
What Is a Thyroid Cancer?
Cancer is a scary word. Few words can evoke the sense of fear and panic that cancer does. Simply hearing the word can cause patients to react emotionally without evaluating the facts. Once patients learn the facts about thyroid cancer, they may be able to approach the diagnosis without undue fear and apprehension. Indeed, the outlook for most patients with thyroid cancer is excellent.
Each year more than 200,000 thyroid nodules-potential cancers are discovered; however, only about 17,000 are actually cancerous. There are approximately 1,300 deaths per year from thyroid cancer, as compared to an estimated 40,000 from breast cancer and 31,000 from prostate cancer. It may be reassuring to know that most thyroid nodules are not cancerous and that patients with thyroid cancer are usually cured.

Thyroid Cancer Terminology
A thyroid nodule or growth that is noncancerous is described as benign; a cancerous growth is described as malignant. Another name for thyroid cancer arising from follicular or C cells (parafollicular cells) is thyroid carcinoma. Many thyroid cancers are contained within their capsules, the membranes around thyroid nodules. Some thyroid cancers break through their capsules but are contained within the thyroid gland. A thyroid cancer may also break through the thyroid gland and invade directly into surrounding structures, such as the windpipe (trachea) and esophagus.
Less Favorable Prognostic Factors
for Patients with Differentiated Thyroid Cancers
|
| age 45 or greater |
tumor size if greater than 4 cm |
| papillary cancer with analplastic transformations |
| poorly differentiated follicular cancer |
| tall-cell, columnar, or diffuse sclerosing variants of papillary cancer |
| Hurthle cell type |
| distant metastasis |
| local invasion |
| lymph node metastasis |
| blood vessel invasion |
| multiple papillary cancers (multifocal papillary cancer) |
| insufficient surgery |
| delay in therapy |
| no levothyroxine therapy |
| no radiactive iodine treatment in some patients |
| male gender |
| presence of Graves' disease |
Typical Treatment of a Patient
with Differentiated Thyroid Cancer |
| Step 1 |
subtotal thyroidectomy
treatment of transient hypoclcemia
preparations for whole body scan
|
Step 2
6 weeks after surgery
|
physical examination
blood tests for TSH, free T4, and thyroglobulin
thyroid ultrasound
|
Step 3
1 or more days after Step 2 |
whole body scan
radioactive iodine (I131) ablation
thyroid hormon replacement with levothyroxine
|
Step 4
5 to 7 days after ablation |
post-treatment whole body scan |
Step 5
6 to 12 months
after starting levathyroxine |
physical examination
blood tests for TSH, free T4, and thyroglobulin |
Step 6
8 to 12 months after ablation |
follow-up tests
additional treatment, if necessary |
|