Thyroid cancer symptoms & treatment

Thyroid cancer occurs in the thyroid gland, which is located toward the bottom of the front of your neck. The cancer often appears as a painless lump, sometimes on just one side of your neck.

There are four types of thyroid cancer:

• Papillary thyroid carcinoma: This is the most common – and least dangerous – type, accounting for 80 to 90% of all cases. It spreads slowly and usually affects women of childbearing age.
• Follicular thyroid carcinoma: This is the second most common type, accounting for about 15% of all cases. It typically affects adults between the ages of 40 and 60.
• Medullary thyroid carcinoma: This type accounts for 3 to 5% of thyroid cancer cases. By the time it’s diagnosed, it has often spread to the lymph nodes. It occurs most often in older adults.
• Anaplastic thyroid carcinoma: This is the least common type, accounting for just 1% of all cases. It tends to grow quickly and typically affects people ages 65 or older.

Symptoms

Many people with thyroid cancer experience no symptoms, although you might notice the following:

• Cough
• Difficulty or pain when swallowing
• Enlarged thyroid gland
• Hoarseness or changes to your voice
• Lump in your neck
• Swollen neck

Diagnosis

If your doctor suspects you have thyroid cancer, he or she will feel for a lump in your neck or thyroid or swollen lymph nodes in your neck. Your doctor may also look inside your throat using a flexible tube called a laryngoscope.

To make a thyroid cancer diagnosis, your doctor may order these tests:

• Biopsy: Your doctor will remove a small piece of thyroid tissue and examine it for cancerous cells.
• Blood tests: This may include a test of your thyroid stimulating hormone (TSH) and free T4 levels, to check your thyroid function.
• Fine needle aspiration biopsy: A thin needle is placed into the lump in your neck, and cells are drawn out and then examined under a microscope to look for cancer.
• Imaging tests: An ultrasound may be ordered to evaluate the mass and may be used to perform a biopsy.

Treatment options

Treatment for thyroid cancer usually requires surgery, most often to remove the entire thyroid gland. If your thyroid tumor is small or only on one side, though, your doctor may only remove part of the gland. And if the cancer has spread to your lymph nodes, your doctor may remove those, as well.

In some cases, especially if your cancer has spread, your doctor may also recommend radiation, often in the form of radioactive iodine, or chemotherapy, either in combination with surgery, or on their own.