Doctors Say These Are the Signs of Thyroid Cancer, Including Lump in Throat
Each year an estimated 43,800 new cases of thyroid cancer are detected and an average of 2,230 die from the disease, according to the American Cancer Society. Until recently, the number of cases were increasing steadily and the ASC states, "Much of this rise appears to be the result of the use of more sensitive diagnostic procedures, such as CT or MRI scans (done for other medical problems), which can detect incidental small thyroid nodules that might not otherwise have been found in the past."
Unlike other cancers, thyroid cancer isn't one disease. The National Cancer Institute states, "There are several different types of thyroid cancer (based in part on the type of cell in the thyroid that the cancer began in), and each type can have very different prognoses. For example, few people with anaplastic thyroid cancer, a very rare but aggressive type, will live for even a year. But almost everyone diagnosed with a small papillary thyroid cancer will be alive 5 years after diagnosis."
The good news is, thyroid cancer is successfully treatable and there are ways to help reduce the risk. "Thyroid cancer is very treatable (with surgery) and most types of thyroid cancer are unlikely to cause significant harm," Dr. T.K. Pandian, Washington University surgeon at Siteman Cancer Center tells us. "However, it is still a cancer and therefore, it should be taken seriously and a treatment plan should be established in a timely fashion after diagnosis."
Why the Thyroid is so Important
Dr. Ben Bikman, Metabolic Research Scientist, Author, and Co-Founder of HLTH Code tells us. "The thyroid gland is essential because thyroid hormone is critical to every cell of the body,"The overall effect of thyroid hormone is that it determines the "idle of the engine". In other words, thyroid hormone influences the rate at which cells are doing their jobs. Thyroid hormone has a tremendous impact on metabolism. By increasing the activity of cells, thyroid hormone can dramatically increase metabolic rate. In fact, this effect is so substantial that a person with high thyroid levels will feel hot—the body is working so much faster that it heats up. In contrast, when thyroid hormone levels are low, the body will feel colder, in part, because the cells of the body are slowing down. Thyroid hormone further influences metabolism by directly affecting fat cells. When thyroid levels are high, fat cells have fewer insulin receptors. If a fat cell has less response to insulin, it will naturally break down fat more rapidly, leading to fat loss."
In addition, the thyroid can affect cognitive function, according to Dr. Birkman. "Normal brain function is wholly reliant on thyroid hormone. In fact, low thyroid hormone levels are known to lead to dementia-like symptoms. Thyroid hormone is not only important to the adult brain, but also to the brains of developing babies and children. Insufficient thyroid hormone during development can lead to substantial and irreversible brain damage."
What to Know About Thyroid Cancer
Danny Nguyen, M.D., a board-certified medical oncologist and hematologist practicing at City of Hope Orange County Lennar Foundation Cancer Center in Irvine, California, City of Hope Huntington Beach and City of Hope Irvine Sand Canyon tells us. "Although thyroid cancer is highly treatable, you should still be alert to signs and symptoms. There are also steps you can take to help prevent thyroid cancer, such as eating a healthy diet and avoiding excessive weight gain. Radiation exposure, especially in childhood, is also a known risk factor for thyroid cancer."
Dr. Nguyen says, "Many of us have heard the story of a television viewer who wrote to the news station to warn that the anchorperson reading the news might have thyroid cancer. The viewer said she saw a lump on the news reporter's neck, which the reporter herself had never noticed. Although sensational, the story doesn't surprise most doctors. Thyroid cancer typically goes unnoticed. Generally, the disease is asymptomatic with the exception of an occasional small lump –or nodule –on the neck. The good news is that thyroid cancer tends to be slow moving, and the prognosis for long-term survival is generally very good."
Chemo is Seldom Effective with Thyroid Cancer
Dr. Pandian says, "The exact answer to this question is not entirely known. Most other types of cancer (lung, breast, colon, etc.) are generally faster growing than thyroid cancer. Chemotherapy is usually more effective against cells that grow and divide rapidly. Thyroid cancers are very "indolent" or slow growing and it is possible this is why chemotherapy is not all that effective. Chemotherapy and immunotherapy can sometimes be used for rare and aggressive types of thyroid cancer."
Dr. Nguyen explains, "Chemotherapy is seldom used for most types of thyroid cancer because it is unnecessary. However, fast-growing thyroid cancers, such anaplastic thyroid cancer, may be treated with chemotherapy. It is often combined with external beam radiation therapy for these rare cases and sometimes used for other advanced cancers. Surgery is the most common treatment for thyroid cancer. These procedures tend to be highly effective as most thyroid cancers are very curable. The most common types of thyroid cancer — papillary and follicular cancers — have a more than 98% cure rate if they're caught and treated at an early stage."
Dr. Brian Lawenda, Radiation Oncologist with GenesisCare explains, "There are several different treatment options for thyroid cancer, including total thyroidectomy (removal of the entire thyroid gland), partial thyroidectomy (removal of part of the thyroid gland), surveillance (close monitoring of the cancer without active treatment), postoperative radioactive iodine (RAI) therapy, biological targeted drugs, chemotherapy, and radiation therapy. Chemotherapy is not commonly used to treat thyroid cancer because it is not as effective as other treatments, such as surgery and RAI therapy. In situations where cancer has not spread throughout the entire thyroid, a surgeon may opt to only remove the half of the thyroid containing cancer cells.
Alternatively, if the cancer has spread to other parts of the body, then radiation therapy, medication, and chemotherapy may be more effective treatment alternatives. Which treatment or mix of treatments should be used can be different for each person, as it is dependent on their independent risk factors and family history. RAI therapy is often recommended for patients with papillary or follicular thyroid cancer that is localized to the neck or has spread to other parts of the body. However, patients with very low risk thyroid cancers may not need RAI therapy. Imaging studies, such as ultrasound, CT scan, radioactive iodine imaging, PET imaging or MRI, may be ordered to stage thyroid cancer and determine the best treatment plan."
Signs of Thyroid Cancer
Dr. Nguyen emphasizes, "As noted earlier, most thyroid cancers don't cause any signs or symptoms early in the disease. As thyroid cancer grows, it may cause a lump –or nodule –that can be felt through the skin on the neck. Sometimes, people also feel that their shirt collars are too tight or notice changes in their voice and hoarseness, difficulty swallowing, swollen lymph nodes or pain in the neck and throat. If any of these symptoms are concerning you, it's important to see a doctor."
According to Dr. Lawenda, "The key indicators or symptoms of thyroid cancer include:
- A firm, difficult-to-move lump in the throat area that grows over time.
- Pain when swallowing that persists for an unusual amount of time.
- Hoarseness, or any other changes in your voice, that persist for an unusually long period of time.
- A persistent cough that won't go away
- Pain in the front of the neck that spreads up to the ears.
Many of these symptoms can be indicative of other illnesses, and therefore it is important to consult with a physician to receive a precise diagnosis."
Women are at a Higher Risk
According to Dr. Nguyen, "Thyroid cancers occur about three times more often in women than in men. It can occur at any age, but women ages 40-50 are most at risk, while men are more at risk in their 60s and 70s. It is most common among people of Caucasian descent."
Dr. Lawenda adds, "Women are far more likely to develop thyroid cancer than men. The most common age demographic in which thyroid cancer is diagnosed is between the ages of 45-64, but women are more likely to be diagnosed with thyroid cancer between 20-34."
Complications and Risks for Thyroid Cancer Surgery
According to Dr. Nguyen, "Complications are rare, but they include bleeding post-surgery, injury to the larynx, which could cause hoarseness or respiratory distress, and damage to the parathyroid glands that could lead to low levels of calcium in your blood. This is usually temporary if damage does occur."
Dr. Lawenda says, "Much like for any surgical procedure, there are inherent risks involved when removing the thyroid as part of a cancer treatment program. Complications of thyroid cancer surgery can include damage to the parathyroid glands, which can lead to low calcium levels in the body, and damage to the vocal cords, which can cause changes in the voice. Other complications of thyroid surgery include bleeding, infection, and damage to the nerves that control the vocal cords. Side effects of RAI therapy can include nausea, vomiting, and dry mouth."
Dr. Pandian adds, "Overall, thyroid cancer surgery has very low risk. One risk is possible irritation or injury to the nerves that control the vocal cords, called the recurrent laryngeal nerves. Irritation or injury of one of these nerves could lead to severe hoarseness, although if irritation occurs it is usually only temporary. Another risk is related to irritation or injury to small glands near the thyroid called parathyroids. These glands help keep the blood calcium level normal. If the entire thyroid is removed, the parathyroid glands can be temporarily stunned causing calcium levels to be low temporarily. It would be very rare for thyroid surgery to lead to permanent low calcium as a result of parathyroid dysfunction."
Eating Excess Fat Might be Associated with Thyroid Cancer
Dr. Nguyen says, "The issue appears to be that an excess of fat may cause weight gain and obesity, which is linked to thyroid cancer risk. Studies have shown that increasing body mass and body fat percentage are significantly related to an increased risk of papillary thyroid cancer, one of the most common types of the disease."
Dr. Lawenda tells us, "There is limited evidence to suggest that diet may play a role in the development of thyroid cancer. Some studies have found that a diet high in vegetables, fruits, and whole grains may be associated with a lower risk of thyroid cancer, while a diet high in processed meats and salt may be associated with a higher risk of thyroid cancer. However, more research is needed to understand the relationship between diet and thyroid cancer. It is important to note that diet is just one factor that may influence the risk of developing thyroid cancer and that other factors, such as genetics, environmental exposures, and lifestyle factors, also play a role."
Dr. Pandian shares, "While eating excess fat in and of itself is not exactly associated with thyroid cancer, being overweight and having excess body fat can be harmful. In other words, eating one fatty meal does not by itself increase someone's risk of thyroid cancer, but over time, if eating excess fat leads to obesity, this can be a problem. More and more evidence does seem to show that obesity increases the risk of thyroid cancer. It should be noted that excess fat in the body and obesity are associated with increased risk of all cancer types. The exact mechanism of why this occurs is not entirely known but may be due to increased inflammation due to having more fat in the body. Having excess fat can also increase an individual's risk for several other health problems (diabetes, high blood pressure, etc.) which can then in turn, lead to complications while undergoing surgery or other treatments for cancers."