Thyroid Cancer

Thyroid cancer originates from the thyroid gland’s own cells. Its course is much slower when compared to other cancers. This gives us a long time to diagnose. It is more common in women. The occurrence of cancer varies from person to person; Sometimes it may show symptoms with the rapid growth of one of the nodules in a patient with a previous goiter, while in some patients it may suddenly present with a single and firm mass in the neck. Conditions that increase the risk for thyroid cancer; 

• Detection of a single and hard nodule in the thyroid gland,
• Male patient over the age of 50,
• Detection of nodules in a patient younger than 15 years old,
• Fast growing nodule,
• Hard lymph node in the neck,
• Having received radiotherapy for any reason to the neck,
• Family history of thyroid cancer.

What are the Types of Thyroid Cancer?

Thyroid cancer is divided into 5 different groups. These are;

• Papillary thyroid cancer; It is the most common type of thyroid cancer with 70-75%. It is more common in women between the ages of 20-50. When treated, it provides the best life span. It can spread to the lymph nodes in the neck, so the thyroid gland and the lymph nodes on the side of the tumor are also cleaned during surgery.

• Follicular thyroid cancer; It is detected at a rate of 10-15%. It is more common in women over the age of 50. It is generally seen in patients who have been followed up for nodular goiter. The problem with follicular type cancer is that the cell taken from needle biopsies cannot be determined whether it is cancer or not. The probability of having cancer is around 20%, but surgery is usually decided to avoid risk.

• Hurthle cell cancer; It is relatively rare. It is usually detected over the age of 60. It is more aggressive compared to the papillary and follicular types, so all thyroid tissue is cleaned together with the lymph nodes around it in surgery.

• Medullary thyroid cancer; It is seen at a rate of 5-10%. It can be found alone or in families with other disorders. When this type of thyroid cancer is encountered, the patient should be investigated for other disorders. When found alone, the treatment is to remove the thyroid gland with the surrounding lymph nodes.

Anaplasticthyroid cancer; It is detected at a rate of 5%. It is the most aggressive of all thyroid cancers. It appears as a hard mass in the neck and may cause hoarseness and difficulty swallowing. When diagnosed, it may not be surgically removed.

Do I have goiter or thyroid cancer? How will I understand?

There are nodules in the thyroid gland in goiter and thyroid cancer. The important thing is to distinguish whether these nodules are benign or malignant. The structure, size and blood supply of the nodules are determined by ultrasound to the thyroid gland. Diagnosis can be supported by scintigraphy. Different or enlarged nodules are easily detected with intermittent and regular ultrasonography. If these features of the nodule or, if it is more than one, of the nodules raise suspicion, a piece is taken with a needle and examined in the laboratory. The piece taken will most likely make the diagnosis. The most important point to be considered here is that the needle biopsy of the thyroid gland should be performed under ultrasound guidance, not blindly. Otherwise, biopsy can be taken from the wrong area and may cause unnecessary biopsy repetitions.

I have thyroid cancer; how will I be treated?

The treatment of thyroid cancer is surgery. In the treatment, the thyroid gland is removed as a whole, if any, the lymph nodes in the midline of the neck and on the side are also cleaned. Instead of thyroid hormone secreted by the removed thyroid gland, the patient is given a lifelong oral thyroid hormone. In some special patient groups, only radioactive burning treatment can be applied instead of surgery.

Will my voice be muted after surgery? What other complications are there?

Like any surgery, thyroid surgery also has complications. The vocal nerves pass just below the thyroid gland and a 2-3% probability of postoperative hoarseness may be experienced. To prevent this, a device can be used to locate the vocal nerves during surgery and the risk is reduced. Bleeding is another complication that can be seen. There may be low calcium in the blood and contractions in the hands due to the removal of the parathyroid gland in the surgery or the deterioration of its nutrition. But all these risks can be reduced with careful surgery and experience.