It has been an increasingly common tale in the endocrinology office of Ankur Modi, MD, over the past three years. A patient goes in for a routine physical exam or has an imaging test for another medical problem, and they find growths called nodules in their thyroid.
Thyroid cancer is one of the fastest growing cancers in the U.S. There are only about 44,280 new cases each year, but diagnoses have doubled over the last three decades. Much of this increase is a result of improved detection and advancements in imaging tests.
The endocrinology team at Summit Health offers comprehensive and individualized care for the management of thyroid cancers from diagnosis to treatment and follow-up. They work closely with medical oncologists and primary care physicians to provide seamless care throughout the entire cancer journey.
Some of Dr. Modi’s patients simply need to be monitored using a wait-and-see approach, while others need surgical intervention and treatment. Here are 10 things he says everyone should know about thyroid cancer.
The thyroid regulates the body.
The thyroid is a small butterfly-shaped gland located in the lower neck. It has several functions, but its main job is to make thyroid hormones. These hormones help control our metabolism, heart rate, and brain development. If there are too many of these thyroid hormones, or not enough, it can wreak havoc throughout the body affecting digestion, concentration, and movement.
Thyroid nodules are common — and usually benign.
Nodules are growths that develop in the thyroid. They are extremely common and become even more prevalent with age. The good news, however, is that the vast majority are benign. Recent studies show that only between 5 and 15 percent of nodules are cancerous.
Most patients do not experience symptoms. In fact, many cases are discovered by accident.
The first sign of thyroid cancer is usually a nodule. A small number of patients may notice a lump in their neck. But most of the time these growths are too small to notice. Instead, they are usually found in a routine physical exam or during an imaging study like an ultrasound for another problem. Other symptoms of thyroid cancer may include difficulty swallowing, shortness of breath or a hoarse voice.
Endocrinologists specialize in diagnosing thyroid cancer.
Your physician will start with a thorough examination of the neck. They will then use a thyroid
ultrasound to look for abnormal growths. Suspicious growths are typically larger in size and solid in composition. Based on the results of the ultrasound, an endocrinologist will perform a fine needle aspiration (FNA) or biopsy to determine if there are cancerous cells.
There are different types of thyroid cancer.
The most common type of thyroid cancer is papillary thyroid cancer, which accounts for 85 percent of cases. Follicular thyroid cancer makes up another 12 percent. Anaplastic and medullary thyroid cancer are found in less than two percent of patients. It is important to know what type of thyroid cancer you have because it may impact your treatment. Medullary thyroid cancer also has a genetic component and runs in families.
The mainstay of thyroid cancer treatment is surgery.
Surgery is the primary treatment for thyroid cancer. At Summit Health, our endocrinology team recognizes that every case is different. Depending on certain features, including age, size, number and location of the nodule(s), they may recommend a thyroidectomy that removes the entire gland or a partial thyroidectomy that removes only half of the thyroid.
Thyroid hormone replacement can replace thyroid function.
You need a thyroid to survive. When the gland is surgically removed, the hormones it makes must be replaced. Patients who have a thyroidectomy need to take a synthetic thyroid hormone replacement for the rest of their lives. This medication replaces the function of the thyroid gland and suppresses tumor regrowth.
Radioactive iodine, chemotherapy, and radiation may be used after surgery.
Radioactive iodine is a treatment that uses radiation to destroy remaining cancer cells after surgery. It is used in intermediate or high-risk patients after a surgical procedure to ensure that any remaining thyroid tissue is removed from the body.
External beam radiotherapy and chemotherapy are sometimes used in patients with recurrent disease, cancers that have spread to other parts of the body, or in cases where the tumor cannot be removed surgically.
Thyroid cancer is a very curable disease.
The overall prognosis for patients with thyroid cancer is very promising. The 10-year survival rate for the most common form, papillary thyroid cancer, is 93 percent.
Knowing the risk factors can help with prevention.
Thyroid cancer is three times more common in women than in men. The disease tends to affect young people before they turn 30 and then peaks again after age 60. Radiation exposure during childhood and a family history of thyroid cancer in a first-degree relative increases the risk of both benign and malignant thyroid tumors. Smoking, obesity, alcohol consumption, and being diagnosed with uterine fibroids have also been associated with an increased risk of thyroid nodules.