Five things to know about thyroid cancer

Thyroid cancer affects tens of thousands of people each year. Fortunately, thyroid cancer typically has high survival rates, and most patients maintain or regain a good quality of life after diagnosis and treatment.

Alfred Simental, MD, Chair of Loma Linda University Health’s Head and Neck Surgery Department, says early cancer diagnosis helps outcomes and decreases the extent of treatment needed. "Thyroid cancer is highly treatable and even curable when found early, often requiring an outpatient surgery, with most patients back to work within two weeks” he says.

Here are five actions Simental suggests you take to learn more about thyroid cancer, the most common endocrine malignancy:

1. Get to know the gland. The thyroid gland is a butterfly-shaped organ that sits in the front of the neck between the Adam’s apple and collarbones. The gland creates hormones responsible for regulating metabolism, heart rate, blood pressure, and body temperature. Nodules are common in normal thyroid glands and are usually not cancer.  Unfortunately, errors sometimes occur during the cellular replication process in the thyroid.  As a result, cells multiply out of control, sometimes leading to thyroid cancer.
2. Recognize risk factors. Thyroid cancer affects people from all walks of life — from pediatric to geriatric patients. In fact, physicians commonly diagnose it in patients at a younger age than most other adult cancers. Women are three times more likely to develop the cancer than men. ​Factors that place people at higher risk for developing thyroid cancer include:  “The medical community continues to seek out and validate the causes behind these observed trends,” says Simental.
   • Previous exposure to radiation
   • Obesity
   • Family history of thyroid cancers
   • Vitamin D deficiency
   • Iodine deficiency intake
   • Asian ethnicity (potentially a screening issue)
3. Protect your thyroid from radiation. Previous exposure to low-dose ionizing radiation is the most common risk factor for thyroid cancer. Thus, the most active means of thyroid cancer prevention within our control is to protect that area when exposed to radiation — most likely in a medical, dental, or work setting. Ask your healthcare provider or technician for a shield to protect your neck during X-rays.
4. Make self-examination a habit. Recommendations for thyroid cancer screenings in the U.S. have varied over time, and routine imaging studies or blood tests are currently not advocated in patients with no symptoms. Simental says only a minority of non-symptomatic people with a strong family history of thyroid cancer or thyroid disorder like hypothyroidism should get an ultrasound screening for thyroid cancer. In the absence of screening guidelines for the cancer, Simental suggests self-examination of your neck feeling for new lumps or bumps is a safe practice to fold into your self monitoring routine.
   • Most thyroid cancers are, after all, asymptomatic, he says, meaning they do not produce any outward or noticeable physical changes in the body. Some symptoms may include persistent swallowing difficulty, hoarseness, or even pressure when lying on your back.
   • However, by touching your neck where the thyroid sits, you may be able to detect small lumps or bumps, called nodules. If you suspect you have a nodule on your thyroid after self-examination, see a doctor to confirm and discuss the next steps. Keep in mind that nearly half of Americans develop thyroid nodules — yet only a tiny percentage of these are cancerous. The best study is a simple neck ultrasound, as advanced imaging such at CT, MRI, or PET scans may miss thyroid nodules. 
5. Know thyroid cancers are treatable, even curable. Approximately 95% of people who have thyroid cancer will survive by cure or by living with the disease, Simental says. He characterizes thyroid cancer as being closer to a leaking roof than a house on fire: “It won’t burn your house down, but it can precipitate secondary problems like mold, structural or electric problems. So you can still live with a leak in your house, though you should fix it if you can.”

If allowed to progress, cancer in the thyroid may:

• Spread and cause pressure on lymph nodes in the neck
• Invade the trachea and precipitate bleeding in the airway
• Invade the recurrent laryngeal nerve, leading to hoarseness or paralyzed vocal cords
• Spread to the lungs, causing difficulty with coughing, coughing blood, or even oxygenation issues (rarely).

While each of these secondary conditions is treatable, Simental says catching and treating the thyroid cancer itself as soon as possible dodges such downstream effects while optimizing outcomes and ensuring the best quality of life.

Learn more about head and neck cancer screening and treatment options online.