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Q&A: How to identify, treat thyroid cancer
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Cases of thyroid cancer are increasing, according to the American Cancer Society.
In 2018, the society estimates that 54,000 new cases will be diagnosed, mainly in women (75%).
With September designated as Thyroid Cancer Awareness Month, Healio Internal Medicine spoke with Erin Buczek, MD, assistant professor in the department of otolaryngology at the University of Alabama at Birmingham, about the symptoms, risk factors, causes, preventive measures and treatments for thyroid cancer. – by Alaina Tedesco
Question: What are signs and symptoms of thyroid cancer?
Answer: Thyroid cancer can present as a neck mass — either in the lower part of the neck or as a lymph node along the side of the neck — trouble swallowing, hoarse voice or pain in the neck.
It can also be completely asymptomatic and picked up at a routine physical exam or on imaging for other medical problems.
A: Risk factors include history of radiation to the neck in the past, gender (women are three times more likely to get thyroid cancer than men), age (often presents in women aged 40 to 50 years and in men aged 60 to 70 years) and a low iodine diet. This is much less common in the United States but is associated with follicular thyroid carcinoma.
Some thyroid cancers are associated with genetic syndromes such as multiple endocrine neoplasia which are associated with medullary thyroid cancer and other genetic syndromes. Having a first-degree relative with a history of thyroid cancer also increases the risk.
Q: What are the causes of thyroid cancer?
A: Most thyroid cancers are caused by genetic abnormalities that are either acquired — occur throughout our lifetime — or inherited from parents. Specifically, mutations in the BRAF, RET/PTC, RET and RAS genes are associated with different types of thyroid cancers.
Q: How can thyroid cancer be prevented?
A: If a patient has a family history of thyroid cancer, particularly medullary thyroid carcinoma, genetic testing can be performed on the family. If the cancer is caused by multiple endocrine neoplasia syndrome or other high-risk genetic syndromes, prophylactic thyroid surgery is usually recommended for young children to prevent them from developing thyroid cancer. Aside from this group, most thyroid cancers are not preventable but can be caught early.
Q: What are the treatment options for thyroid cancer?
A: Treatment for thyroid cancer usually begins with surgery to remove the thyroid gland and possibly lymph nodes around the gland. Other treatments may include radioactive iodine which is taken up by thyroid cells, external beam radiation or chemotherapy for more advanced cases.
Disclosure: Buczek reports no relevant financial disclosures.