15 Thyroid Cancer Facts Everyone Should Know
Save your neck
If you're relatively young and otherwise healthy, you may not be too concerned with the "c" word. But I know from experience that thyroid cancer can blindside you: at age 33, I was diagnosed with the disease after my doctor discovered a lump in my neck at a routine annual physical. Here's what you should know.
2 in 3 cases are in people younger than 55
Women are more at risk
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Symptoms can be sneaky
I never noticed the lump in my neck until my doctor slid my fingers over it and asked, "How did you not feel this?" I remember telling her that no one ever suggested I check my neck. I was only in the habit of doing a self-exam on my breasts. When I paid more attention in the mirror, I could actually see the lump move when I swallowed. The oncologist immediately picked up on my hoarse voice, the result of the mass pressing on my trachea and vocal cords. He also asked me if I had any trouble swallowing in the past few months. I did, but never guessed that it was related to my thyroid.
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There's more than one type of thyroid cancer
There are several subtypes of papillary carcinoma, one being what I have: papillary-follicular variant. This unique type of cancer is found in about 25% of patientsit seems to present and behave in a more aggressive fashion and has a higher rate of central nodal metastasis (meaning it spreads from the thyroid to the closest lymph node, usually in the throat). When found early, this subtype has a good prognosis. (It does! I'm proof!)
The less-common types of thyroid cancer
Next is medullary thyroid carcinoma, accounting for 4% of cases. This type grows in C cells, so-called because they normally produce calcitonin, a hormone involved in calcium metabolism. It is easier to control and treat if it's caught early on before it has a chance to spread to other parts of the body.
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The rare and more aggressive forms of thyroid cancer
Anaplastic carcinoma makes up 2% of all thyroid cancer cases, and was made famous by the 2012 bestseller The Fault In Our Stars ($11; amazon.com ) (the main character, a teen with this cancer, was played by Shailene Woodley in the movie). It is thought to sometimes develop from an existing papillary or follicular cancer. This cancer often spreads quickly into the neck and to other parts of the body, and is very hard to treat.
Thyroid lymphoma is also a rare form of thyroid cancer that begins in the immune system cells in the thyroid and grows very quickly. Thyroid lymphoma typically occurs in older adults.
There are thyroid cancer risk factors
This is interesting to me because at 14, I was diagnosed with severe scoliosis (the abnormal curvature of the spin.) I underwent dozens of X-rays of my neck and spinal cord during diagnosis, treatment, and prognosis. Did that radiation exposure give me cancer? I can only speculate.
Other risk factors include nuclear power plant accidents or weapons testing, a diet low in iodine (not a risk for most Americans), family history, and genetics.
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Ultrasounds help diagnose thyroid cancer
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PET scans also help diagnose thyroid cancer
I had a PET scan before and after treatment. The 40-minute test took place on a table and scanned my entire body. I hated that I needed to remain completely still throughout the test, nor did I like when a metal plate hovered just an inch from my face.
Most treatments coincide, but surgery is first
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Thyroidectomy leads to lifetime of meds
Radioactive iodine treatment is common
Before undergoing this type of therapy, patients are advised to go on a low iodine diet to ultimately starve their body of iodine, an element that is essential for the production of thyroid hormone. When iodine is reintroduced through RAI it will kill remaining thyroid tissue and cancer cells. "Think of thyroid tissue like a sponge," says Dr. Sherman. "For a sponge to soak up a maximum amount of water, first it must be wrung out of all the water it already contained."
Chemo and external beam radiation therapy aren't as common
Another treatment is called "alcohol ablation." This involves injecting small thyroid cancers with alcohol using guided ultrasound imaging to ensure precise placement of the injection. "This treatment is helpful for treating cancer that occurs in areas that aren't easily accessible during surgery and is not widely used to treat thyroid cancer," says Dr. Dao.
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