Thyroid cancer - Symptoms, Diagnosis, and Treatments

Thyroid cancer is among the malignant , so malignant cancer . Its occurrence has been increasing in recent years, also thanks to more accessible diagnostics and preventive examinations. Early diagnosis changes has a positive effect on the outcome of treatment.

Thyroid cancer is less common in all cancers, accounting for about 2%. However, it is one of the most common cancers of the endocrine system of the human body. It affects women and people over the age of 40 to a greater extent , but also children.

Why its occurrence tends to increase is not fully understood. But the main reason is cited gene damage and which is the trigger for tumor cell formation. The long-term negative effects of modern times , industry , environmental pollution and the intake of pollutants in food also contribute to this .

As with other cancers, early diagnosis and early treatment are very important in thyroid cancer . It also has a direct impact on the success of treatment and a good prognosis.

Interesting information: More detailed information on the placement, structure and function of the thyroid gland can also be found in the magazine article  Thyroid gland and symptoms of problem activity or in the article on the disease Hyperthyroidism .

Oncological diseases of the thyroid gland

Thyroid cancers are divided into benign , ie benign and malignant , ie malignant . A benign tumor does not behave invasively, although its presence can cause a problem. And the opposite cancer. It affects the surrounding tissues and damages them.

A benign disease is, for example, adenoma or Hürtle's adenoma. A malignant tumor can be primary or secondary . It primarily comes directly from the thyroid tissue. The secondary is created by metastasis, ie the transfer of tumor cells from another part of the body. This is the case, for example , with breast , lung or kidney cancer .

TIP:  Information on these cancers can be found in the separate articles Breast Cancer  and Lung Cancer .

Tumor proliferation can affect the follicular tissue that makes up the thyroid gland itself, or the C cells that are responsible for the production of the hormone calcitonin. Thyroid cancer is a general term that can refer to 4 basic types of diseases, namely:

1. papillary carcinoma of the thyroid gland
2. follicular carcinoma of the thyroid gland
3. medullary thyroid carcinoma
4. anaplastic thyroid carcinoma

The table shows the basic histological classification of thyroid cancer

In addition, lymphomas and thyroid sarcomas are among the oncological diseases of the thyroid gland . Their occurrence is rare, about 0.6 - 5%. They mostly affect older women. And they can have an autoimmune cause. Secondary thyroid tumor is caused, for example, by the invasive behavior of cancer of the larynx or pharynx , but also of other surrounding structures. Alternatively, as a blood-borne metastasis from breast cancer .

The exact cause of thyroid cancer is not fully understood. Tumor proliferation is triggered by a disorder of the cell's genetic information . This disorder also occurs, for example, due to the long-term effects of risk factors . How is the negative impact of the environment or smoking.

The risk factor may also be unaffected , such as in hereditary predisposition, older age or gender. Because some types of cancer are inherited, they occur mainly in old age or are more prevalent in women. 

The risk factors that may be associated with thyroid cancer are listed in the table

The symptoms of the thyroid nation can usually be easily recognized by sight or touch . Which is a consequence of the anatomical deposition of the thyroid gland. One of the significant symptoms is the presence of a lump , nodule, or nodular goiter on the front of the neck, around the pituitary gland.

Enlargement of the thyroid gland , either one or both of its lobes , may also occur . Enlargement of the thyroid gland and the oncological unit may be due to symptoms related to the surrounding structures and their oppression.

The airways and digestive tract are nearby. For example, there is a deflection of the trachea to the side, but also a problem with breathing or swallowing. A hoarseness is associated with vocal cord damage. In thyroid cancer, enlargement of the nearby cervical lymph nodes is also present .

Difficulties that have arisen suddenly require special attention. It is important to note the  warning signs of thyroid cancer :

• palpable lumps and enlargement in the thyroid gland
• enlargement of the cervical lymph nodes
• feeling of pressure in the throat
• difficulty breathing
• swallowing problem
• snoring
• irritating cough

If any of these problems occur, it may not be cancer , but a professional examination is recommended . Early diagnosis of the disease is directly related to a good prognosis .

Symptoms of thyroid cancer in a nutshell:

• knot, lump, which can be alone, but also multiple, in the area of ​​the front side of the neck,
• fast growing knot
• change of already present goiter
• vocal cord paralysis and hoarseness, hoarseness
• shortness of breath, wheezing (stridor)
• difficulty swallowing, pain when swallowing
• irritating cough
• oppression of surrounding structures can cause tracheal deflection
• Sore throat pain is not the first symptom, but rather a late symptom of cancer
• enlargement of the cervical lymph nodes
• hyperthyroidism is not a clear manifestation of cancer, but occurs in functionally active tumors
• metastasis to other organs and associated difficulties
• in some cases the  knot is fixed to the skin
• slightly elevated body temperature is also less common
• a person may not have the typical appearance of a cancer patient, so he may not be associated with weight loss

Diagnosis is based on professional examination . Although warning signs may suggest cancer, this may not be the case. Of course, early detection and identification of the difficulties encountered is of great importance.

The doctor evaluates the clinical picture , takes a medical history . The thyroid gland is evaluated by sight , palpation , and cervical lymph nodes are also examined. Similarly, the shape, symmetry and size of the neck. Subsequently, the overall condition of the person is examined . And for the need of surgery.

Collection of biological material , ie blood for the determination of oncomarkers , levels of thyroid hormones (TSH, T ₃ and T ₄ ), but also levels of calcitonin and calcium. The basic diagnostic methods include ultrasonography , ie SONO, USG. It is further performed a biopsy fine needle and histological examination of the removed tissue.

Radioiodine testing is used for the ability of the thyroid gland to take up iodine from the blood. The form of radioactive iodine is deposited in the thyroid gland, followed by scintigraphy (gammagraphy). According to her, the size, shape and deposition of iodine in the thyroid tissue are evaluated.

Other imaging examinations include X-ray , CT , magnetic resonance (NMR, MRI). These imaging methods are also used in metastasis detection (MTS). Significant is laryngoscopy , bronchoscopy and endoscopy of the esophagus, and for detection of contact with surrounding structures cancer.

The table shows the TNM classification for cancer

Thyroid cancer manifests itself as a change in shape, size or the presence of hardening in the anterior part of the neck, when bitten. The palpation of the thyroid gland by a layman is very difficult. However, enlarging one or both lobes and forming a nodule is usually well visible and palpable.

Of course, it's not always cancer . In the case of pre-existing goiter, its change in size and shape may occur. The speed of the disease depends mainly on the type of disease. However, sudden changes and difficulties require increased attention.

Invasive tumor behavior is associated with difficulties associated with oppression of surrounding tissue. Hoarseness and hoarseness occur when the vocal cord is damaged. If the tumor pushes the airways, it may irritate the cough, or it will drink wheezing. 

Swallowing problems and pain when swallowing indicate a problem with the digestive tract. Enlarged lymph nodes in the neck are also one of the onset of symptoms. Alternatively, at a late stage and during metastasis, symptoms appear according to the location and extent of the metastases.