Written by Melanie Goldfarb, M.D., Associate Professor of Surgery, Director for the Endocrine Tumors and Disorders Center, and Medical Director for Cancer Survivorship at the John Wayne Cancer Institute.
The American Cancer Society, estimates about 53,990 new cases of thyroid cancer this year. It’s the most common cancer in women under 30 and the second most common cancer in women ages 30-45. Although it occurs more often in women, men can also have thyroid cancer it at an older age. Luckily, most types of thyroid cancer are very treatable and survivors live long, healthy and productive lives. However, knowing what to expect can help you cope. Discover the 7 things you need to know about thyroid cancer and how you can be proactive about the symptoms, diagnoses and treatment options.
1. There are almost no symptoms (except maybe a lump in your throat)
Thyroid cancer rarely has any symptoms:
- If it is big, you may feel a nodule in your neck or a lump in your throat.
- Big nodules (or cancer) can cause problems with swallowing (mainly with solid food), breathing when you lie flat to sleep, or increased coughing.
- Very advanced thyroid cancer can present with permanent voice change / hoarseness (meaning it doesn’t come and go throughout the day).
- Most patients are euthyroid (meaning there thyroid is working normally and producing the right amount of thyroid hormone).
2. How do you prevent Thyroid Cancer?
There is really no way to “prevent” thyroid cancer (except to not expose yourself to a nuclear disaster or significant radiation treatment to the neck). Other than radiation, we have yet to figure out other risk factors or causes of thyroid cancer, so until then it’s hard to say how to prevent it.
3. What happens if a thyroid nodule is left untreated?
Thyroid nodules, or growths, are very common. 50-70 of postmenopausal females have nodules and even 20-30% of women in their 30s and 40s have nodules. However, most are benign and can be watched once discovered. However, 5-10% are cancerous and therefore, if you have a thyroid nodule, it should be examined with a screening ultrasound. This can be ordered by your physician and be performed by a radiologist, endocrinologist, or endocrine surgeon. Solid thyroid nodules generally don’t shrink, but may grow slowly over time. If it grows large enough, it could cause symptoms such as problems swallowing or breathing.
4. What is the best test to evaluate a thyroid nodule?
If a nodule is palpated, the best test is an ultrasound performed by an experienced thyroid ultrasonographer, endocrine surgeon, or endocrinologist. Both the thyroid and surrounding lymph nodes should be looked at and a biopsy performed of anything suspicious. Some specialists (like we have) can do everything in one appointment (see “one-stop shop thyroid nodule clinic”)
5. What symptoms or characteristics would lead you to recommend surgery for a thyroid nodule?
Each patient is treated individually. However, characteristics that usually push me to recommend surgery are:
- Large nodule size (larger than 4cm)
- Worrisome ultrasound characteristics
- Suspicious or positive for cancer thyroid biopsy
- Compressive symptoms such as problems swallowing or breathing
- Multiple abnormal nodules that are difficult to follow.
6. How long is the recovery for thyroid surgery/ Parathyroidectomy? Can I eat after I have surgery?
Parathyroidectomy is surgery to remove one or more parathyroid tumors from your neck. Most patients go home the same day after surgery (in specialized centers such as ours).
- Patients can eat, drink, and talk right after surgery and shower the next morning.
- There are no restrictions – just listen to your body and most people are able to go back to normal activities almost right away. (I even had one patient take a spin class 48 hours later).
- The biggest complaint is sore throat – and the best treatment? Ice Cream!!!
- Sometimes it may hurt to swallow. That will go away as the inflammation around your esophagus goes down.
7. The good news – the cure rate is excellent! (97-99%)
The John Wayne Cancer Center for Endocrine Tumors and Disorders offers comprehensive, personalized care to patients (older children, adolescents, and adults) with endocrine conditions including thyroid cancer and nodules, hyperparathyroidism, osteoporosis and other bone disorders, adrenal tumors, PCOS, and transgender medicine. Contact us today to schedule your appointment!