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That Lump in Your Throat Could be Thyroid Cancer

July 30, 2013

Learn the Signs, Symptoms and Treatment Options

The thyroid gland plays a critical role in how the body functions. The small butterfly-shaped gland is located in the front part of the neck and secretes hormones that regulate growth and metabolism. Sometimes the gland can develop growths called nodules that can be cancerous.

"The thyroid is an important endocrine gland because it manages the metabolic rate of the body and its actions affect a lot of different organs like the heart, skin, brain, and bowels," said Dr. Prasad Katta, a local endocrinologist and member of the Washington Hospital medical staff. "These nodules are quite common, but most of the time they are not cancerous. Thyroid cancer is not as common as some other cancers and the cure rate is high. But the standard treatment is to remove the thyroid gland, and then you have to take medication every day for the rest of your life because the hormone is necessary for the body to function."

The American Cancer Society estimates that nearly 62,300 people will be diagnosed with thyroid cancer this year. The most common type of thyroid cancer is papillary carcinoma, responsible for about 70 to 80 percent of all cases, according to Dr. Katta. It tends to grow very slowly and can develop in one or both of the thyroid gland lobes.

"This type grows slowly, but it can spread to the lymph nodes in the neck," he explained. "Still, these cancers can usually be treated successfully and are rarely fatal."

Follicular carcinoma and Hurthle cell carcinoma are two other types that are much less common, but the prognosis is not quite as good for these as it is for papillary carcinoma, he said. Even more rare is medullary thyroid carcinoma, which includes an inherited type that is passed from generation to generation.

While the exact cause of thyroid cancer is unknown, there are certain factors than can raise your risk, according to Dr. Katta. At a rate of nearly three to one, women are much more likely to develop thyroid cancer than men. Other risk factors include exposure to radiation, a diet low in iodine, and heredity.

Symptoms include a lump in the neck that may be growing quickly, swelling in the neck, pain in the front of the neck, hoarse voice, trouble swallowing or breathing, and a constant cough that is not due to a cold.

"If you have any of these symptoms, you should consult with your physician," Dr. Katta said. "An ultrasound can determine if there are any nodules on the gland."

Early Detection Leads to Better Outcomes

"Less than 10 percent of these nodules are cancerous," added Dr. Jason Van Tassel, an ear, nose, and throat surgeon and a member of the Washington Hospital medical staff. "When the nodule gets too big or is growing rapidly, it needs to be biopsied to determine if it is malignant. The biopsy is done with a small needle with the use of a local anesthetic. We can get the results back in 24 to 48 hours."

The standard treatment for thyroid cancer is to remove part or all of the thyroid gland. Dr. Van Tassel said medical advancements have made this surgery very effective and less invasive than even 10 or 15 years ago.

At one or two inches, the incision is much smaller now than it used to be with the help of better instruments and retractors that can move the tissue out of the way, he explained. The ability to monitor the nerves around the thyroid gland has also improved.

"The nerves around the thyroid affect the voice and if they are damaged could lead to permanent hoarseness, so surgeons really need to be careful not to cut any of those nerves," Dr. Van Tassel said. "For thyroid cancers, it is necessary to remove the entire gland, but if one is undergoing surgery for a benign, noncancerous reason, only one lobe of the gland or just the nodule itself can be removed. If the cancer has spread to the lymph nodes in the neck, we will remove those during the same procedure."

Most thyroid cancer patients are also treated with radioactive iodine after the surgery to get rid of any remaining cancer. The iodine is given either in an injection or a pill and then patients are able to go home where they need to stay in isolation for several days because they are radioactive, he explained.

"Patients used to have to stay in the hospital for five days," he added. "Now they can undergo the treatment in the comfort of their own homes."

Because the thyroid gland plays such a pivotal role in how the body functions, thyroid cancer patients who have had the entire gland removed need to take daily medication for the rest of their lives to replace the hormone produced by the thyroid gland.

"The important thing for thyroid cancer patients to know is that this is a very survivable cancer," Dr. Van Tassel concluded. "Treatment options are better than ever before and you can live a long life with the replacement hormone."

For information about programs and services at Washington Hospital that can help you stay healthy, visit www.whhs.com.

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