thyroid cancer

Thyroid cancer is a type of cancer that starts in the thyroid gland, an organ located at the base of the throat that produces hormones to regulate various bodily functions such as heart rate, blood pressure, and body temperature.

Types of Thyroid Cancer

There are several types of thyroid cancer, including:

• Papillary thyroid cancer: This is the most common type of thyroid cancer, accounting for about 80-85% of all cases. It typically grows slowly and may spread to lymph nodes in the neck.
• Follicular thyroid cancer: This type of cancer accounts for about 10-15% of all thyroid cancer cases. It can grow quickly and may spread to other parts of the body, such as the lungs or bones.
• Medullary thyroid carcinoma (MTC): This is a rare type of thyroid cancer that begins in the C-cells of the thyroid gland. It can be inherited in some cases and may spread to lymph nodes in the neck.

Causes and Risk Factors

The exact cause of thyroid cancer is not known, but there are several risk factors that can increase a person's chances of developing this disease. These include:

• Age: Thyroid cancer is more common in people over 60 years old.
• Family history: A family history of thyroid cancer or other cancers may increase the risk.
• Radiation exposure: Exposure to radiation, especially during childhood, can increase the risk of developing thyroid cancer.

Symptoms

Thyroid cancer can cause a range of symptoms, including:

• A painless lump in the neck
• Trouble swallowing
• Difficulty breathing
• Changes to the voice, such as hoarseness

Diagnosis and Treatment

Thyroid cancer is typically diagnosed by finding a lump or nodule in the thyroid gland. The diagnosis is confirmed through imaging studies, such as ultrasound or CT scans, and biopsy.

Treatment for thyroid cancer usually involves surgery to remove part or all of the thyroid gland, along with nearby lymph nodes. In some cases, additional treatments such as radioactive iodine therapy or chemotherapy may be necessary.

References

• [1] Thyroid cancer is a disease in which malignant (cancer) cells form in the tissues of the thyroid gland. (Source: Search result 4)
• [2] Thyroid cancer starts in the cells of the thyroid. A cancerous (malignant) tumour is a group of cancer cells that can grow into nearby tissue and destroy it. (Source: Search result 6)
• [3] Papillary thyroid cancer is the most common type of thyroid cancer, accounting for about 80-85% of all cases. (Source: Search result 14)
• [4] Follicular thyroid cancer accounts for about 10-15% of all thyroid cancer cases. (Source: Search result 14)

Thyroid cancer can be asymptomatic in its early stages, but as it grows, it may cause various signs and symptoms. Here are some common ones:

• A lump or nodule in the front of the neck: This is often the first noticeable symptom, which can be felt through the skin (1).
• Swelling in the neck: As the cancer grows, it can cause swelling in the neck area (2).
• Pain in the front of the neck: Pain can radiate to the ears and may be a sign of thyroid cancer (3).
• Voice changes or hoarseness: Thyroid cancer can affect the vocal cords, leading to voice changes or hoarseness (4, 7, 8).
• Difficulty swallowing: As the cancer grows, it can cause difficulty in swallowing food or liquids (5, 9).
• Changes in breathing: In some cases, thyroid cancer can cause difficulty breathing or shortness of breath (5, 15).
• Fatigue: This is often one of the earliest symptoms, and it's a common complaint among patients with thyroid cancer (10, 13).
• Loss of appetite: As the cancer progresses, it can lead to loss of appetite (4).

It's essential to note that these symptoms can be subtle and may not always be specific to thyroid cancer. If you're experiencing any unusual lumps or swelling in your neck, it's crucial to consult a healthcare professional for proper evaluation and diagnosis.

References:

1. A lump or nodule in the front of the neck is often the first noticeable symptom (1).
2. Swelling in the neck can be caused by thyroid cancer (2).
3. Pain in the front of the neck can radiate to the ears (3).
4. Voice changes, hoarseness, and difficulty swallowing are common symptoms (4, 7, 8).
5. Difficulty breathing or shortness of breath can occur (5, 15).
6. Fatigue is a common early symptom (10, 13).
7. Loss of appetite can be caused by thyroid cancer progression (4).

Diagnostic Tests for Thyroid Cancer

Thyroid cancer diagnosis involves a combination of physical examination, imaging tests, and laboratory tests to confirm the presence of cancerous cells in the thyroid gland.

• Physical Exam: A healthcare provider will examine the neck to feel for changes in the thyroid, such as lumps or nodules. They may also ask about risk factors, such as past exposure to radiation and family history of thyroid cancers [2].
• Imaging Tests: Various imaging tests can be used to evaluate tumor size and look for metastasis (spread) of cancer to lymph nodes and other parts of the body. These include:
  • Ultrasound: Uses high-frequency sound waves to create detailed pictures of the thyroid gland [3].
  • Computed Tomography (CT) scan: Takes cross-sectional images of the neck and chest to evaluate tumor size and spread [11].
  • Magnetic Resonance Imaging (MRI): Provides detailed images of the thyroid gland and surrounding tissues [11].
  • Positron Emission Tomography (PET) scan: Uses a small amount of radioactive iodine to help visualize thyroid nodules and identify cancer cells [11].
• Biopsy: A biopsy is the only certain way to confirm a diagnosis of cancer. During a biopsy, a doctor takes a sample of tissue from the thyroid gland for testing in a laboratory [12][13]. This can be done using a fine needle aspiration (FNA) or surgical excision.
• Blood Tests: Blood tests can help diagnose thyroid cancer by checking thyroid hormone levels (T3, T4, and TSH), as well as monitoring blood counts, liver, and kidney function [5][6].
• Genomic Testing: Advanced genomic testing examines a tumor on a genetic level to look for the DNA alterations that drive the growth of cancer. This can help tailor treatment based on these mutations [10].

It's essential to note that a diagnosis of thyroid cancer is typically made by a combination of these tests, rather than relying on a single test result.

References: [1] Not provided [2] Context 2 [3] Context 3 [4] Not provided [5] Context 5 [6] Context 6 [7] Context 7 [8] Context 8 [9] Not provided [10] Context 10 [11] Context 11 [12] Context 12 [13] Context 13

Treatment Options for Thyroid Cancer

Thyroid cancer treatment options depend on the type and stage of the cancer, as well as the patient's overall health and preferences. One of the treatment options is drug treatment, which uses medications to kill or slow down the growth of cancer cells.

Types of Drug Treatment

There are several types of drug treatments used for thyroid cancer:

• Targeted therapy: This type of treatment targets specific genes or proteins that are involved in the growth and spread of cancer cells. For example, Dabrafenib (Tafinlar) and trametinib (Mekinist) can be used to treat cancers with certain BRAF gene changes [4].
• Chemotherapy: This type of treatment uses chemicals to kill or slow down the growth of cancer cells. Chemotherapy drugs such as doxorubicin, carboplatin, and cisplatin are commonly used to treat advanced thyroid cancers [8].
• Hormone therapy: In some cases, hormone therapy may be used to prevent the body from making thyroid-stimulating hormone (TSH), which can increase the chance that thyroid cancer will grow or recur [5].

Targeted Drugs for Thyroid Cancer

Several targeted drugs have been approved for the treatment of thyroid cancer. These include:

• Vandetanib: This drug works like sorafenib but is approved to treat medullary thyroid cancers that cannot be removed with surgery, have spread to lymph nodes, or are inoperable [7].
• Sorafenib: This drug can be used to treat advanced thyroid cancers that have spread to other parts of the body [3].

Chemotherapy for Thyroid Cancer

Chemotherapy is a common treatment option for advanced thyroid cancers. Chemotherapy drugs such as doxorubicin, carboplatin, and cisplatin are commonly used to treat this type of cancer [8]. However, chemotherapy can also affect heart function, so regular monitoring with tests such as echocardiograms may be necessary [11].

Other Treatment Options

In addition to drug treatment, other treatment options for thyroid cancer include surgery, radioactive iodine therapy (RAI), and external beam radiation therapy. The choice of treatment depends on the individual patient's needs and circumstances.

References:

[3] Sherman SI, Gianoukakis AG. Differentiated thyroid cancer refractory to standard treatment: Systemic therapy. UpToDate. 20204

[4] Dabrafenib (Tafinlar) and trametinib (Mekinist) for BRAF-mutated metastatic melanoma or unresectable or metastatic papillary or follicular thyroid cancer.

[5] Treatment options for iodine-sensitive thyroid cancer. Treatment options for iodine-sensitive thyroid cancer include the following: RAI therapy. Metastases that demonstrate uptake of this isotope may be ablated by therapeutic doses of 131I.

[7] Vandetanib for medullary thyroid cancer.

[8] Chemotherapy, or chemo, means using chemicals for treatment.For cancer, the medicines attack and kill fast-growing cells, like cancer cells. You may get pills, shots, or intravenous (IV) chemo.

[11] Doxorubicin (one of the most common chemo drugs for thyroid cancer) can affect heart function. If you are getting doxorubicin, your doctor will check your heart regularly using tests such as echocardiograms.

Thyroid cancer, a malignancy of the thyroid parenchymal cells, can be challenging to diagnose due to its similarity in presentation with other thyroid conditions. A differential diagnosis is essential to rule out other possible causes and confirm the presence of thyroid cancer.

Possible Differential Diagnoses:

• Anaplastic Thyroid Carcinoma: A rare and aggressive form of thyroid cancer that can present as a rapidly growing mass or nodule in the thyroid gland [5].
• Goiter: An enlargement of the thyroid gland, which can be caused by various factors such as iodine deficiency, thyroiditis, or other conditions. While goiter is not typically malignant, it can sometimes be associated with thyroid cancer [5].
• Graves Disease: A condition characterized by an overactive thyroid gland (hyperthyroidism), which can cause a range of symptoms including weight loss, heat intolerance, and tremors. Graves disease is not directly related to thyroid cancer but can sometimes coexist with it [5].
• Hurthle Cell Carcinoma (Oncocytic Carcinoma): A rare type of thyroid cancer that arises from the follicular cells of the thyroid gland. It is often associated with a worse prognosis than other forms of thyroid cancer [6].

Key Features to Consider:

• Rapid growth: Anaplastic thyroid carcinoma and Hurthle cell carcinoma tend to grow rapidly, whereas papillary and follicular thyroid cancers typically grow slowly [7].
• Symptoms: Patients with anaplastic thyroid carcinoma often present with symptoms such as difficulty swallowing, hoarseness, or a mass in the neck [5]. In contrast, patients with Graves disease may experience weight loss, heat intolerance, or tremors.
• Imaging studies: Imaging studies such as ultrasound, CT scans, or MRI can help differentiate between these conditions. For example, anaplastic thyroid carcinoma often appears as a large, irregular mass on imaging studies [5].

Conclusion:

A thorough differential diagnosis is essential to accurately diagnose and manage thyroid cancer. By considering the possible differential diagnoses listed above and key features such as rapid growth, symptoms, and imaging findings, healthcare providers can make informed decisions about patient care.

References:

[1] Context result 3 [2] Context result 5 [3] Context result 6 [4] Context result 7