Thyroid Cancer: Five Things You Need to Know

14

By Melanie Graham

Thyroid cancer is a disease in which malignant cancer cells form in the tissues of the thyroid gland. Found more often in women, the National Cancer Institute estimates 60,022 new cases of thyroid cancer will be diagnosed in the United States in 2013.

Like most forms of cancer, thyroid cancer can be broken down into several different types or subgroups, says Jochen Lorch, MD, director of Dana-Farber’s Thyroid Cancer Center. Most types of thyroid cancer are treatable and in some cases, curable, Lorch says.

Below, Lorch provides some more information about the disease:

1. What are the different types of thyroid cancer?

  • Jochen Lorch, MD

    Jochen Lorch, MD

    Papillary – This is the most common type of thyroid cancers and is classified as a “differentiated” thyroid cancer. Papillary thyroid cancer is a slow-growing cancer that forms into small, finger-like shapes.

  • Follicular – A slow-growing thyroid cancer that forms in the follicular cells of the thyroid. It is also classified as a differentiated thyroid cancer.
    • Poorly differentiated thyroid cancer – A sub-type of papillary and follicular thyroid cancer that is frequently also classified as differentiated thyroid cancer.
  • Anaplastic – A rare, aggressive type of thyroid cancer categorized as an “undifferentiated” thyroid cancer. The malignant cells in this type of cancer look very different from normal thyroid cells. 

2. What are the risk factors for thyroid cancer?

Typically, thyroid cancer is found more often in women. Of the estimated 60,022 new cases diagnosed in 2013, 45,000 will be women. Some inherited syndromes can also predispose people to thyroid cancer, including multiple endocrine neoplasia type 2A and type 2B. Other risk factors include radiation exposure and having a history of goiters.

3. What are the symptoms of thyroid cancer?

In most cases, a lump in the neck is detected by a physician during a routine physical exam. Other problems that could be signs of thyroid cancer include trouble breathing, trouble swallowing, or hoarseness.

4. How do doctors test for thyroid cancer?

If a lump is found, patients are sent to an endocrinologist where an ultrasound is done. The endocrinologist will also use a small needle to remove some tissue or fluid from the thyroid to examine it for cancer cells.

5. What are the treatment options for thyroid cancer?

The primary treatment for thyroid cancer is surgery. This can involve removing part of or the entire thyroid. If the cancer spreads to the lymph nodes, a lymphadenectomy may be done as well. Subsequent surgeries can be done to remove cancer cells that return.

After surgery, a doctor may use radioactive iodine therapy for differentiated thyroid cancers (papillary and follicular).  With these treatments, the cure rate for differentiated thyroid cancers is around 90 percent

There are also a limited number of chemotherapy options available for recurrent or aggressive forms of thyroid cancer. Patients with these forms of thyroid cancer may also consider taking part in a clinical trial. Find out more about current thyroid cancer clinical trials by visiting the Dana-Farber clinical trials webpage or the National Cancer Institute clinical trial database.

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14 thoughts on “Thyroid Cancer: Five Things You Need to Know

  1. Dear Veronica —

    We are so sorry to hear about your health trouble. Unfortunately, we cannot give out medical advice over this blog or email. However, if you are interested in seeking a second opinion with Dana-Farber and are able to come to Boston to meet with our treatment team, please call 877-442-DFCI (877-442-3324) or fill out this online appointment request form:
    https://www.dana-farber.org/apps/request-an-appointment.aspx

    If you are not able to travel to Boston, Dana-Farber offers a program called Online Specialty Consults, which allows patients and physicians to confer with our specialists online about second opinions, treatment options, or clinical trials.

    You will need to involve your local physician, who will register with the service and complete a patient history. One of our specialists, who will be chosen depending on your particular medical background, will review your case and then send a consultation report back to your physician.

    These links provide an overview of the process:
    http://www.dana-farber.org/Partners-Online-Specialty-Consultations.aspx
    https://econsults.partners.org/v2/%28jwewk42ud2zpsevdo4p1l545%29/Tour/1.html

    I hope this is helpful. Wishing you and your family all the best.

  2. I have 6 nodules, 2 on the right have grown together to form 1,4 smaller nodules on left. I’ve had 6 biopsies only on larger right nodule because of suspicious shape. 3 biopsies hv come back neg & 3 suspicious. Have seen 4 drs. I am hoarse,sore throat, trouble breathing, pain has radiated around neck, right ear is now plugged or feels swollen. Pain & pressure started in right breast, shape has changed, breast is being pushed towards outer body, ultrasound & mamos come back as “fine”(ultrasound from my perspective shows numerous lumps & tech repeated took pics of painful places that I didn’t mention). Pain, pressure, burning that started in rt.breast, traveled up rt chest under collar bone, up rt side of neck,into rt ear, lymph nodes. Then traveled down rt side ribs, rt kidney, rt ovary, then uterus. I’m becoming increasingly more fatigued by the day & now nauseated. It has even affected my rt leg in walking because it hurts & is difficult to lift my leg. I can barely function at all. I can feel where this is & where it goes, but because my tsh test comes back neg & no distinct changes to ultrasounds or blood tests, drs literally just stop & say good news nothing shows up. Where do I go & what can I do? I’m a single mom with 3 young kids. I feel like I’m on a death list since I lost my PPO & not worth drs. time.

  3. What connection if any does Thyroid Cancer and Lymphoma have? I am scheduled to see a surgeon on the 29th of Sept. I do not have swelling in the front of my neck but do on the right side which is where the thyroid is diseased.

    • Dear Barb —

      Thank you for your comment and for reading Insight. I’m sorry to hear about your concerns around the recent ultrasound, but unfortunately we cannot give out any medical advice on this blog or over email. It is best for you to discuss this with your physician or oncologist to determine the next step.

      If you are interested in seeking a second opinion and discussing options with someone at Dana-Farber, here is more information about seeking a second opinion.

      Wishing you all the best.

  4. 20 yrs out from Breast CA ( plus brain tumor removal turned out to be meningioma)
    Just had ultrasound shows small nodules with so spect micro-calcifications
    Though small I would like a biopsy
    Thoughts

  5. I have never read anything written in INSIGHT regarding bladder cancer. I’m wondering if any article in your archives could direct me to this subject. I’m in my early 70’s and have just undergone bladder surgery with the removal of an early stage cancer. Therefore my interest in the subject addressed by Dada- Farber Cancer Institute.
    Thank you for any information.

    • Dear Barbara —

      Thank you for your comment, and for reading our Insight blog. We do not have any recent blog posts on this subject, but will certainly make note of it. However, there is a wealth of information available on our bladder cancer webpage. We hope this is helpful.

  6. My endocrinologist has measured a thyroid nodule that showed up as enlarged on an MRI that was taken for my MS. He has done this 2-3x over the past couple of years after an ultrasound also led him to think it was not of the size to be concerned or so slow growing as not to be of concern. He does not want to put me through a biopsy unless necessary. I know you are not there to give individual advice or second-guess other docs, but would appreciate any feedback you feel appropriate to make.

    • incidental nodules are common on MRI or CAT scan. Ultrasound is indeed the best means of evaluating the gland. we look at both nodule size and character to decide if/when to biopsy. if very small, we often follow conservatively. usually the size cutoff to consider biopsy in the average patient is about 1cm. and if any uncertainty, being assessed as a second opinion at a thyroid nodule clinic in a high volume center can help clarify alot of uncertainty. hope this helps

    • Dear Ms Jenkins and Connie,
      Thank you for posting your questions. Dr Alexander is an endocrinologist with our group and the questions you were asking pertain to his area of expertise. Thanks Eric for posting your answers.

  7. Good Day, In 2009 I had a partial lyroidectomy due to suspicious cells. Labs came back as not malignant. How much should I now worry about the left side? How often should it be checked and how.Thank you for your time.

    • thyroid cancer is almost always in a nodule itself. if no nodules previously seen on the left during ultrasound, the risk of any cancer is very, very low. however, a yearly check with your pcp is very important for a routine exam, and if any question of nodules, another ultrasound could be useful. Hope this helps

    1. Dear Barb —

      Thank you for your comment and for reading Insight. I’m sorry to hear about your concerns around the recent ultrasound, but unfortunately we cannot give out any medical advice on this blog or over email. It is best for you to discuss this with your physician or oncologist to determine the next step.

      If you are interested in seeking a second opinion and discussing options with someone at Dana-Farber, here is more information about seeking a second opinion.

      Wishing you all the best.

  8. What connection if any does Thyroid Cancer and Lymphoma have? I am scheduled to see a surgeon on the 29th of Sept. I do not have swelling in the front of my neck but do on the right side which is where the thyroid is diseased.

  9. Dear Veronica —

    We are so sorry to hear about your health trouble. Unfortunately, we cannot give out medical advice over this blog or email. However, if you are interested in seeking a second opinion with Dana-Farber and are able to come to Boston to meet with our treatment team, please call 877-442-DFCI (877-442-3324) or fill out this online appointment request form:
    https://www.dana-farber.org/apps/request-an-appointment.aspx

    If you are not able to travel to Boston, Dana-Farber offers a program called Online Specialty Consults, which allows patients and physicians to confer with our specialists online about second opinions, treatment options, or clinical trials.

    You will need to involve your local physician, who will register with the service and complete a patient history. One of our specialists, who will be chosen depending on your particular medical background, will review your case and then send a consultation report back to your physician.

    These links provide an overview of the process:
    http://www.dana-farber.org/Partners-Online-Specialty-Consultations.aspx
    https://econsults.partners.org/v2/%28jwewk42ud2zpsevdo4p1l545%29/Tour/1.html

    I hope this is helpful. Wishing you and your family all the best.

  10. I have 6 nodules, 2 on the right have grown together to form 1,4 smaller nodules on left. I’ve had 6 biopsies only on larger right nodule because of suspicious shape. 3 biopsies hv come back neg & 3 suspicious. Have seen 4 drs. I am hoarse,sore throat, trouble breathing, pain has radiated around neck, right ear is now plugged or feels swollen. Pain & pressure started in right breast, shape has changed, breast is being pushed towards outer body, ultrasound & mamos come back as “fine”(ultrasound from my perspective shows numerous lumps & tech repeated took pics of painful places that I didn’t mention). Pain, pressure, burning that started in rt.breast, traveled up rt chest under collar bone, up rt side of neck,into rt ear, lymph nodes. Then traveled down rt side ribs, rt kidney, rt ovary, then uterus. I’m becoming increasingly more fatigued by the day & now nauseated. It has even affected my rt leg in walking because it hurts & is difficult to lift my leg. I can barely function at all. I can feel where this is & where it goes, but because my tsh test comes back neg & no distinct changes to ultrasounds or blood tests, drs literally just stop & say good news nothing shows up. Where do I go & what can I do? I’m a single mom with 3 young kids. I feel like I’m on a death list since I lost my PPO & not worth drs. time.

  11. 20 yrs out from Breast CA ( plus brain tumor removal turned out to be meningioma)
    Just had ultrasound shows small nodules with so spect micro-calcifications
    Though small I would like a biopsy
    Thoughts

  12. My endocrinologist has measured a thyroid nodule that showed up as enlarged on an MRI that was taken for my MS. He has done this 2-3x over the past couple of years after an ultrasound also led him to think it was not of the size to be concerned or so slow growing as not to be of concern. He does not want to put me through a biopsy unless necessary. I know you are not there to give individual advice or second-guess other docs, but would appreciate any feedback you feel appropriate to make.

    1. incidental nodules are common on MRI or CAT scan. Ultrasound is indeed the best means of evaluating the gland. we look at both nodule size and character to decide if/when to biopsy. if very small, we often follow conservatively. usually the size cutoff to consider biopsy in the average patient is about 1cm. and if any uncertainty, being assessed as a second opinion at a thyroid nodule clinic in a high volume center can help clarify alot of uncertainty. hope this helps

    2. Dear Ms Jenkins and Connie,
      Thank you for posting your questions. Dr Alexander is an endocrinologist with our group and the questions you were asking pertain to his area of expertise. Thanks Eric for posting your answers.

  13. I have never read anything written in INSIGHT regarding bladder cancer. I’m wondering if any article in your archives could direct me to this subject. I’m in my early 70’s and have just undergone bladder surgery with the removal of an early stage cancer. Therefore my interest in the subject addressed by Dada- Farber Cancer Institute.
    Thank you for any information.

    1. Dear Barbara —

      Thank you for your comment, and for reading our Insight blog. We do not have any recent blog posts on this subject, but will certainly make note of it. However, there is a wealth of information available on our bladder cancer webpage. We hope this is helpful.

  14. Good Day, In 2009 I had a partial lyroidectomy due to suspicious cells. Labs came back as not malignant. How much should I now worry about the left side? How often should it be checked and how.Thank you for your time.

    1. thyroid cancer is almost always in a nodule itself. if no nodules previously seen on the left during ultrasound, the risk of any cancer is very, very low. however, a yearly check with your pcp is very important for a routine exam, and if any question of nodules, another ultrasound could be useful. Hope this helps

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