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Thyroid cancer

Tumor - thyroid; Cancer - thyroid; Nodule - thyroid cancer; Papillary thyroid carcinoma; Medullary thyroid carcinoma; Anaplastic thyroid carcinoma; Follicular thyroid cancer

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Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located inside the front of your lower neck.

Causes

Thyroid cancer can occur in people of any age.

Radiation increases the risk of developing thyroid cancer. Exposure may occur from:

Other risk factors are a family history of thyroid cancer and chronic goiter (enlarged thyroid).

There are several types of thyroid cancer:

Symptoms

Symptoms vary depending on the type of thyroid cancer, but may include:

  • Cough
  • Difficulty swallowing
  • Enlargement of the thyroid gland
  • Hoarseness or changing voice
  • Neck swelling
  • Thyroid lump (nodule)

Exams and Tests

Your health care provider will perform a physical exam. This may reveal a lump in the thyroid, or swollen lymph nodes in the neck.

The following tests may be done:

Treatment

Treatment depends on the type of thyroid cancer. Treatment of most thyroid cancer types is effective if diagnosed early.

Surgery is most often done. The entire thyroid gland is usually removed. If your provider suspects that the cancer has spread to lymph nodes in the neck, these will also be removed.

Radiation therapy may be done with or without surgery. It may be performed by:

  • Aiming external beam (x-ray) radiation at the thyroid
  • Taking radioactive iodine by mouth

After treatment for thyroid cancer, you must take thyroid hormone pills for the rest of your life. The dosage is usually slightly higher than what your body needs. This helps keep the cancer from coming back. The pills also replace the thyroid hormone your body needs to function normally.

If the cancer does not respond to surgery or radiation, and has spread to other parts of the body, chemotherapy or targeted therapy may be used. These are only effective for a small number of people.

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

Possible Complications

Complications of thyroid cancer may include:

  • Injury to the voice box and hoarseness after thyroid surgery
  • Low calcium level from accidental removal of the parathyroid glands during surgery
  • Spread of the cancer to the lungs, bones, or other parts of the body

When to Contact a Medical Professional

Call your provider if you notice a lump in your neck.

Prevention

There is no known prevention. Awareness of risk (such as previous radiation therapy to the neck) can allow earlier diagnosis and treatment.

Sometimes, people with family histories and genetic mutations related to thyroid cancer will have their thyroid gland removed to prevent cancer.

References

Kim M, Ladenson PW. Thyroid. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 226.

National Cancer Institute website. Thyroid cancer treatment (adult) (PDQ) - health provisional version. www.cancer.gov/cancertopics/pdq/treatment/thyroid/HealthProfessional. Updated February 1, 2018. Accessed March 22, 2018.

Smith PW, Hanks LR, Salomone LJ, Hanks JB. Thyroid. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 36.

Thompson LDR. Malignant neoplasms of the thyroid gland. In: Thompson LDR, Bishop JA, eds. Head and Neck Pathology. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 25.

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    Review Date: 1/19/2018

    Reviewed By: Richard LoCicero, MD, private practice specializing in hematology and medical oncology, Longstreet Cancer Center, Gainesville, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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