Stages Of Thyroid Cancer
If you are diagnosed with thyroid cancer, your doctor may give the cancer a stage.
Doctors usually use the TNM system to stage thyroid cancer. This is a combination of letters and numbers that describe its size and how far the cancer has spread.
- T given from 1 to 4, which describes the size of the tumour
- N given as either 0 or 1, to indicate whether the cancer has spread to nearby lymph glands
- M given as either 0 or 1, to indicate whether the cancer has spread to another part of the body
Knowing the stage of your cancer will help your doctors decide on the best treatment for you.
Find out more about the TNM staging system for thyroid cancer from Cancer Research UK.
Page last reviewed: 28 August 2019 Next review due: 28 August 2022
All You Need To Know About Thyroid Cancer
Symptoms of thyroid disease are relatively non-specific, says Mechanick, and do not necessarily have to be associated with a structural abnormality, such as a lump.
However, the most common tip-off to thyroid cancer is a mass in the neck. Its very rare that it would manifest itself in any other way, Mechanick said.
He adds, We generally dont see people presenting with advanced thyroid cancer with clinical deterioration the way you might with other forms of cancer. Some cancers, he says, such as pancreatic or gastric cancer, have common, telltale symptoms, including drastic weight loss.
People with a family history of under-active or overactive thyroid glands have a greater risk of developing thyroid problems themselves. People who have been exposed to radiation treatment in the head and neck or toxic radiation are also at risk.
Fortunately, thyroid cancer is slow-growing, and people infrequently succumb to it, said Mechanick. The cancer can often be treated with surgery or radioactive iodine treatment, and it rarely requires further therapy after that.
Prevention is only possible with early detection, which is why self-exams are so crucial for finding and treating thyroid diseases.
Thyroid Problems: Here Are The Warning Signs And How To Check
If youre a woman, theres a good chance you spend a lot of time thinking about your breasts. You may have wanted them to be bigger as an adolescent, stressed about your milk supply as you became a mother and started lactating, or entered the stage of life where you need regular mammograms to help protect against breast cancer .
But theres another body part you need to make sure youre monitoring: your thyroid. Similar to the prevalence of breast cancer among women, the American Thyroid Association says that 1 in 8 women in the U.S. will develop a thyroid disorder, and 60% of those who have one are unaware of their condition.
Here, experts explain why staying on top of your thyroid function is important, and list some red flags that something may be up with yours.
But What If Its Thyroid Cancer
A cancer diagnosis is always worrisome, but even if a nodule turns out to be thyroid cancer, you still have plenty of reasons to be hopeful.
Thyroid cancer is one of the most treatable kinds of cancer. Surgery to remove the gland typically addresses the problem, and recurrences or spread of the cancer cells are both uncommon. People who undergo thyroid gland surgery may need to take thyroid hormone afterward to keep their body chemistry in balance.
Whether its benign or not, a bothersome thyroid nodule can often be successfully managed. Choosing an experienced specialist can mean more options to help personalize your treatment and achieve better results.
How Is Thyroid Cancer Diagnosed
If you have an enlarged thyroid nodule or other signs of thyroid cancer, your healthcare provider may order one or more of these tests:
- Blood tests: A thyroid blood test checks hormone levels and gauges whether your thyroid is functioning properly.
- Biopsy: During a fine-needle aspiration biopsy, your healthcare provider removes cells from your thyroid to test for cancer cells. A sentinel node biopsy can determine if cancer cells have spread to lymph nodes. Your provider may use ultrasound technology to guide these biopsy procedures.
- Radioiodine scan: This test can detect thyroid cancer and determine if cancer has spread. You swallow a pill containing a safe amount of radioactive iodine . Over a few hours, the thyroid gland absorbs the iodine. Your healthcare provider uses a special device to measure the amount of radiation in the gland. Areas with less radioactivity need more testing to confirm the presence of cancer.
- Imaging scans:Magnetic resonance imaging , computed tomography and positron emission tomography scans can detect thyroid cancer and cancer spread.
Hello Alapahmy Name Is Alla
My name is Alla and I was diagnosed with PTC few months ago, I am scheduled to have surgery on 9/2, however, I did do BRAF mutation mark before surgery and was positive. Did you have BRAF done for you? How big was you nodule? How long has it been since you had your surgery? My understanding since I have BRAF my form as well more aggresive and can reccure between 1-5 years. Sorry to ask you all these questions, but I am very scared for my upcoming surgery, thinking am I better off leave it the way it is or fight for my life after they remove it and I have less chances of survival?Â
How To Make Sure Sure You Are On The Right Dose
If you have hypothyroidism, you must find the right type and dose of thyroid medicationÂ for you. Your doctor will determine your starting dose based on your age, underlying health conditions, and blood test results. Starting doses may vary. For example, some people begin at a full replacement dose of 1.7 mcg/kg/day. In contrast, others are started at low doses between 25mcg-50mcg/day and titrated up as necessary. It can take several weeks to determine if the amount is therapeutic or not.
Once you find the right dose of thyroid medication, is it essential that you stay on that same dose and take it every day. You will also want to use the same brand continuously. Switching between generic and brand medications can change how your body responds to each type of medication. To remain stable on your thyroid medication, make sure that you know aboutÂ things that can affect thyroid medication absorption.Â
Your Thyroid Does Change As You Age
As with any organ, your thyroid may start to function differently as you get older.
Thyroid dysfunction generally occurs in either early adulthood or between the ages of 40 to 50, Lee said. As we get into our 70s, TSH naturally increases, meaning that your thyroid hormone levels may shift to be a little lower. This seems to happen to protect our bodies as we age, with less stress on our heart and metabolic system.
This is important to note, Lee said, because it gives physicians a greater threshold to treat someone who is older who may have higher TSH levels. Alternatively, low TSH levels can be more harmful the older we get.
This isnt to say that if youre young, you dont need to think about your thyroid at all. Thyroid disorders can happen at many different ages, as can lumps.
We do know that the younger population, those in their 20s, 30s and 40s, can develop thyroid nodules, Rao said. The vast majority of these nodules, especially if theyre below one centimeter, are 95% of the time completely benign. But its still important to be aware that they are there, and periodically monitor them.
How Does Thyroid Cancer Affect Pregnancy
Thyroid cancer is the second most common cancer diagnosed in pregnant women . Approximately 10% of thyroid cancers develop during pregnancy or within the first year after childbirth. Experts believe fluctuating hormone levels during pregnancy may trigger the cancer.
If you receive a thyroid cancer diagnosis during pregnancy, your healthcare provider can discuss treatment options. Depending on the cancer type and severity, your provider may recommend delaying treatment until after you deliver your baby. If treatment cant wait, most women can safely undergo surgery to remove the cancerous gland. You shouldnt have radioactive diagnostic tests or treatments when youre pregnant or breastfeeding.
Benefits And Limitation Of The Self
An at-home self-exam known as the “neck check” can help you find thyroid lumps or enlargements on your own thyroid gland. These growths may point to any number of thyroid conditions from nodules and goiters to thyroid cancer.
Lumps in the neck can be caused by thyroid disease, and they can also be caused by a variety of other conditions, such as lymph node enlargement, lymphoma, an infectious abscess, or a traumatic injury.
In general, a neck check is not considered the most accurate or reliable way to identify thyroid disease. You can have serious thyroid disease if you have a completely normal neck check. On the other hand, a major growth can often be a sign of an easily treatable condition, such as an iodine deficiency.
In the end, there are limitations as to what a neck check can tell you. A 2017 report from the U.S. Preventive Services Task Force concluded that neck palpation was able to detect thyroid nodules in only 11.6% of cases. Ultrasound, an imaging procedure using sound waves, was five times more accurate in detecting abnormal growths.
Who Is At Risk For Thyroid Cancer
Thyroid cancer can occur at any age, but women 40-50 years old and men 60-70 years old are most often diagnosed. Women are three times more likely to be diagnosed, or have a type of thyroid disease, according to the American Cancer Society.
Most people who develop cancer of the thyroid do not have an inherited condition or family history of the disease, but several inherited conditions have been linked to different types of thyroid cancer and having a close relative with thyroid cancer increases your risk.
Other risk factors include being overweight or obese, radiation exposure, and diets low in iodine.
What Blood Tests Are Used For Thyroid Diagnosis
Thyroid hormone levels can be measured from blood samples and used to help figure out if thyroid nodules are cancerous or not.
A hormone called TSH is checked to get a sense of overall thyroid activity. TSH is not actually made in the thyroid, but it helps regulate the production of other thyroid hormones. Most patients with thyroid cancer will have normal TSH levels.
Blood samples will also be checked for T3&T4 and calcitonin . Most thyroid cancers will have normal T3 and T4 levels.
High calcitonin levels are often seen in medullary thyroid cancer. A blood protein called CEA may also be elevated in those with this form of cancer. People with medullary thyroid cancer can also have a CEA blood test to check for genetic mutations linked to other conditions, like MEN-2.
There Is No Standard Or Routine Screening Test For Thyroid Cancer
There is no standard or routine screening test used for early detection of thyroid cancer. Thyroid cancer that does not cause symptoms may be found during the following:
- A routine physical exam when the doctor checks the patient’s neck for lumps or swelling in the neck, voice box, and lymph nodes, or anything else that seems unusual.
- Surgery that is done for another condition.
- An ultrasound that is done for another condition.
Who Should Perform Neck Checks
Theres no definitive recommendation for when to begin performing self-exams, but Mechanick does note that the cancer can appear in young adulthood. It also rarely develops in childhood or adolescence.
Every person when they have their general physical should have a thyroid exam, and then people who are at higher risk should potentially have a thyroid ultrasoundand not rely just on the manual exam, Mechanick said. By doing this you can detect thyroid cancer at the very early stages.
How To Check Your Thyroid
This article was medically reviewed by Ricardo Correa, MD. Dr. Correa is a board certified Endocrinologist. Dr. Correa is the Program Director of the Endocrinology, Diabetes and Metabolism Fellowship at the University of Arizona College of Medicine and was a previous Assistant Professor of Medicine at Brown University. He completed his MD at the University of Panama and completed an internal medicine residency at the Jackson Memorial Hospital – University of Miami. He has been voted one of the 40 Under 40 Leaders in Health by the National Minority Quality Forum in 2019.There are 12 references cited in this article, which can be found at the bottom of the page. This article has been viewed 40,747 times.
The thyroid gland is located at the base of your neck. It is a very important gland that produces a hormone that helps regulate your entire bodys metabolism, temperature, heart rate, growth, and development.XResearch source The thyroid gland can be functionally underactive or overactive. The thyroid can be enlarged, have benign nodules and, more rarely, malignant nodules.
Thyroid Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Thyroid Gland
The thyroid is a gland at the base of the throat near the trachea . It is shaped like a butterfly, with a right lobe and a left lobe. The isthmus, a thin piece of tissue, connects the two lobes. A healthy thyroid is about the size of a walnut. It usually cannot be felt through the skin.
- Control heart rate, body temperature, and how quickly food is changed into energy .
- Control the amount of calcium in the blood.
Screening Tests Have Risks
Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.
Signs And Symptoms Of Thyroid Cancer
Thyroid cancer can cause any of the following signs or symptoms:
- A lump in the neck, sometimes growing quickly
- Swelling in the neck
- Pain in the front of the neck, sometimes going up to the ears
- Hoarseness or other voice changes that do not go away
- Trouble swallowing
- Trouble breathing
- A constant cough that is not due to a cold
If you have any of these signs or symptoms, talk to your doctor right away. Many of these symptoms can also be caused by non-cancerous conditions or even other cancers of the neck area. Lumps in the thyroid are common and are usually benign. Still, if you have any of these symptoms, its important to see your doctor so the cause can be found and treated, if needed.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Davidge-Pitts CJ and Thompson GB. Chapter 82: Thyroid Tumors. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and RosenbergsCancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
National Cancer Institute. Physician Data Query . Thyroid Cancer Treatment. 05/23/2018. Accessed at https://www.cancer.gov/types/thyroid/patient/thyroid-treatment-pdq#_1. on February 20, 2019.
Last Revised: March 14, 2019
Being Exposed To Radiation Increases The Risk Of Thyroid Cancer
Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor.
Risk factors for thyroid cancer include the following:
- Being exposed to radiation to the head and neck as an infant or child or being exposed to radiation from an atomic bomb. The cancer may occur as soon as 5 years after exposure.
- Having a family history of thyroid disease or thyroid cancer.
- Having a history of goiter .
- Having a geneticcondition such as multiple endocrine neoplasia type 2 syndrome , which is caused by a change in the RET gene.
- Being female.
What Are The Symptoms Of Thyroid Cancer
You or your healthcare provider might feel a lump or growth in your neck called a thyroid nodule. Dont panic if you have a thyroid nodule. Most nodules are benign . Only about three out of 20 thyroid nodules turn out to be cancerous .
Other signs of thyroid cancer include:
- Difficulty breathing or swallowing.
- Swollen lymph nodes in the neck.
Diagnosis Of Papillary Thyroid Cancer
- There are approximately 64,000 new thyroid cancers diagnosed in the United States annually
- The diagnosis of papillary thyroid cancer accounts for approximately 85% of all thyroid cancers
- The diagnosis of papillary thyroid cancer is most common in women between the ages of 30 to 50
- The diagnosis of papillary thyroid cancer may occur at any age including infants, children and later years of life
- The diagnosis of papillary thyroid cancer effects women three times more frequently than it does men
- The diagnosis of papillary thyroid cancer is the fifth most common cancer affecting women in the United States
How Thyroid Cancer Is Diagnosed
There are many tests used for diagnosing thyroid cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:
The type of cancer suspected
Your signs and symptoms
Your age and general health
The results of earlier medical tests
The following tests may be used to diagnose thyroid cancer:
Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. An ultrasound wand or probe is guided over the skin of the neck area. High-frequency sound waves create a pattern of echoes that show the doctor the size of the thyroid gland and specific information about any nodules, including whether a nodule is solid or a fluid-filled sac called a cyst.
Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The way to determine whether a nodule is cancerous or benign is through a biopsy. During this procedure, the doctor removes cells from the nodule that are then examined by a cytopathologist. A cytopathologist is a doctor who specializes in analyzing cells and tissue to diagnose disease. This test is often done with the help of an ultrasound . A biopsy for thyroid nodules will be done in 1 of 2 ways:
Feel The Bumps And Enlargements
Gently touch the area around your thyroid gland to try to palpate any enlargement, bumps, or protrusions. To differentiate between the thyroid and the other structures of your neck:
Thyroid Hormone Is Necessary For Life
Lets review some of the basics:
Your thyroid gland produces two very important hormones: and .
These are the most active thyroid hormones in your body.
Once they are released from your thyroid gland, which is located in your neck, they circulate through your entire body and interact with all of your cells.
Your thyroid gland is the only place that these thyroid hormones can be created.
So, you can imagine if that gland is damaged or removed the consequence will be an abrupt reduction in circulating thyroid hormone.
This is a major problem because thyroid hormone helps regulate several important functions in your body.
If you dont have any thyroid hormone then this regulation stops and serious problems tend to occur.
The most serious consequence from not having thyroid hormone in your body is coma or death .
Long before this happens, though, you still start to experience other side effects which will tell you that your thyroid isnt functioning properly.
Now that you understand why the thyroid is so important we can start to talk about the reasons why you may want to have it removed.
What Its Really Like To Have Thyroid Cancer
My year with a so-called good cancer.
About a little over a year ago, I found myself reclined in an exam chair about to have a big needle jabbed into my neck.
Big pinch, the doctor said, as he gave me the local anesthetic. I just stared at the ceiling, trying to remain calm despite the fear and the burning bee sting sensation.
I spent the previous evening drinking wine and Googling, cancer in your neck,biopsy needle,lump in neck, and thyroid cancer deathwhile my six-year-old son, Jack, and our brand new Golden Retriever puppy, Lucia, slept peacefully unaware that their single mom had a very suspicious 4-centimeter lump on her thyroid gland. Two weeks prior, my regular doctor had discovered the lump during a routine physical. An ultrasound and CT scan later, this needle was to determine whether it was cancer.
But it didnt.
Thats the first thing I learned about having cancer: it can take an awfully long time to confirm that you actually have it.
How To Prevent Thyroid Cancer
Here you can get information about How to Prevent Thyroid Cancer. Your thyroid may be a small, butterfly-shaped gland situated within the front of the neck, which makes hormones that control metabolism, pulse, vital sign, and body temperature.
Thyroid cancer begins when its cells change and grow uncontrollably, which eventually form small nodules. There are a few different types of thyroid cancer, and most are curable when detected early. Most of the people with thyroid cancer develop it for unknown reasons, so effective prevention is difficult to know. However, reducing the most common risk factors can help prevent thyroid cancer in some cases.
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What Is Molecular Profiling
At UCLA, thyroid nodules with indeterminate biopsies are sent out for an additional molecular marker test. An indeterminate biopsy result is the gray zone where the risk of cancer is intermediate but cannot be ignored.
Sometimes the biopsy result is reported as indeterminate. This means the cells are not normal, but there are not definite signs of cancer. When biopsies are indeterminate, the risk of thyroid cancer is 15-30%.
In the past, to avoid missing a cancer, we recommended thyroid lobectomy to establish a definitive diagnosis. Now, we use molecular profiling. This refers to commercial DNA or RNA tests made specifically for indeterminate thyroid nodules. If the genetic profile appears benign, patients can avoid surgery and we simply watch the nodule over time with neck ultrasound.