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Thyroid Cancer

While thyroid cancer has a remarkably low mortality rate compared to other cancers, this rate has slightly increased in recent years.

While thyroid cancer has a remarkably low mortality rate compared to other cancers, this rate has slightly increased in recent years.

Overview

In the last 30 years, thyroid cancer has tripled in frequency, perhaps due to a rise in the use of thyroid ultrasounds, which are able to detect small nodules that otherwise wouldn’t have been found1https://www.cancer.org/cancer/thyroid-cancer/about/key-statistics.html.

About 80% of thyroid cancers are papillary cancers, which generally grow very slowly, developing in only one of the thyroid gland’s lobes. They will often spread to the lymph nodes located in the neck, but are rarely fatal2https://www.cancer.org/cancer/thyroid-cancer/about/what-is-thyroid-cancer.html.

Physicians traditionally screen for thyroid cancer using CT scans and MRIs, the former of which can expose you to potentially harmful radiation3https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/what-are-radiation-risks-ct. Furthermore, a 2013 study showed that both CT scans and MRI are useful in assessing how far beyond the original organ a thyroid cancer has spread4https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3613791/.

However, neck palpation and ultrasound are arguably the most effective screening method for thyroid cancer.

Symptoms

Signs and symptoms of thyroid cancer may include5https://www.cancer.org/cancer/thyroid-cancer/detection-diagnosis-staging/signs-symptoms.html:

  • Trouble breathing or swallowing
  • A constant cough not caused by a cold
  • A lump in the neck that could grow quickly
  • Swelling in the neck
  • Hoarseness or other voice changes that don’t go away
  • Pain in the front of the neck that could radiate up to the ears

The above symptoms could also be caused by other neck cancers, or perhaps even benign conditions. 

If you are having any of the above symptoms you need to talk to a doctor about the appropriate diagnostic work up. The Ezra scan is a screening test for asymptomatic individuals and it is not designed to diagnose existing or suspected cancers.

Causes

It is difficult for researchers to pinpoint precisely what causes most cases of thyroid cancer, though they do know that it originates in genetic changes, or mutations, found in the DNA of normal thyroid cells. Sometimes, these mutations can occur in oncogenes or tumor suppressor genes, which are the genes in charge of when cells grow, divide, or die. Such mutations can at least in part be responsible for cancer and can be inherited from one’s parents or be picked up randomly during one’s life. Furthermore, some thyroid cancer risk factors are known to sometimes cause changes specifically in thyroid cell DNA6https://www.cancer.org/cancer/thyroid-cancer/causes-risks-prevention/what-causes.html.

It is, however, known that thyroid cancer is sometimes linked with a handful of inherited genetic conditions:

    • Multiple endocrine neoplasia type 2, which is caused by a mutation in the RET gene
    • Cowden disease, which is caused by defects in the PTEN gene
    • Familial adenomatous polyposis, which is due to defects in the APC gene
    • Carney complex, type 1, which is caused by defects in a gene called PRKAR1A

Some additional risk factors that may increase your likelihood of developing thyroid cancer are:

    • Age: most women who are diagnosed with thyroid cancer are in their 40s or 50s, while most men are in their 60s or 70s
    • Gender: for reasons that are yet to be discovered, women are about three times more likely to develop thyroid cancer than men
    • Radiation exposure
    • Iodine in the diet
    • Family history of thyroid cancer

(Source)

Detection

Thyroid cancer could be detected if you present with symptoms, or simply during a routine physical exam. If there is cause for concern, it is likely that your physician will perform some type of imaging test, each with its own costs and benefits:

Diagnosis

A definitive diagnosis of thyroid cancer can only be made through a biopsy, in which a sample of a portion of the thyroid nodule is removed via a process called fine needle aspiration; these cells are later analyzed in a lab10https://www.cancer.org/cancer/thyroid-cancer/detection-diagnosis-staging/how-diagnosed.html.

Upon diagnosis, physicians will typically describe a cancer using a stage. This helps them assess how serious the case is, and will help inform what treatment route they suggest. Thyroid cancer is most often staged using the TNM system:

  • T is for tumor: how big is the tumor? Has it spread to nearby structures?
  • N is for lymph nodes: has the cancer spread to nearby lymph nodes?
  • M is for metastasis: has the cancer metastasized to distant body parts?

(Source)

Treatment

The best treatment for thyroid cancer depends on the nature of the disease and how far it has spread. Treatment options may include: chemotherapy, radioactive iodine therapy, surgery, targeted therapy, hormone therapy, or external beam radiation therapy11https://www.cancer.org/cancer/thyroid-cancer/treating.html.

Please consult with a physician on treatment options as necessary.

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