Thyroid Cancer: Symptoms, Causes, Diagnosis, and Treatment

Thyroid cancer originates from the thyroid gland. Women are three times more likely to develop this cancer than men, usually in their 40s or 50s, and men in their 60s or 70s.

In Malaysia, the incidence of thyroid cancer is 1.6% among all new cases reported in 2020. The good news is – it is usually highly treatable with an excellent cure rate.

Types of thyroid cancer

If an individual is diagnosed with thyroid cancer, they may have one of the four main types:

• Papillary carcinoma which makes up about 8 out of 10 thyroid cancers
• Follicular carcinoma which comprises about 1 out of 10 thyroid cancers
• Medullary thyroid carcinoma which accounts for about 4% of thyroid cancers
• Anaplastic thyroid carcinoma which records 2% of all thyroid cancers

Risk factors of thyroid cancer

People who are at risk for being diagnosed with thyroid cancer include:

• Previous exposure to strong radiation
• Inheriting genetic syndromes, like familial medullary thyroid cancer, multiple endocrine neoplasia, Cowden's syndrome, Carney complex, and familial adenomatous polyposis
• Being of the female sex
• Having a family history of relatives who had thyroid cancer
• Being overweight or obese
• Lacking iodine in the diet

Signs and symptoms of thyroid cancer

Common signs and symptoms:

• Persistent coughing, which is not caused by a cold
• Hoarse voice
• Pain in neck and throat, sometimes going up the ears
• A lump that can be felt in the neck area
• Swelling in the neck area
• Difficulty swallowing food
• Difficulty breathing

Diagnosis of thyroid cancer

The presence of a lump in the throat or neck usually alerts an individual to seek medical attention. The doctor will examine the size and firmness of the thyroid, as well as to detect any enlarged lymph nodes in the neck.

Other ways to diagnose thyroid cancer are:

• Blood tests
• Biopsy
• Vocal cord exam (laryngoscopy)
• Imaging tests: Ultrasound, radioiodine scan, chest x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), magnetic resonance imaging (MRI), positron emission tomography (PET) scan

Learn more about the different types of screening and diagnostic procedures performed to diagnose thyroid cancer.

Treatment options for thyroid cancer

The treatment option is dependent on the stage and type of cancer, and patient’s general health. Often, more than one type of treatment is required.

• Surgery is the main treatment in thyroid cancer, except for some anaplastic thyroid cancers. Options include lobectomy (removal of the lobe containing cancer), thyroidectomy (removal of thyroid gland), and lymph node removal.
• Radioactive iodine (RAI) involves the collection of RAI in the thyroid cells, where the radiation destroys the thyroid gland and other thyroid cells that absorbs iodine. This treatment ablates or destroys thyroid tissues not removed by surgery, or thyroid cancers that have spread to the lymph nodes or other body parts.
• Thyroid hormone therapy with levothyroxine (a thyroid hormone) ensues after thyroidectomy to maintain normal metabolism and lower risk of cancer relapse.
• External beam radiation therapy uses high-energy rays (or particles) to destroy cancer cells or slow their growth. This therapy is most often used for cancers that do not take up iodine and have spread beyond the thyroid.
• Other forms of treatment include chemotherapy, targeted drug therapy, and palliative care.

Learn more about the different types of treatment technologies to treat thyroid cancer.

Prevention of thyroid cancer

It may not be possible to prevent thyroid cancer in people with an average risk of the disease. However, steps can be taken to reduce cancer risk in individuals with genetic mutation.

Preventive (prophylactic) surgery may be considered in adults and children with an inherited gene that increases the risk of medullary thyroid cancer. This procedure involves the surgical removal of thyroid gland before cancer develops.

Detect to Protect!

Currently, there is no recommended screening test for individuals at average risk. Although blood test or thyroid ultrasound can show changes in the thyroid, these tests are only routinely used in individuals with increased risk of thyroid cancer.

Genetic testing may be recommended for people with a family history of medullary thyroid cancer at an early age to check if they carry the mutations contributing to the cancer.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of thyroid cancer, get in touch with us to find out more about our Oncology Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with oncologists to assist patients through cancer treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.