13 Things You Need to Know About Thyroid Cancerby Mary Shomon Patient Advocate
Thyroid cancer is one of the few cancers that are actually on the rise in the United States. Here are 13 things you should know about this misunderstood thyroid, but increasingly common cancer.
Thyroid cancer is on the rise
According to the American Cancer Society, almost 54,000 new cases of thyroid cancer will be diagnosed in 2018. Thyroid cancer is one of the few cancers that is actually on the rise in the United States. Your chance of being diagnosed with thyroid cancer has tripled over the last 30 years. Much of this increase is, however, due to ultrasound detection of small nodules that were not being discovered in the past.
Thyroid cancer often has no symptoms
Thyroid cancer frequently is diagnosed in people who have no obvious symptoms. The most common “symptom” of thyroid cancer is a lump or swelling in the neck, but in some cases, that is not something the patient or practitioner can feel or see, and it is detected by X-ray or ultrasound. When there are symptoms, they are often mild and may include neck discomfort or sensitivity, neck or ear pain, a sore throat, a hoarse voice, difficulty swallowing, or a chronic cough.
Radiation is a risk factor for thyroid cancer
One of the key risk factors for thyroid cancer is exposure to radiation. People who are exposed to radioactive fallout after nuclear accidents such as Chernobyl or Fukushima — especially at a young age — are at greater risk of developing thyroid cancer. If you underwent childhood radiation treatments to the head or neck — such as for lymphoma — you are also at greater risk of developing thyroid cancer.
There are three key categories of thyroid cancer
There are three different categories of thyroid cancer.
- Differentiated thyroid cancer — which includes papillary cancer, follicular cancer, and Hurthle cell cancer. About 95 percent of thyroid cancers fall into this category.
- Medullary thyroid cancer. About 3 percent of thyroid cancers are medullary.
- Anaplastic thyroid cancer — a very rare, aggressive, and undifferentiated type of thyroid cancer. About 2 percent of thyroid cancers are anaplastic.
Some thyroid cancer runs in families
A form of medullary thyroid cancer called familial medullary thyroid cancer has a genetic component. This thyroid cancer results from a mutation in a gene called the RET proto-oncogene. Around 25 percent of medullary cancer cases are familial and inherited from a parent.
One type of thyroid cancer can be prevented
If you have a family history of medullary thyroid cancer, you can be tested for the RET proto-oncogene. Since the presence of this gene signifies a strong chance that you will develop medullary thyroid cancer, your health care provider may recommend a preventative thyroidectomy to surgically remove your thyroid gland. Removal of your thyroid gland can then prevent the development of thyroid cancer.
Some thyroid cancers may not need treatment
Experts increasingly feel that for a small papillary thyroid cancer that has not spread, especially in adults and seniors, active surveillance — also known as “watchful waiting” — may be the best approach. Because these cancers grow so slowly, research shows that regular ultrasound monitoring of changes to the nodule can detect the point at which treatment is warranted without any change in long-term prognosis.
Thyroid cancer is not treated like most other cancers
Thyroid cancer is first treated with surgery. After surgery, the treatment differs. Some patients are treated with oral radioactive iodine (RAI) to destroy any remaining thyroid tissue. After surgery and/or RAI, patients are prescribed a thyroid hormone drug like levothyroxine to replace the missing hormone and help prevent cancer recurrence. Chemotherapy, radiation, and other cancer drugs are rarely used for thyroid cancer, and only in very specialized situations.
Most thyroid cancers have a good prognosis
Overall, the five-year survival rate for people with thyroid cancer is approximately 98 percent. Survival rates are highest for those with differentiated cancers like papillary, follicular, and Hurthle cell cancer, and in those that are contained to the thyroid and have not spread. Stage 1 medullary thyroid cancer that has not spread outside the thyroid have a 95 percent 10-year survival rate.
Thyroid cancer patients require lifelong hypothyroidism treatment
Thyroid cancer patients typically have their thyroid surgically removed. The thyroid makes a hormone that is essential for all physiologic functions. As a result, after a thyroidectomy, you need lifelong treatment for the resulting hypothyroidism. This treatment involves taking a thyroid hormone replacement drug like levothyroxine (Synthroid, Levoxyl, Tirosint), or natural desiccated thyroid (Nature-throid, Armour Thyroid.)
Thyroid cancer is sometimes referred to as the “good cancer”
Because most cases of thyroid cancer have a good, long-term prognosis, some health care providers refer to it as the “good cancer.” This is controversial, however, as most thyroid cancer patients undergo surgery to remove the thyroid, radioactive iodine treatment, frequent monitoring, life-long treatment for their resulting hypothyroidism, and face the risk of thyroid cancer recurrence or new cancers.
Thyroid cancer requires lifelong monitoring
Despite the good long-term prognosis of most thyroid cancer, thyroid cancer can and does recur. For this reason, lifetime monitoring and follow-up are required for anyone who has had thyroid cancer. This monitoring can include blood tests to measure thyroid hormone levels, ultrasound testing, radioactive scans to detect recurrence, and imaging tests such as Magnetic Resonance Imaging (MRI), computerized tomography (CT) scans, positron emission tomography (PET) scans, and X-rays.
There is a support group for thyroid cancer survivors
There is a group dedicated to providing information and support to thyroid cancer patients. The Thyroid Cancer Survivors’ Association — also known as ThyCa — offers a comprehensive website with information about diagnosis and treatment of thyroid cancer, a free low-iodine cookbook, a newsletter, and a network of in-person, online, and telephone support groups. ThyCa also sponsors an annual conference for thyroid cancer patients and caregivers.