It looks like a butterfly, but when your thyroid is diseased, it can sting you like a bee. Your thyroid gland produces hormones that regulate metabolism, and when it’s dysfunctional, the result is a cascade of symptoms that can affect nearly every system in your body. And, according to the American Cancer Society (ACS), each year more than 62,000 American men and women experience another thyroid-related problem: thyroid cancer. Symptoms, fortunately, often allow for early detection of the disease.
By quickly identifying and addressing thyroid cancer symptoms, the chances of curing the cancer are relatively good. In fact, the death rate from thyroid cancer (about 1,950 deaths per year in the United States, according to the ACS) is fairly low compared to other cancers.
Unlike many other cancers, thyroid cancer is more commonly diagnosed at a younger age—nearly two-thirds of cases occur in people younger than age 55. Women are significantly more likely than men to develop the disease. Most people with thyroid cancer have no known risk factors, so most cases are unpreventable.
Recognizing Thyroid Cancer Symptoms
The thyroid gland is situated at the lower part of the front of your neck, and usually it can’t be seen or felt. However, when thyroid cancer develops, the gland may become enlarged (a condition known as goiter) or develop one or more nodules, which may grow rapidly. Oftentimes, thyroid cancer is identified when patients visit their doctors because of these abnormalities.
Although thyroid enlargement and nodules are perhaps the most common and identifiable thyroid cancer symptoms, keep in mind that the thyroid may be enlarged for a number of reasons, usually not cancer. And, only about one in 20 thyroid nodules is cancerous, according to the ACS.
The ACS recommends that physicians examine the thyroid as part of a routine health checkup, and some experts suggest that people periodically check their necks for abnormal lumps or growths. See your doctor immediately if you notice any lumps or swelling in the front of your neck.
Other thyroid cancer symptoms include pain in the front of the neck, swallowing difficulties, persistent hoarseness or cough, and trouble breathing. If a thyroid tumor grows large enough, it also may cause facial or neck pain or changes in your voice. Seek help if you experience these potential symptoms of thyroid cancer.
Treating Thyroid Cancer
Scientists have identified several types of thyroid cancer:
- Papillary cancers comprise about 80 percent of all thyroid cancers. Although they tend to grow slowly, they often spread to nearby lymph nodes in the neck, but they usually spread no farther. In most cases, these cancers can be treated successfully and aren’t lethal.
- Follicular cancers account for about 10 percent of thyroid cancers and are more common in areas where iodine deficiencies are more common. These tumors are more likely than papillary cancers to spread outside the neck, and the prognosis is not quite as favorable. A variant of follicular cancer, Hurthle cell cancer, accounts for only about 3 percent of thyroid cancers and may be more difficult to detect and treat.
- Medullary cancers, which account for only about 4 percent of thyroid cancers, originate in cells that produce calcitonin, a hormone that regulates calcium levels in the blood. These cancers may be more difficult to identify and may spread elsewhere before they’re detected, making the prognosis not as good for people with medullary thyroid cancers.
- Anaplastic cancer makes up only about 2 percent of all thyroid cancers. This form of cancer, more common in older adults, usually grows quickly, spreads rapidly, and is difficult to treat.
- Lymphoma cancer, which develops from immune cells, occurs rarely in the thyroid. Surgery to remove all or part of the thyroid is the primary treatment for nearly all thyroid cancers, and if the cancer is confined to the gland, surgery will cure it.
Radiation and Chemotherapy: Thyroid Cancer Options
Thyroid cells (including cancerous papillary or follicular cells) absorb radioactive iodine and are killed by it. So, radioactive iodine may be used to eradicate any cancerous thyroid cells left after surgery or cancer that has spread beyond the thyroid, while having little effect on the rest of the body.
However, medullary or anaplastic thyroid cancers do not absorb iodine and thus do not respond to radioiodine treatment. If these cancers spread beyond the thyroid, external radiation may be used. Chemotherapy may be added to radiotherapy to treat anaplastic thyroid cancer or other advanced cancers that no longer respond to other treatments. For advanced medullary thyroid cancer, targeted treatment with drugs such as cabozantinib (Cometriq) and vandetanib (Caprelsa) may be prescribed.
Originally published in March 2016 and updated.