and Neck Surgeon should be immediately consulted.