Thyroid cancer is one of the most commonly diagnosed cancers in the United States. There are approximately 57,000 newly diagnosed thyroid cancers yearly. While it makes up 4 percent of cancers annually in the U.S., survival and outcomes are good, representing 0.3 percent of deaths from cancer. Papillary thyroid cancer is by far the most common type. Other types include follicular thyroid cancer, medullary thyroid cancer, thyroid lymphoma, and anaplastic thyroid cancer.
The thyroid gland is a butterfly-shaped gland in the lower neck, and it makes a hormone that plays a role in cell metabolism. While thyroid cancers are common, they may have few or no signs or symptoms. Many are found “incidentally,” which means the cancer was found while doing an imaging test, such as an ultrasound, for something else.
For those persons with signs and symptoms of thyroid cancer, the cancer typically presents as a lump in the middle part of the neck. It is not usually painful. Sometimes it causes a feeling of pressure at the point of the mass. In more advanced cancers, the voice may change and become hoarse or breathy. All masses in the neck should be evaluated first by a good history and physical exam, and then a decision is made to pursue further testing if needed. To evaluate for thyroid masses, an ultrasound is done first. A biopsy may be recommended depending on those results. Risk factors for thyroid cancer include a family history of thyroid cancers and exposure to radiation to the neck area.
Amanda M. Laird, MD, FACS
Treatment of thyroid cancer almost always is by surgery to remove part or all of the thyroid gland. Depending on factors related to the tumor, additional treatment with radioactive iodine may be necessary. If all of the thyroid is removed, then life-long thyroid hormone replacement therapy is given. Patients are seen annually after diagnosis and treatment to follow for recurrences, however, the prognosis for most thyroid cancers is very good.
Amanda M. Laird, MD, FACS is an endocrine surgeon and the chief of the Section of Endocrine Surgery at Rutgers Cancer Institute of New Jersey; and an associate professor of surgery at Rutgers Robert Wood Johnson Medical School.