Thyroid cancer

Most thyroid lumps are not cancer, but it’s important to see your doctor to be sure. If a lump is cancerous, specialists at Atrium Health Floyd and Harbin Clinic offer skilled care, guidance and support. Our accreditation as a Comprehensive Community Cancer Program means we’re with you at every step, from diagnosis and treatment to follow-up care.

What is thyroid cancer?

Thyroid cancer develops in the tissues of the thyroid gland, a butterfly-shaped structure at the base of your throat. The two wings, or lobes, of the thyroid sit on either side of your windpipe, connected by a thin piece of tissue (isthmus).

Your thyroid gland makes hormones that regulate essential body functions such as:

• Blood pressure
• Body temperature
• Breathing
• Heart rate
• Metabolism

Thyroid cancer types

There are several types and subtypes of thyroid cancer. Papillary thyroid cancer is the most common type, making up about 80% of thyroid cancers. This slow-growing cancer usually develops on one side of the thyroid and is highly treatable.

Doctors classify papillary thyroid cancer as a differentiated cancer because the cells look similar to healthy thyroid cells. In general, differentiated cancers have a better outlook than nondifferentiated cancers.

Follicular thyroid cancer is the other type of differentiated thyroid cancer. It accounts for about 10% of thyroid cancers. Although follicular thyroid cancer can spread to other areas of the body, treatment is often successful.

Two of the other main types of thyroid cancer are medullary thyroid cancer and anaplastic thyroid cancer. They are much less common but are often harder to treat.

Causes of thyroid cancer

Thyroid cancer happens when genetic changes lead to an increase in cell growth. Doctors have identified some of these genetic changes and risk factors that make them more likely. But what causes them is unclear.

Thyroid cancer symptoms

The most common symptom of thyroid cancer is swelling or a lump (nodule) in your neck. You may notice it on your own, or your doctor may find it during a routine physical exam. Some thyroid cancers are found on imaging tests done for other reasons.

Other thyroid cancer symptoms include:

• Difficulty breathing or swallowing
• Hoarseness
• Pain in your neck, jaw or ear
• Persistent cough

Thyroid cancer diagnosis

Most of the time, thyroid enlargement and thyroid nodules are not cancer. To find out the cause of these changes, your doctor will examine you and ask about other symptoms. They will review your medical and family history and order one or more tests.

Common tests used to diagnose thyroid cancer include:

• Blood tests to evaluate thyroid function
• Ultrasound imaging to look at your thyroid
• Biopsy to remove a small tissue sample to check for cancer cells

Your doctor may order other imaging tests to further evaluate the thyroid and rule out other thyroid conditions. Imaging tests can also determine if cancer has spread to nearby lymph nodes or other areas of your body.

Thyroid cancer risk factors

Risk factors for thyroid cancer include:

• Age between 30 and 69
• Family history of thyroid cancer
• Female sex
• Inherited conditions, such as multiple endocrine neoplasia type 2, familial adenomatous polyposis and Cowden syndrome
• Obesity
• Radiation exposure to the head or neck as a child

Thyroid cancer prevention

For most people, thyroid cancer is not preventable. One area of prevention is limiting childhood exposure to radiation from medical imaging tests. Doctors try to limit imaging tests in children. When needed, they use the lowest radiation doses possible.

If you have a family history of thyroid cancer or known genetic changes, you also have options to reduce your risk. Your doctor may recommend frequent checks to catch thyroid changes early or proactive removal of your thyroid gland.

Thyroid cancer treatment

Thyroid cancer treatment depends on the cancer type and stage. Staging is the process doctors use to find out how serious the cancer is. It considers tumor size and whether cancer has spread to nearby or distant tissues. Thyroid cancer stages range from 0 (least advanced) to IV (most advanced).

Surgery to remove all or part of your thyroid is usually the first step in thyroid cancer treatment. If surgery causes low thyroid hormone levels, you’ll need daily hormone therapy to maintain your health.

Radioactive iodine therapy is often used after surgery. Your thyroid uses iodine to make hormones. Radioactive iodine can help destroy thyroid tissue remaining after surgery or if cancer has spread outside the thyroid.

If surgery and radioactive iodine therapy are not effective or if cancer has returned, your care team may recommend:

• Chemotherapy and other medications, such as targeted therapy
• Radiation therapy