Description

Overview 

Thyroid gland is a small organ with a bridge-like
structure called isthmus, which connects two lobes, located at the base of the
anterior neck.

The thyroid gland produces hormones that regulate the metabolism of your
body. The elevation of thyroid hormones (hyperthyroidism)
are manifested by high heart rate, excessive sweating, heat intolerance, muscle
weakness, overactive bowel and accelerated metabolism, such as tremor.  Hypothyroidism, characterized by low thyroid hormones, is, as can be
expected, characterized by a slowed down metabolism. While the thyroid gland regulates the body metabolism, the pituitary gland
in our brain produces and secretes hormones that regulate the amount of
hormones secreted by the thyroid gland.

Risk Factors:

Etiology of the thyroid cancer is not completely understood. Factors that increase the risk of thyroid cancer include being a woman,
exposure to high radiation, and certain inherited genetic diseases.

Types:

Papillary cancer:papillary cancer accounts for a substantial part of
all thyroid cancers. They originate from follicular cells that produce hormone in the thyroid
gland. It is usually benign in nature and the prognosis becomes poor, when it
spreads to other organs of the body.

Follicular cancer:It is the second most common type of the thyroid
cancer. Quicker spread and higher risk of recurrence are remarkable properties.

Medullar cancer:this type of thyroid cancer originates from C cells
that secrete the hormone calcitonin in the thyroid gland. It can be detected at an early state due to elevation
of calcitonin in blood. This cancer requires removal of the thyroid gland.

Anaplastic cancer:although it is the least common type of thyroid
cancer, it grows very quickly and the treatment is challenging. It is mostly seen in people aged 60 or older and
removal of the gland may be necessary, as its quick growth makes breathing
difficult.

Symptoms:

Thyroid cancer may not show any symptom at the early stage. Following symptoms can be manifested at advanced stages:

• A lump on neck
• Pain in throat and neck
• Hoarseness
• Difficulty swallowing
• Difficulty in breathing
• >Enlarged lymph nodes in neck

Prevention:

As is the case for all other cancers, prevention of thyroid cancer is also
to eliminate or minimize manageable risks. Excluding radiation and genetic factors, the basic approach includes
healthy lifestyle recommendations healthy nutrition, regular exercise and
etc.), as the causes of thyroid cancer are not exactly known.

Thyroid cancer may develop in a part of thyroid nodules and therefore,
thyroid examinations and screening are important. In the presence of these nodules, one should consult an endocrinologist as
soon as possible.

Diagnosis:

If the physical examination and the imaging studies (CT, MRI, PET) that are
ordered to investigate findings suspicious for thyroid cancer show a mass,
provisional diagnosis is made. If family
history is notable for thyroid cancer, genetic tests may be required to
determine the risk of cancer. Blood tests may
also give clues about the irregularities in the thyroid gland. The definitive diagnosis of the thyroid cancer requires biopsy.

Treatment:

After the diagnosis of thyroid cancer is made, the next step is to
determine the stage. Your doctor will determine stage (I to IV) of your
cancer based on a set of very strict criteria.  You may think that thyroid cancer is very broadly staged as local, limited
or regional and distant.

Generally cancer phases are symbolized with Roman numbers I to IV. The phase IV is the last phase and the most severe cancer. A personalized treatment is planned for each patient by considering stage,
age, general health status and personal preferences.

For the thyroid cancer, the treatment options include chemotherapy, hormone
therapy, iodine therapy, radiotherapy, targeted therapy and surgery. While these treatments are used to cure the tumor, they can be used to
increase quality of life and to ease the severity of the symptoms in advanced
stages. Moreover, the treatment options can be used together
or alone.

Chemotherapy

Chemotherapy uses drugs to cure cancer. The active ingredients in these drugs kill cancer cells. Chemotherapy drugs can be administered intravenously or by mouth. If the drug is administrated through a vein, a thin tube, called a
catheter, is inserted into a large vein and chemotherapy drug is delivered from
this catheter throughout the course of the treatment.

One or more chemotherapy medicines may be administered according to the
response of the cancer to the treatment and the type of cancer. After chemotherapy is given for a certain period, treatment is paused. After the completion of this defined “break” period, treatment resumes. Each of these periods is called cycle.

Targeted Therapy

Targeted therapies are newer anti-cancer treatments compared to
chemotherapy. These medicines target specific abnormalities that are
present in cancerous cells. Before these
medicines are started, cancer cells are first analyzed in laboratories to
determine whether they have particular mutations or not.

Radiotherapy

Radiation therapy aims to kill cancer cells by using high-powered energy
beams.

If the radiation source is out of the body and beams are directed to
cancer, this treatment is called external radiotherapy.  On the other hand, if the radioactive agent is put into the area that
cancer is present by a needle or catheter, method is called internal
radiotherapy (brachytheraphy).

Although radiation therapy can also be used as first order therapy of
cancer, generally it is used to kill cells that are not removed by surgery. In the first-line treatment, mostly radiotherapy and chemotherapy are
administered together and this treatment is also known as chemoradiotheraphy. In advanced stage cancers, it plays an important role in relieving or
removing the symptoms.

Surgery:

As a result of your surgeon’s evaluation, your thyroid
gland can be entirely removed (total thyroidectomy), or one lobe of the thyroid
gland can be removed (lobectomy).

When the entire thyroid gland is removed (total
thyroidectomy), you will need to use thyroid hormone pills in the rest of your
life.

Your surgeon makes an incision on the neck base to
expose the thyroid gland. Total thyroidectomy or lobectomy is performed according to the preoperative
planning. In total lobectomy, thyroid tissue surrounding the parathyroid glands may
not be removed. This approach is commonly referred to as near total thyroidectomy. No matter how much of the thyroid gland is removed,
your surgeon removes the enlarged lymph nodes in the neck.

Asking
your questions about the treatment of the thyroid cancer, your life after
treatment, rehabilitation, pain management, clinical studies and all the
questions in your mind about the thyroid cancer to your doctor will help you
for an informed participation to your treatment and alleviating your concerns.