Definition

Thyroid carcinoma is the abnormal growth of cells in the thyroid gland, resulting in a tumor or cancer. The thyroid is a butterfly-shaped gland located in the neck, below the Adam's apple. It produces hormones that regulate heart rate, blood pressure, body temperature, and weight.

Causes

Thyroid carcinoma occurs when there are changes in the DNA structure of thyroid gland cells. DNA regulates cell activity, including cell growth and related tissues. Mutations in DNA instruct cells to grow and multiply uncontrollably, outpacing normal cell turnover. These cells persist when healthy cells would normally die, forming a mass known as a tumor.

The tumor can invade surrounding tissues and may metastasize to lymph nodes or other organs, particularly those in the neck. Occasionally, cancer cells may spread to other organs, such as the lungs, bones, or other parts of the body. The exact cause of DNA mutations leading to thyroid cancer is often unclear.

Risk Factor

Risk factors for thyroid carcinoma include:

• Gender: Thyroid cancer is more common in women, possibly related to naturally higher levels of estrogen.
• High radiation exposure: Radiation therapy to the head and neck increases the risk of thyroid cancer.
• Genetic abnormalities: Certain genetic conditions may elevate the risk.

Symptoms

Thyroid carcinoma may be asymptomatic in its early stages. As it progresses, symptoms may include:

• A palpable lump in the neck.
• A sensation of tightness around the collar area.
• Voice changes, including persistent hoarseness.
• Difficulty swallowing.
• Swelling of lymph nodes in the neck.
• Pain in the neck and throat.

Diagnosis

Diagnostic procedures for thyroid cancer include:

• Physicalt examination: The doctor will palpate the neck to detect changes in the thyroid, such as lumps, and inquire about risk factors, such as radiation exposure and family history of thyroid cancer.
• Laboratory tests: Blood tests to assess thyroid function by measuring levels of thyroid-stimulating hormone (TSH) and thyroid hormones can provide insights into thyroid health.
• Ultrasound: Uses high-frequency sound waves to create images of body structures. If a lump is suspected to be malignant, additional tests may be required to confirm the diagnosis and type of thyroid cancer. Ultrasound can also be used to examine lymph nodes for cancer signs.
• Biopsy: During fine-needle aspiration, a thin needle is inserted into the thyroid lump to collect a sample for laboratory analysis. A pathologist examines the sample under a microscope to determine the presence of cancer. Additional biopsy procedures or surgery may be recommended for further examination.
• Radiological scans with racers: Radioactive iodine scans use radioactive iodine and special cameras to detect thyroid cancer cells. This procedure is often used after surgery to find any remaining cancer cells and is particularly useful for papillary and follicular thyroid cancers.
• Other imaging studies: Various scans, including ultrasound, CT, and MRI, may be performed to assess whether the cancer has spread beyond the thyroid.
• Genetic testing: Medullary thyroid cancer may be caused by inherited genes. If diagnosed with this type, genetic counseling and testing may be recommended to assess cancer risk and its implications for your family.

Management

Treatment options for thyroid carcinoma depend on the type, stage, overall health, and patient preferences. Most people diagnosed with thyroid cancer have a very favorable prognosis, as many cases can be treated successfully.

Small, low-risk papillary thyroid cancers may not require immediate treatment. Instead, regular monitoring with blood tests and neck ultrasounds may be recommended. In some cases, the cancer may not grow and may not require any treatment.

• Surgery: Most patients will undergo surgery to remove part or all of the thyroid gland. The type of surgery depends on the cancer type, size, and whether it has spread beyond the thyroid to lymph nodes.
• Thyroid hormone therapy: This therapy replaces or supplements the hormones produced by the thyroid, usually given after thyroid removal surgery.
• Radioactive iodine therapy: Uses radioactive iodine to kill remaining thyroid cells and cancer cells after surgery.
• Alcohol ablation therapy: Involves injecting alcohol into the cancerous tissue.
• Advanced cancer therapy: Aggressive thyroid cancers that grow rapidly may require additional treatments, including:

• • Targeted drug therapy: Focuses on specific chemicals in cancer cells to inhibit their growth, particularly effective for cancers that have spread to the lungs, liver, and bones.
  • Radiation therapy: Uses high-energy radiation, such as X-rays, to kill cancer cells, recommended if other treatments are ineffective or if there is a recurrence.
  • Chemotherapy: Uses chemicals to kill cancer cells.

Complications

Complications of thyroid carcinoma may include:

• Recurrence: Thyroid carcinoma can recur even after treatment, particularly if cancer cells spread beyond the thyroid before its removal. While recurrence is uncommon, it is more likely with aggressive cancers or if the cancer grows beyond the thyroid. Recurrence usually occurs within five years of the initial diagnosis but can often be treated successfully.
• Metastasis: Thyroid cancer may spread to nearby lymph nodes or other body parts, such as the lungs, bones, brain, liver, or skin. Most thyroid cancers do not spread, but when they do, common sites include:

• Lymph nodes in the neck
• Lungs
• Bones
• Brain
• Liver
• Skin

Prevention

Since the exact cause of genetic changes in thyroid carcinoma is unknown, there is no definitive way to prevent it. However, adults and children with inherited genetic risks for medullary thyroid cancer may consider thyroid surgery to prevent cancer. Consult with a genetic counselor to discuss your risks and preventive options.

When to See a Doctor?

Consult a doctor if you experience any concerning symptoms or signs.

Looking for more information about other diseases? Click here!