Thyroid Cancer

Thyroid cancer originates in the thyroid gland, a butterfly-shaped organ located at the base of the neck.

Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

Types of Thyroid Cancer

Thyroid cancer is categorised into several types, each with distinct characteristics and outcomes. The most common forms include:

This is the most prevalent form, making up the majority of all thyroid cancer cases. It grows slowly and is often confined to the thyroid. When detected early, it has a high cure rate.

This form occurs predominantly in older adults and represents a significant but smaller portion of thyroid cancer cases. It also has a good prognosis, especially when it has not spread to distant parts of the body.

A smaller fraction of thyroid cancers are of the medullary type. It can be more challenging to treat if it spreads beyond the thyroid. Genetic testing is often recommended, as it can be familial.

Although rare, anaplastic thyroid cancer is the most aggressive form and is difficult to treat. It usually occurs in older adults.

There are other less common types of thyroid cancer, including thyroid lymphoma and thyroid sarcoma, which originate from the immune and connective tissues of the thyroid, respectively.

Causes

The exact causes of thyroid cancer are not fully understood, but several factors have been identified that may increase the risk of developing the disease. These include:

Genetic Factors

Certain genetic mutations and familial conditions, such as familial medullary thyroid cancer and Gardner’s syndrome (a hereditary genetic disorder), are known to increase the risk of thyroid cancer.

Radiation Exposure

Exposure to high levels of radiation, particularly during childhood, is a significant risk factor. This includes exposure from medical treatments or from nuclear accidents.

Iodine Deficiency or Excess

While less common, both iodine deficiency and excess have been linked to an increased risk of certain types of thyroid cancer.

Gender and Age

Women are more likely to develop thyroid cancer than men, and while it can occur at any age, it is most common in people aged 30 to 60.

Hormonal Factors

Some evidence suggests that reproduction-related hormonal factors may influence the risk, though this link is not fully established.

Other Risk Factors

A history of goitre or thyroid nodules, as well as certain benign thyroid conditions, can also increase the risk of thyroid cancer.

Symptoms

Thyroid cancer may not cause any symptoms in its early stages. As it grows, it can lead to a variety of signs and symptoms, including:

A lump or swelling in the neck: This is often the first sign of thyroid cancer, noticeable when shaving or looking in a mirror.
Changes to voice: Including hoarseness or other voice changes that do not go away.
Difficulty swallowing: The presence of a tumour may make swallowing difficult.
Pain in the neck and throat: Pain that may extend to the ears.
Persistent cough: A cough that is not related to a cold.
Breathing difficulties: Feeling short of breath even when at rest.

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Diagnosis

Diagnosing thyroid cancer typically involves a combination of clinical evaluation, imaging tests, and biopsy procedures. The steps usually include:

Physical Examination

A thyroid specialist will examine the neck for physical signs of thyroid nodules, swelling, or changes in the thyroid gland.

Blood Tests

Tests to measure thyroid function and look for markers that might indicate cancer.

Ultrasound

This imaging test uses sound waves to create pictures of the thyroid gland and can help identify nodules or areas of concern.

Fine-Needle Aspiration Biopsy

Under ultrasound guidance, a thin needle is inserted into the thyroid nodule to collect cells for microscopic examination. This test is important for diagnosing the type of thyroid cancer.

Computed Tomography (CT) or Magnetic Resonance Imaging (MRI)

These imaging tests may be used to determine the extent of the cancer and to check for metastasis, particularly in more advanced cases.

Treatment Options for Thyroid Cancer

The treatment for thyroid cancer depends on the type, size, stage of the cancer, and the patient’s overall health. Options may include:

This is the most common treatment and may involve removing part (lobectomy) or all (thyroidectomy) of the thyroid gland. If cancer has spread to nearby lymph nodes, they may also be removed.

Used after thyroidectomy to destroy any remaining thyroid tissue or cancer cells. This treatment is particularly effective for papillary and follicular thyroid cancers.

This may be used when thyroid cancer is not responsive to radioactive iodine treatment or in cases of advanced cancer to relieve symptoms.

After thyroidectomy, patients often require thyroid hormone pills to replace the natural hormone and to help suppress the growth of any remaining cancer cells.

Targets specific abnormalities in cancer cells. For advanced thyroid cancers that do not respond to radioactive iodine therapy, targeted therapies can be an option.

Rarely used for thyroid cancer, but it may be an option for aggressive forms of thyroid cancer that do not respond to other treatments.

Preventive Measures

While it is challenging to prevent thyroid cancer due to the unknown cause of most cases, some strategies can help in reducing risk and ensuring early detection:

Avoid Unnecessary Exposure to Radiation

Especially in children and adolescents, avoid excessive radiation exposure, such as from medical imaging tests, unless necessary.

Regular Medical Check-ups

Routine health examinations can help detect thyroid nodules or thyroid gland changes early.

Genetic Counseling and Testing

For people with a family history of medullary thyroid cancer or related genetic syndromes, genetic counselling and testing may be recommended to assess risk and consider preventive surgery.

Diet and Lifestyle

Although the link between diet and thyroid cancer risk is not clear, maintaining a healthy diet rich in fruits, vegetables, and iodine (as recommended for your area) can support overall thyroid health.

Dr Jesse Hu

Consultant General Surgeon, Breast, Thyroid & Endocrine Surgery

Dr Jesse specialises in managing both benign and malignant breast and thyroid conditions, which also includes breast pain, breast lumps, breastfeeding problems, neck lumps, amongst others.

Her dual expertise in cancer removal and plastic surgery techniques expands the design of individualized treatments, leading to holistic patient outcomes.

Dr Jesse was part of the teaching faculties of both NUS Yong Loo Lin School of Medicine and Lee Kong Chian School of Medicine, where she teaches and mentors the next generation of medical students and trainee doctors.

Surgical training at NUS School of Medicine
FRCS (Fellow of the Royal College of Surgeons) Edinburgh, UK in 2014
Completed 2 Health Manpower Development Program (HMDP) fellowships at Oxford University Hospital, UK in 2016

Dr Jesse is recognized as an authority in breast cancer and thyroid surgery and a sought-after conference speaker.

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Thyroid Cancer

Frequently Asked
Questions

Can Thyroid Cancer Be Cured?

Yes, especially if diagnosed early, thyroid cancer has a high potential for being cured. The majority of patients with papillary and follicular thyroid cancers can expect a normal life expectancy with appropriate surgical and medical management. Treatment success rates are particularly high when the cancer is confined to the thyroid gland.

Is Thyroid Cancer Hereditary?

While the vast majority of thyroid cancer cases occur sporadically, certain types, such as medullary thyroid cancer, have a known genetic component and can run in families. Early identification of such genetic markers can lead to proactive surveillance and management of the disease.

Are There Any Long-Term Effects of Thyroid Cancer Treatment?

Treatment for thyroid cancer, particularly surgery (thyroidectomy) and radioactive iodine therapy can necessitate lifelong thyroid hormone replacement therapy to maintain normal metabolic functions. Patients may experience variations in energy levels, weight control, and mental well-being due to fluctuations in hormone levels.

Additionally, regular monitoring for potential side effects of treatment, such as changes in calcium levels due to parathyroid gland damage, is important for maintaining health.

Thyroid Cancer

Types of Thyroid Cancer