KOCHI: “Dear Doctor, I am writing this from Switzerland. In the last two weeks, I have been travelling through Europe, visiting multiple countries, meeting different types of people, experiencing their culture and thus living a dream which I had from childhood. I could not imagine this two years ago, when I was diagnosed with recurrent thyroid cancer….”- the message from Rajeev reflected not only the state of euphoria that he was in, but also the agony of a difficult period of illness he has been through.
Two years ago when Rajeev was diagnosed with recurrent cancer, it seemed the end of the world for him and his family. After going through an extensive surgery and adjuvant ablation treatment, he was back to work and life, but with a fear of the disease coming back again. Now after a post treatment period of two years and preserved health, he is less worried and so am I.
Introduction to thyroid cancer
Thyroid cancer includes a heterogeneous group of tumors with varying behavior, but majority of them fall into a group called differentiated thyroid cancers, which show excellent cure rates with proper treatment. Statistics from various cancer registries and studies from multiple international centres show that thyroid cancer incidence has shown significant increase world over, in the last few decades. Thyroid cancer is the second leading cause of cancer in females in Kerala as per the cancer registry at Regional cancer centre, Trivandrum and has shown a threefold increase in number over the last three decades. It forms 13% of all cancers in females. It is also the tenth leading cause of cancer in males.
Surgery
Recurrent laryngeal nerve- the nerve of voice and parathyroid gland that controls the function of calcium in the body is situated close to the thyroid gland. Because of this many patients share the fear of losing their voice post surgery. However such complications rarely occur in the hands of an expert surgeon.
Endoscopic surgeries for thyroid lumps is different from the other key hole surgeries. This requires more dissection than open surgery. Therefore, this is not a minimally invasive surgery. The only benefit of such keyhole surgeries is that the scars around the neck move to the relatively hidden areas like arm pits or to behind the ears. Globally, Endoscopic surgery is not preferred by the major hospitals and doctors for thyroid cancers. This is because the most important aim of thyroid cancer surgery is to leave no or as little part of thyroid gland as possible after surgery and to preserve the recurrent laryngeal nerve- the voice nerve and parathyroid glands, the glands adjacent to thyroid gland, which are important in calcium metabolism.
Shawn T. Joseph, Head and Neck surgical oncologist,
Lakeshore hospital