This September 24 marks the World Thyroid Cancer Day. In Spain, between 4,000 and 5,000 cases are diagnosed each year. The average age is between 40 and 60 years. And the majority of patients are women (79%) versus 21% men.
This is how the doctor specifies Javier Santamariamember of the (SEEN):
-
“It is more frequent in women, since the prevalence in women is 3 or 4 times higher than in men”
However, as explained by the (AECAT), unlike the rest of the tumors, “most of them have slow growth”.
He forecastAlso, it is very hopeful. Five-year survival is 96.9%, being 99.7% for localized stages and 57.8% for more advanced ones. “Most thyroid cancers are totally removed with surgery and treatment, depending on their type.”
Symptoms of thyroid cancer
It is one of the most silent cancers, since most cases do not produce any type of symptom, the main one being a lump or nodule in the neck. Besides:
-
Pain in the neck, jaw or ear.
-
Hoarseness.
-
Chronic cough.
-
Difficulty breathing.
-
Sensation of oppression in the throat.
-
Difficulty to swallow.
Although, as highlighted by AECAT, “all these symptoms derive simply from the existence of the lump or nodule in the thyroid. However, this does not mean that the nodule is cancer. There are many other causes for which a lump may appear in the neck, and only 5 out of 100 turn out to be malignant”.
Risk factor’s
- Sex and age. They are diagnosed more frequently in women and, above all, between the ages of 40 and 59.
- family history.
- radiation exposure.
- Cowden’s disease. It is an inherited disorder that is characterized by the formation of benign tumors, although it represents a greater risk of developing malignant tumors.
- Hashimoto’s thyroiditis. Disease that produces a reaction of the immune system against the thyroid gland.
- High iodine diet.
How is it diagnosed?
The endocrinology specialist is in charge of collecting all the information, through the medical history, and performing different tests to rule out or confirm the presence of a carcinoma or malignant tumor.
- Physical exam. Through palpation, the characteristics of the nodules, their hardness and solidity or the presence of cervical nodes can be taken into account.
- Blood test. Although a blood test cannot provide whether a nodule is cancerous, it does indicate whether it is functioning normally. Thus, other complementary tests can be performed to shed light on the diagnosis.
- ultrasound. It is another test that helps diagnose thyroid cancer. Using this painless and very quick ultrasound test, the size of your thyroid can be measured, as well as your size and number of nodules. It is a key medical examination: it guides on the need to carry out other types of tests.
- Fine Needle Aspiration Puncture (PAAF). It is performed in those solitary nodules of more than 1 centimeter and in micronodules in which, in previous tests, there are indications of carcinoma or malignant tumor.
TNM: The classification of thyroid cancer
- T: Tumor size.
- N: State of the ganglia.
- M: Presence of metastases.
The AECAT specialists emphasize that “if you are in this situation, the steps to follow will depend on the criteria of the endocrinologist who handles your individual case.”
But, “if you decide to monitor the progress of the nodule for a while, remember that it is important that you carry out all the reviews and tests that are scheduled for you on time without exception. If, even so, you do not stay calm, ask for a second opinion.
Thyroid cancer treatment
The next step after diagnosis is surgical intervention, which aims to “eliminate or stop the disease and prevent the spread of cancer to neighboring and/or distant organs.”
Doctor Javier Santamaría explains that, however, there are “avoid interventions that can lead to morbidity, but at the same time, it is necessary to identify those that may evolve poorly in order to be able to apply these new treatments early: numerous molecules that can stop their development”.
Among all the types of surgery that can be performed, the most frequent are the following:
- total thyroidectomy. It is the total extraction of the thyroid glands. This total excision is only performed in cases considered to be of high or medium risk, either due to tumor size, the presence of metastases, or family history.
- hemithyroidectomy. It consists of the extirpation of one or two lobes. It is only available for low-risk patients and “with tumors smaller than 1 centimeter without lymph node invasion.”
However, as a consequence of any of these interventions, the patient will stop producing all or part of the thyroid hormones T3 and T4. “They are essential for your body, so, from that moment on, you will need hormone replacement therapy indefinitely”. This treatment consists of taking a daily pill on an empty stomach.
Like any surgical intervention, thyroidectomy is not without risks:
- dysphonia. The operation can produce “a transient hoarseness or a change in the voice.” These are consequences that generally disappear between two and ten weeks after the intervention.
- hypocalcemia. During thyroidectomies, the parathyroid glands can be affected and are responsible for maintaining the balance of calcium and phosphorus. “Transient hypocalcemia for a few days after the operation is relatively common (30% of patients), but it recovers, usually with a few weeks’ treatment with oral calcium and, eventually, with activated vitamin D.” This complication presents with tingling in the fingers and lips and with muscle cramps.
Dr. Santamaría emphasizes that Wes is a frequent disease, whose prognosis is excellent, and even in the few cases of poor evolution there are, and increasingly, options…