Thyroid cancer: Knowing the facts
“Thyroid disease is a highly prevalent condition with impact on childhood development, women’s fertility, and risk of malignancy, making it an important global health issue of high priority.” This according to the Science Direct website.“Many South Africans are still unaware of what the thyroid is and what to look out for when it comes to thyroid health,” says Dr Justus Apffelstaedt, a specialist surgeon with an interest in thyroid and parathyroid health management. “Being armed with the facts greatly increases the opportunity for early detection and diagnosis, which are a patient’s best chance for recovery.”
The thyroid, small as it is, is crucial. It affects, directly or indirectly, almost every function in our bodies, including our temperature, digestive system, and mental development. It even plays an important role in female fertility, amongst many other functions.
While thyroid dysfunction is fairly common, diseases of the thyroid such as hypothyroidism (lack of thyroid hormones secreted) and hyperthyroidism (increase in thyroid hormones secreted) are rarely cancerous and can usually be well-managed.
Low incidence, yet common
“Thyroid cancer has a low incidence within the general population,” says Dr Fatima Hoosain, a specialist surgeon, “but it is still one of the more common cancers. Fortunately, with early detection, there is a high survival rate. Like many cancers, thyroid cancer can have a genetic component. People with a family history of thyroid cancer or the rare pheochromocytoma tumour (a tumour that develops in the adrenal gland that is usually benign), have higher chances of developing thyroid cancer. As in the case of breast cancer, a genetic test can be advised to determine if the patient carries genes that increase the potential risk of having the disease.”
A key factor in early thyroid disease diagnosis is that doctors must not ignore patients who present early symptoms. Whilst symptoms do vary, some can be fairly generic and include:
• The appearance of a lump in the neck.
• Swollen lymph nodes.
• A persistent cough not linked to a cold.
• Difficulty in breathing.
• Constant voice changes and hoarseness.
The abovementioned signs and symptoms most commonly point to benign causes but can be related to thyroid cancer; so if they are present, medical advice is recommended.
Incidental finding
“These days, many patients undergo imaging such as CTs, MRIs and ultrasounds of the neck for problems unrelated to the thyroid,” says Dr Apffelstaedt. “Often, in these examinations, there is an incidental finding of a lump in the thyroid gland. The vast majority of these lumps are benign, but they must be further investigated to avoid missing a cancer. This is done with ultrasound by a skilled operator and in some cases, taking a sample of the lump with a fine needle for examination by a pathologist. These procedures are generally enough for a diagnosis. An operation to remove part of the thyroid gland where the lump resides is sometimes done for a final diagnosis, but this is rarely required.”
Surgery is generally the main treatment of thyroid cancer. If thyroid cancer is diagnosed by a fine needle biopsy, surgery to remove half or all of the thyroid gland is recommended. The slow growth of most thyroid cancers also means that if treated properly, they have an excellent prognosis. It is rare for thyroid cancers to require more aggressive treatments such as radiation, chemotherapy, and biologicals.
Doctors Apffelstaedt and Hoosain advise that you remain vigilant about your overall health and consult your doctor with any concerns. If your doctor is unhappy with the symptoms presented, you should be referred to a specialist for further investigation and diagnosis to assess the appropriate treatment.