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thyroid cancer

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Definition
The thyroid gland produces chemicals that regulate how the body uses energy. Thyroid cancer develops in the tissue of the thyroid gland. It is not very common. Death from thyroid cancer is unusual, especially in young people. Thyroid cancer is found twice as often in women.

There are several types of thyroid cancer.
  • Papillary is the most common and has the best outlook for cure.
  • Follicular is less common but is also easy to treat.
  • Medullary is uncommon and is more difficult to treat.
  • Anaplastic is the least common and difficult to treat.
What is going on in the body? 
The thyroid gland continues to function normally even when the cancer has taken up part of the thyroid. The cancer may spread, or metastasise, to other parts of the body. Those parts may show damage from the cancer.

What are the signs and symptoms of the disease? 
The only symptom may be a lump growing on the neck. It can become large and press on the throat. When that happens, the person may become hoarse and have difficulty swallowing.

What are the causes and risks of the disease? 
In most cases, the cause of thyroid cancer is unknown. The risk is increased if the neck is exposed to radiation from any source. This happens very rarely. Some families tend to develop thyroid and other cancers. This is also rare. Countries where the iodine content in the food supply is either low or high also show increased risk for thyroid cancer.

What can be done to prevent the disease? 
Nothing can be done to prevent thyroid cancer except to avoid exposure to radiation.

How is the disease diagnosed? 
If a person has a lump growing on the neck near the thyroid gland, a doctor may suspect cancer. Special x-rays can show that the lump might be cancerous but cannot prove it. A biopsy is done to remove tissue from the lump for examination in the laboratory. Recent research has shown that the development of thyroid cancer may be related to a genetic problem. Because of this, genetic testing may be done if person has other family members with thyroid or similar cancers.

What are the long-term effects of the disease? 
Untreated cancer will cause death. A person who undergoes successful treatment will be able to live a normal life. The cure rate for this cancer is very high.

What are the risks to others? 
Thyroid cancer poses no risks to others.

What are the treatments for the disease? 
There are several treatments that may be used, depending on the extent of the cancer:
  • surgery. The cancerous tissue must be removed. Often the whole thyroid gland will be removed. Tissue around the thyroid may also be removed.
  • internal radiation. In certain cases after surgery, a radioactive substance or isotope, such as iodine-131, may be given in a drink. Any remaining cancerous tissue will absorb the isotope. The isotope will then kill this tissue.
  • other treatments such as chemotherapy and external radiation therapy for cancers that are difficult to treat
What are the side effects of the treatments? 
The side effects depend on the treatment given:
  • Persons who have surgery to remove the thyroid gland need to take thyroid hormones for the rest of their lives.
  • Radioactive isotopes cause weakness, nausea, and fatigue. These side effects do not last long. There are usually no long-term effects.
  • Chemotherapy can cause several different side effects depending on which medications are used.
  • External radiation therapy causes side effects that depend on the area of the neck that is treated. Effects may include skin irritations, dry mouth, difficulty swallowing, and loss of appetite.
What happens after treatment for the disease? 
The person will need to be monitored for many years to make sure the cancer has not come back. The daily dose of thyroid hormones may need to be adjusted. Otherwise the person can expect to live a normal life.

How is the disease monitored? 
CT scans, thyroid scans, and chest x-rays will be performed to check and see if the cancer has come back. Thyroid function blood tests will be done to make sure the dose of thyroid hormone is correct.

Author: Miriam P. Rogers, EdD, RN, AOCN, CNS
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 21/03/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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