Types of Thyroid Cancer
Thyroid Cancer is divided into several types-
Papillary thyroid cancer: Also known as Papillary Thyroid Carcinoma, Papillary is the most common of the thyroid cancers happen to effect people. In most of the cases, it usually effects children and is marked by an asymptomatic thyroid nodule at the neck region.
Follicular thyroid cancer: Follicular cancer is the disease mostly diagnosed in the middle age group of people. Alarming fact about Follicular cancer is, it has the potential to spread to other parts of the body like bones and lungs.
Medullary thyroid cancer: It is one of the rare types of thyroid cancers and is usually caused by inherited faulty genes within a family. Medullary thyroid cancer is characterized as a hard mass accompanied by blood vessel invasions.
Anaplastic Thyroid cancer: Older people are more prone to be getting infected with this type of cancer. Anaplastic thyroid is also highly common in women.
Thyroid Lymphoma: Effecting the immune system cells of the thyroid gland, Thyroid Lymphoma cancer usually targets people over 70 years of age.
Causes of Thyroid cancer
A number of inherited conditions of the human body like exposure to radiation, family history of goiter and low levels of iodine can somewhat describe the causes of thyroid cancer. However, the picture is still not clear as in what triggers such changes in the normally functioning of cells.
Symptoms of Thyroid Cancer
There are a lot of symptoms that can be the possible signs of thyroid cancer. Such symptoms are mentioned below:
Swelling in the neck
Lump in the neck sometimes growing quickly
Trouble in swallowing
Trouble in breathing
Pain in the front of the neck, sometimes going up to the ears
Hoarseness or change in the texture of voice that do not go away
Constant cough that is not due to cold
If you come across anyone of them, make a visit to the doctor immediately
Stages of Thyroid cancer
Papillary and Follicular
Stage 1: In the first stage of these two types of Thyroid cancers, the tumor is of any size (usually a small one) and is present in the thyroid area. There can be chances of the infection getting spread to the nearby lymph nodes and tissues. However, the cancer is not known to be spread to the other parts of the body at the first stage.
Stage 2: This is the second or one can say the final stage in Papillary and Follicular thyroid cancer. At this stage, the cancerous tumor has spread to the other parts of the body like lungs, bones, brain and lymph nodes.
Medullary Thyroid Cancer
Stage 1: In the first stage of the diagnosis of Medullary thyroid cancer, tumor (not more than 2 centimeters) is found in the thyroid region. It has not spread anywhere else.
Stage 2: Two conditions are likely to develop at the second stage-either the tumor has grown more than 2 centimeters, but is still in the thyroid gland, or the cancerous tumor is of any size and has spread to the nearby tissues. Lymph nodes are untouched by the tumor at this stage.
Stage 3: The tumor has made its way to the lymph nodes just near to the trachea and larynx (voice box). Chances of the cancer spreading to tissues just outside are thyroid are also quite possible.
Stage 4: Stage 4 of Medullary thyroid cancer can be explained through various sub stages.
I. Stage IV A: Cancerous tumor has spread to the tissues, outside the thyroid. Trachea, larynx, esophagus and recurrent laryngeal nerve. There lies strong possibility of the cancerous tumor reaching the lymph nodes. At this stage, the tumor has also made its reach to both sides of the neck or between the lungs.
II. Stage IV B: The frontal part of the spiral column or the blood vessels between the lungs are effected by the cancerous tumor.
III. Stage IV C:Tissues outside the thyroid gland, lungs and bones are directly affected by the tumor.
The stages of Anaplastic thyroid cancer are quite similar to the other types of cancers. It begs to differ only at stage 4, which is explained as below:
Stage IV A: Cancer is present in the thyroid region and chances of it spreading to the lymph nodes are quite high.
Stage IV B: Outside tissues of the thyroid gland are also compromised by the tumor, accompanied by a big possibility of making to the lymph nodes.
Stage IV C: This stage marks the spreading of the tumor to various parts of the human body.
Diagnosis of Thyroid Cancer
In order to be fully sure about the cancerous tumor, patients must undergo the process of Biopsy. This is the most factually correct diagnosis method, in which cells from the suspicious area are taken out and thoroughly examined under a microscope. Depending upon the condition of the lump, your doctor might also suggest some other tests.
Ultrasound: The process make use of ultrasonic sound waves to create images of body parts. In this, a small instrument known as ‘Transducer’ is placed just in front, on the skin of the neck. Echoes of the sound waves generated after hitting the thyroid gland are received by the instrument, which further displays black and white images of the suspicious area on the screen.
Radioiodine scan: This is a particular type of imaging test, which is carried on to differentiate the type of thyroid cancer the patient has been infected with. It works for papillary and follicular cancers, but not in medullary. It is only due to the fact that Medullary thyroid cancer cells do not absorb iodine.
Chest X-Ray: This is done to check if the thyroid cancer has spread to the lungs or not. Under this, an X-Ray of the chest is taken out.
Computed tomography (CT) scan: It is a special type of x-ray that is done to get detailed cross-sectional images of the human body. CT scan is very much helpful to analyze if the cancerous tumor has spread to the other parts of the body or not. In short, it tells the doctor about the size and location of the cancer. Unlike the normal x-ray, CT Scan takes multiple pictures, by rotating over the patient.
Magnetic Resonance Imaging (MRI) scan: Quite like the CT scan, MRI scans also provide useful information about the cancerous tumor that has made its way to the different parts of the thyroid and body. MRI technique make use of radio waves and strong magnets to get the images of soft tissues, effected by the cancer.
Positron Emission Tomography (PET) scan: This is a special type of diagnosis test for thyroid cancer as it makes use of a radioactive substance. This substance is usually a type of sugar, known as FDG, is injected into the blood line of the patient. After a while, images of the parts effected by radioactivity are obtained using a camera. The process is helpful to detect, if the patient has Medullary thyroid cancer as it does not mix up with radioactive iodine.
Thyroid-stimulating hormone (TSH): Also known as Thyrotropin, TSH is used to check how the thyroid gland after getting infected with cancer is functioning. TSH level in the body would be quite high if the thyroid fails to produce sufficient hormones. In other words, the gland is announced to be infected by the cancer. With the help of this information, the doctor can assess as to which type of imaging tests are best suited for the patient.
T3 and T4 (thyroid hormones): In order to check the functioning of thyroid gland, the doctor may check T3 and T4 thyroid hormones. Levels of these two hormones usually stays normal, when the gland gets effected by cancer.
Thyroglobulin: Blood tests to check the levels of this particular type of hormone prove beneficial only after the treatment of cancer is done. If the level of Thyroglobulin in the thyroid gland low, then it is a sure sign of the treatment being done properly.
Calcitonin: For the body to use calcium efficiently, calcitonin hormone is released in the thyroid gland. On examining the levels of Calcitonin, possible detection of Medullary thyroid cancer can be done. Recurrence of the cancer after treatment can also be checked by testing the levels of Calcitonin.
Vocal cord exam (laryngoscopy): It has also been seen, the vocal cord getting effected by thyroid tumors. In such a case, the procedure of laryngoscopy is carried on to check the functioning of the vocal cords. It involves examining of the vocal cord with the help of special mirrors or an equipment (thin tube with light and lens at the end).
Treatment of Thyroid Cancer
In most of thyroid cancer cases, surgery is the most opted solution. There are different types of surgical procedures available, which are mentioned as below:
Lobectomy: This procedure involves removal of the affected lobe, which has been diagnosed of thyroid cancer.
Lymphadenectomy:It involves surgical removal of the lymph nodes in the neck.
Near-total thyroidectomy: The process involves cutting off only a small part of the thyroid gland.
Total Thyroidectomy: The whole thyroid gland is removed in this procedure. It is opted when the cancer has spread to whole of the gland.
A highly opted procedure to treat all kinds of cancers, chemotherapy make use of drugs to stop the growth of malign (cancer) cells. While treating thyroid cancer, chemotherapy is given in two different ways.
The first method deals with the consumption of the drug directly from mouth or injecting the drug into a vein or muscle (Systematic chemotherapy). Whereas, in the second method, the drug is injected into the cerebrospinal fluid, or the abdomen (Regional chemotherapy).
Regional chemotherapy is used to only cure particular areas, which have been effected by cancer. Chemotherapy is also highly dependent on the type of thyroid cancer the body is infected with.
Radiation therapy, including radioactive iodine therapy
Making use of high energy x-rays or some other types of radiations to cure cancer is known as Radiation therapy. Medical science defines radiation therapy into two types-Internal Radiation therapy and external Radiation therapy. In the first alternative, radioactive substance stored in needles, wires or catheter, are used to kill the harmful cancer cells.
In this treatment, the apparatus (needles or wire) is placed directly to the affected area. Whereas, in the second type of therapy, the doctor uses a machine externally to send radiations to destroy cancer cells.
Another method to treat thyroid cancer is by making use of iodine, known as Radioactive Iodine therapy. This method is recommended for follicular and papillary thyroid cancers. Under this, the radioactive iodine is ingested through the mouth. When the radioactive iodine gets absorbed by thyroid cells, it destroys cancer cells existing in that region.
Thyroid hormone therapy
This particular cancer therapy works to the core of the disease. Growth of cancer cells inside the human body is triggered by hormones, and the therapy works to block the actions of them.In order to prevent the body from generating thyroid-stimulating hormone (TSH), certain drugs are given to the patient.
As TSH is primarily responsible for the recurrence of cancer cells, it is this hormone that is targeted by the therapy. As part of the process, thyroid replacement pills are given to the patients.
Targeted therapy is a treatment which attack specific cancer cells, effecting the thyroid gland. The treatment makes use of certain drugs and substance to identify and destroy the cancer cells. One such therapy is the Tyrosine Kinase Inhibitor therapy, by which signals needed for the growth of tumors can be blocked.