Understanding Thyroid Cancer: Recognizing Symptoms, Causes, Diagnosis, Treatment, and Complications

Thyroid-related conditions are prevalent globally, with the majority being benign and non-threatening. However, malignant thyroid diseases, accounting for approximately 5% of cases, can manifest as thyroid hypertrophy. Various forms of thyroid cancer exist, with thyroid papillary carcinoma being the most common, alongside follicular carcinoma, medullary carcinoma, anaplastic carcinoma, lymphoma, and other less frequent types.

1. Recognizing Symptoms of Thyroid Cancer

The primary symptom of thyroid cancer is swelling in the neck, often linked to the enlargement of neck nodes. Patients may experience weight gain, reduced appetite, diminished perspiration, cold sensitivity, and other hypothyroidism-related symptoms. Factors such as a family history of thyroid issues, a history of radiation exposure during childhood, or a sudden increase in the size of a long-standing thyroid enlargement may indicate thyroid cancer. Severe cases can lead to breathing or swallowing difficulties, vocal hoarseness, and bone discomfort or fractures in distant areas if the cancer has spread.

2. Understanding Causes of Thyroid Cancer

Dr. Akshat Malik, Head & Neck Cancer Surgeon at Max Super Specialty Hospital, Saket, New Delhi, notes that the causes of thyroid cancer vary depending on the type. Papillary carcinoma is associated with radiation exposure during childhood, a family history of thyroid cancer, and specific genetic mutations. Medullary carcinoma may have a familial link in 25% of cases. Iodine-deficient regions are more prone to lymphoma and follicular cancer, while anaplastic cancer results from persistent thyroid swellings. Thyroid cancers are more common in women, especially those aged 40 to 50.

3. Diagnosis and Evaluation of Thyroid Cancer

Comprehensive clinical evaluations for thyroid cancer patients involve assessing the size and extent of the swelling, examining the vocal cords' condition using an endoscope, and conducting thyroid function tests. Neck ultrasonography and fine needle aspiration cytology (FNAC) help determine the type and extent of edema and identify cancer cells. Additional imaging such as CT scans, PET scans, or bone scans may be necessary to assess the spread of cancer.

4. Treatment Approaches for Thyroid Cancer

Thyroid cancer treatment is tailored to factors like lesion size, age, sex, and the presence of distant or lymph node tumors. Surgery is often the preferred treatment, with options including hemi-thyroidectomy or total thyroidectomy, depending on the extent of gland involvement. Removal of neck lymph nodes may also be necessary.

5. Complications Associated with Thyroid Cancer Treatment

Post-thyroid surgery complications may include vocal cord palsy and hypocalcemia. Vocal cord damage during surgery can result in transient or persistent hoarseness. Hypocalcemia, a drop in blood calcium levels, may occur if blood flow to the parathyroid glands is compromised, requiring calcium supplements. Patients who undergo a total thyroidectomy may need lifelong thyroid hormone supplements. Thyroid cancer, generally associated with favorable survival rates, requires regular follow-ups to monitor for recurrence or residual illness using markers like thyroglobulin, ultrasonography, and clinical examinations.

In summary, understanding the symptoms, causes, diagnosis, treatment, and potential complications associated with thyroid cancer is crucial for effective management and patient care.