Thyroid Cancer

Thyroid cancer occurs in the cells of the thyroid, which is a butterfly-shaped gland located at the base of your neck, just above the collarbone. The thyroid produces hormones that regulate your heart rate, blood pressure, body temperature, and weight.

There are several types of cancer of the thyroid gland. You are at greater risk of developing thyroid cancer if you:

• are between ages 25 and 65
• are a woman
• are Asian
• have a family member who has had thyroid disease
• have had radiation treatments to your head or neck

Often, the first sign or symptom of thyroid cancer is a lump or swelling in the neck.

Thyroid cancer is not common in the United States, and most cases of thyroid cancer can be cured with treatment that includes surgery, radioactive iodine, hormone treatment, radiation therapy, chemotherapy, or targeted therapy.

Thyroid cancer typically does not cause any signs or symptoms early in the disease. As thyroid cancer grows, it may cause:

• a lump that can be felt through the skin on your neck
• changes to your voice, including increasing hoarseness
• difficulty swallowing
• pain in your neck and throat
• swollen lymph nodes in your neck

In most cases, it is not clear what causes thyroid cancer.

In general, cancer occurs when cells develop errors (mutations) in their DNA. The errors make cells grow and divide out of control. The accumulating abnormal cells form a tumor that can grow to invade nearby structures and spread to other parts of the body.

Radiation exposure to the head or neck can increase your risk of developing thyroid cancer.

Doctors use several tests to diagnose thyroid cancer, including:

• physical exam. Your doctor will look for physical changes in your thyroid and ask about your risk factors, such as excessive exposure to radiation and a family history of thyroid tumors.
• blood tests. Blood tests help determine if the thyroid gland is functioning normally.
• removing a sample of thyroid tissue. During a fine-needle biopsy, your doctor inserts a long, thin needle through your skin and into the thyroid nodule. The sample is analyzed in the laboratory to look for cancer cells.
• imaging tests. You may have one or more imaging tests, including computerized tomography (CT) scans, positron emission tomography (PET), or ultrasound. to help your doctor determine whether your cancer has spread beyond the thyroid.

If you have or have had thyroid cancer, you can take steps to manage the stress that accompanies the diagnosis.

• Learn about thyroid cancer you have so you can make informed decisions about your care.
• Have a schedule of follow-up tests and go to each appointment.
• Take care of yourself so that you are ready to fight cancer. This includes eating a healthy that includes plenty of fruits, vegetables and whole grains, exercising for at least 30 minutes most days of the week, and getting enough sleep so that you wake feeling rested.
• Accept help and support from family and friends.

Treatment options for thyroid cancer will depend on the size, type, and stage of your cancer. Surgery, radioactive iodine, radiation therapy, chemotherapy, and targeted therapy may be used alone or in combination to treat thyroid cancer.

Surgery. Surgery may be used to treat thyroid cancer by removing part or all of the the thyroid and/or the surrounding lymph nodes.

Radioactive iodine treatment. Radioactive iodine treatment uses large doses of a form of iodine that's radioactive. It is often used after thyroidectomy to destroy any remaining healthy thyroid tissue, as well as microscopic areas of thyroid cancer that were not removed during surgery. Radioactive iodine treatment may also be used to treat thyroid cancer that recurs after treatment or that spreads to other areas of the body.

Radiation therapy. Radiation therapy involves treating cancer with high-powered beams of energy, such as X-rays or protons. Radiation may be used if you cannot undergo surgery and your cancer continues to grow after radioactive iodine treatment. It may also be used to slow the growth of cancer that has spread to the bones.

Chemotherapy. Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy can be administered by pill, through a vein (intravenously), or both methods may be used. Chemotherapy is not commonly used in the treatment of thyroid cancer, but it may benefit some people who do not respond to other therapies.

• cabozantinib (Cometriq)
• sorafenib (Nexavar)
• vandetanib (Caprelsa)