Thyroid cancer (Tumours) – Causes, Types & Treatment

The thyroid gland is located just below the voice box (larynx) in the front of the neck. It is a butterfly-shaped gland with two lobes on either side. These lobes are joined by a narrow band of tissue called the isthmus. Being a part of the endocrine gland, it regulates hormones. It produces thyroid hormones that regulate metabolism. The hormones of the thyroid gland regulate weight, body temperature, heart rate and blood pressure.

The thyroid gland contains 2 types of cells

Follicular cells of the thyroid gland produce thyroid hormone. It controls energy utilization, fat burning, weight gain and weight loss, body temperature, heartbeats, movement of food through the digestive tract, muscles contraction and cell growth and development. C cells of the thyroid gland produce calcitonin hormone – which helps in calcium metabolism.

A healthy thyroid gland is hardly noticeable – even difficult to find by touch. But when something goes wrong in the thyroid, it gets noticed and can be found by touch (palpable). A lump appears in the neck. Deficiency or inadequate consumption of iodine results in a swollen or enlarged thyroid. The condition is known as goitre. The condition can also be due to several other causes as well.

Thyroid cancer develops in the thyroid gland when the healthy cells grow abnormally and form a tumour. In the beginning, a thyroid tumour may not cause any symptoms, but grows slowly and causes pain and swelling in the neck.

Thyroid tumours or thyroid nodules are of different types including slowly growing and aggressive types; benign or cancerous (malignant). The cancerous tumour spreads to other parts of the body – whereas benign cancers grow, but do not spread.

Thyroid cancer types

There are five types of thyroid cancers 1. Follicular thyroid cancer. A slow-growing less common type of cancer that develops in the follicular cells. It mostly does not spread to lymph nodes. 2. Papillary thyroid cancer is also a slow-growing most commonly found type of cancer. In the majority of the cases, it is found in only one lobe. It spreads to lymph nodes.

3. Certain types of follicular cells give rise to Hurthle cell cancer. These are invasive types of cancers that spread to lymph nodes. 4. Anaplastic thyroid cancers are a very rare type, but fast-growing with poor differentiation and therefore very difficult to treat. 5. Medullary thyroid cancer (MTC) is a very rare type. They develop from C cells. They do not share any similarity with normal thyroid cells. They can also develop sometimes due to multiple endocrine neoplasia type 2 (MEN2) – a genetic syndrome. Early diagnosis can offer effective treatment. These tumours are mostly hereditary.

Symptoms of Thyroid Tumour

A thyroid tumour may not show any symptoms in the early stages. Initially, if symptoms manifest – the first sign is the appearance of a painless lump in the neck. As the tumour grows, it may cause pain in the throat and neck, swallowing difficulty, changes in the voice, a clearly visible lump in the neck; persistent cough, breathing difficulty and swollen lymph nodes in the neck. However, all these signs and symptoms could be due to other health conditions as well. Therefore, if any of the above signs and symptoms make you nervous, then it is always better to fix an appointment with a specialist doctor (head and neck surgeon).

Causes of Thyroid Tumour

Thyroid cancer causes: There is no clear cause of thyroid cancer. When cells in your thyroid undergo genetic changes, thyroid tumours occur. Gene mutation let the cells to multiply and grow rapidly. As normal cells would die, these cells lose the ability to die. When this happens, they accumulate and form thyroid tumour. The abnormal cells grow and multiply rapidly attacking and invading nearby cells and tissues and spread to other body parts (metastasize).

Diagnosis of Thyroid Cancer

An ENT doctor examines you physically – check your neck and feel the presence of a nodule or lump in the neck. The doctor may ask a few questions regarding previous radiation exposure or a family history of thyroid problems. Subsequently, the doctor orders blood tests to learn about thyroid gland functioning and then recommends an ultrasound to know whether the nodule is benign or cancerous. The doctor will order a CT or MRI to get more details about the lump or nodule and then confirms the diagnosis with a thyroid biopsy test.

Treatment for Thyroid Tumour

Thyroid cancer treatment: If you are diagnosed with thyroid cancer, depending on the stage and type and your overall health the treatment options may vary.

With treatment, most thyroid cancer can be cured.

A low-risk thyroid tumour may not require treatment straight away. When doctors see that there is no risk of spread, then they prefer frequent monitoring of cancer – which includes blood tests and scanning (ultrasound and other scans) once or twice a year. When cancer grows, doctors initiate treatment immediately.

Thyroid cancer surgery is the most common treatment – but it mainly depends on the location, size and nature of cancer – whether it has spread outside the gland. ENT surgeons with a specialization in head and neck surgery decides the type of surgery based on the results of the ultrasound and other radiology tests (CT scans).

Surgeries used to treat thyroid cancer include:

• Thyroidectomy (removal of all or near-total thyroidectomy)
• Thyroid lobectomy (Removal of a portion of the thyroid)
• Lymph node dissection (Removal lymph nodes in the neck)

After thyroidectomy, Doctors give radioactive iodine treatment to destroy any remaining healthy thyroid tissue.

If you have any symptoms and signs that worry you, seek an appointment with Dr Neetu Modgil.