You get regular mammograms to screen for breast cancer and see a dermatologist to make sure you don't have skin cancer, but is thyroid cancer even on your radar? Maybe it should be: Rates seem to be skyrocketing, as the number of people diagnosed with it has doubled since the 1970s. Women, in particular, seem to be at risk.
While that sounds scary, there's no reason to panic, says Dr Ilya Likhterov. "While it's true that thyroid cancer diagnoses are on the rise, we're usually talking about papillary thyroid cancer, which is the least aggressive type." He also explains that a rise in diagnosis doesn't necessarily mean that more people are getting it—just that doctors are doing a better job of catching it. Many people today have ultrasounds and other scans for totally unrelated health issues, and those tests sometimes end up picking up very small thyroid nodules. Even if they turn out to be cancerous, many of these are so tiny and slow-growing that they might not ever cause problems during your lifetime.
That said, not all thyroid cancers are so innocuous, so it's smart to see a doctor if you notice any of the following symptoms:
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A lump in your neck
The thyroid gland is located in the front of your neck, but any bump that doesn't disappear on its own within a few weeks should be checked out, says Likhterov. "If thyroid cancer has already spread to the nearby lymph nodes, the mass might be on side of the neck where the lymph nodes are instead of in the front where the thyroid gland is."
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As a mass grows it could interfere with your ability to swallow. As with a lump, if this issue doesn't go away in a few weeks (like a cold or other virus that might cause swelling in the throat would), it's worth getting checked out.
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"Your voice box sits right on top of your thyroid," so changes to the gland could make you chronically hoarse, says Likhterov.
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Trouble speaking, eating or breathing
These symptoms probably wouldn't occur unless the cancer is very advanced, but they all warrant immediate medical attention.
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If you do develop thyroid cancer, your treatment options will depend on the size and stage of your tumour. "Some tumours that are less than 1 centimetre—micro-papillary thyroid cancer—can actually be left alone," says Likhterov. Since these are so slow-growing, your doctor might postpone treatment and simply send you for an ultrasound every six months to make sure nothing has changed. (Likhterov likens it to active surveillance for prostate cancer.)
Larger or more aggressive tumours will need to be removed right away, but you won't necessarily need to have your entire thyroid taken out. That used to be the norm, says Likhterov, but if you take out the whole thyroid you'll need to be on thyroid hormones for the rest of your life; there's also a risk of injuring the nearby parathyroid gland, which controls calcium balance in the body. Nowadays many patients only have half of the thyroid removed (the part with the tumour), which allows you to dodge these side effects. Depending on the specifics of your case, you might also need radiation, chemo or a "targeted" medication.
Luckily, the odds of beating thyroid cancer tend to be very good: The 5-year survival rate for stage I and stage II papillary or follicular thyroid is nearly 100%.
24 May 2017