Thyroid cancer is an abnormal cell growth that occurs inside the thyroid gland. The thyroid is a butterfly-shaped gland located at the front of the neck. This gland secretes hormones that regulate metabolism, growth, body temperature, heart rate, blood pressure, weight, and more.
There are three types of hormones released by the thyroid gland, among others:
- Triiodot i ronin (T3) and t i ro ks in (T4). Both of these hormones help regulate the body's metabolism. Excess hormone T3 and T4 can make a person become overactive and weight decreased. Conversely if the deficiencies of these two hormones, then someone will feel weak and weight will increase.
- Calcitonin. It is a type of hormone that regulates the levels of calcium in the blood and helps the process of strong bone formation. This hormone does not have a key role in maintaining health because the body also utilizes other ways of controlling the levels of calcium in the blood.
Thyroid cancer is divided into four types, namely:
- Papillary carcinoma. This is the most common type of thyroid cancer, which is about 60 percent of all thyroid cancer cases, and usually affects women under 40 years of age.
- Follicular carcinoma. About 15 percent of cases of thyroid cancer are of this type. Follicular carcinoma tends to occur in elderly people.
- Medullary thyroid carcinoma. This type occurs in about 5-8 percent of all cases of thyroid cancer. What distinguishes it from other types is thyroid medullary carcinoma generally influenced by hereditary factors.
- Anaplastic thyroid carcinoma. This is the most rare, but most aggressive, type of thyroid cancer. This condition occurs only in 5 percent of all cases of thyroid cancer and generally occurs at the age of 60 years and over.
Symptoms of Thyroid Cancer
In the early stages, thyroid cancer rarely cause symptoms, even tend not to exist at all. However, if it has entered the advanced stage, thyroid cancer is often characterized by the appearance of a lump or swelling on the front of the neck, more precisely under the Adam's apple, and usually does not hurt.
There are several other symptoms that appear after the cancer enters an advanced stage, including:
- Sore throat.
- Difficulty in swallowing.
- The sound becomes hoarse and does not improve after a few weeks.
- Pain in the neck.
- Swollen lymph nodes in the neck.
Risk Factors of Thyroid Cancer
The exact cause of thyroid cancer is still unknown, but there are several factors that can increase the risk of this condition, among others:
- Experiencing thyroid disorders. People who have had benign thyroid disease, such as inflammation of the thyroid gland or mumps, have a greater risk of thyroid cancer than those who have never experienced it.
- Family health history. The inherited genetic disorder is responsible for several cases of thyroid carcinoma. The risk of thyroid cancer increases if a person has a family who has had this cancer.
- Height and weight. The risk of thyroid cancer will increase if a person has excess weight. The risk will also increase in adults with an above average height.
- Exposure to radiation. Radiation from nuclear or radiation from certain medical treatments may increase a person's risk of developing thyroid cancer, especially if the radiation is about the neck and head.
- Indigestion. If a person has familial adenomatous polyposis (FAP) digestive disorders, he is at higher risk of developing thyroid cancer. FAP is a hereditary disease caused by a defective gene.
- Gender. Women have a risk of thyroid cancer 2-3 times more than men. This condition may be related to the hormone released when a woman has menstruation or when she is pregnant.
- Acromegaly. This is a rare condition where the body produces too much growth hormone. This condition causes people who experience acromegaly more at risk of thyroid cancer.
Diagnosis of Thyroid Cancer
To diagnose thyroid cancer, the doctor will perform a physical examination as the initial stage of the examination. Doctors will also inquire about family health history as well as symptoms experienced by patients, one of which is a hoarse voice that does not go away.
Some further tests that can be done to diagnose thyroid cancer are:
- Thyroid function test. This is a type of blood test that serves to check whether there is interference with the function of the thyroid gland, by measuring the levels of thyroid hormones in the blood.
- The cytology of fine needle aspiration. In this test, a very small needle is inserted into a lump in the neck to take a tissue sample which is then examined by a microscope. This test can detect the presence of abnormal cells and cancer cells.
- Scanning. This examination needs to be done to ascertain whether the cancer that appears has spread beyond the thyroid gland. Scanning can be done via CT scan, ultrasound, or PET (positron emission tomography).
- Inherited disease test. Doctors may need to perform genetic testing in patients to look for a gene disorder that may increase the risk of medullary thyroid cancer.
Treatment of Thyroid Cancer
This type of treatment of thyroid cancer depends on the type and stage of the cancer. Some cancers, such as papillary carcinoma, follicular carcinoma, and some medullary thyroid carcinomas, have a better chance of recovery. This type of thyroid cancer is treated by surgical removal of the thyroid gland, and may be combined with radiotherapy.
Here are some treatment steps to deal with thyroid cancer:
- Thyroidectomy. This procedure is performed to remove the thyroid gland, either partially (hemitiroidektomi) or the whole (total thyroidectomy). This procedure depends on the type and size of thyroid cancer, and whether it has spread to other body parts. Patients are encouraged to rest for 2-3 weeks after surgery to avoid weight-bearing activities on the neck.
- Hormone replacement therapy. Patients will not be able to produce hormones that regulate the body's metabolic system after performing thyroidectomy procedures. Therefore patients will need hormone replacement tablets for life. Regular blood tests need to be done to adjust the dose and monitor the right hormone levels for the body.
- Arrangement of calcium levels. Surgical removal of the thyroid gland often affects the parathyroid gland. The parathyroid gland is located near the thyroid gland and acts to regulate the levels of calcium in the blood. Therefore, calcium levels must also continue to be considered.
- Radioactive iodine treatment. This treatment serves to destroy the cancer cells that are still there and prevent it from appearing again after undergoing surgery. Side effects that may occur due to this procedure are nausea, dry mouth, dry eyes, and the sense of taste and smell that changed.
- External radiotherapy. In this procedure, radioactive waves are directed to the affected part of the body. This treatment is usually done to treat advanced stage cancer or anaplastic thyroid carcinoma. The duration of radiotherapy itself depends on the type of cancer and its development.
- Chemotherapy. This procedure is usually only used to treat anaplastic thyroid carcinoma that has spread to other body parts. Patients will be given a very powerful drug to kill cancer cells. This treatment can not cure anaplastic cancer completely, but can slow the progression of cancer and help relieve symptoms that arise from thyroid cancer.
Untreated thyroid cancer may reappear, although the thyroid gland has been removed through surgical procedures. This can happen because the cancer cells that have spread to the outside of the thyroid gland. The re-emergence of thioroid cancer usually occurs within five years after surgery, but may also appear decades after initial treatment.
Reappearance of this cancer can occur in the lymph nodes in the neck, thyroid gland tissue that is still left behind during surgery, or in other body parts. To detect signs of recurrence, the doctor will recommend that patients perform blood tests and thyroid scans at regular intervals.