The thyroid cancer has a very good cure-rate for most folks.
Thyroid cancer occurs actually across all ages. It does happen much more frequently
in women. And it can happen at any age; it does tend to peak around 40s and 50s. But
it can happen in children, young adults and throughout the lifespan.
The thyroid gland is a gland that basically makes a hormone that’s important in the
metabolism and it sits in the low neck right down here. What frequently will bring someone
in, is either their physician found a lump in the neck and it’s very important that
when you swallow, that lump will move up and down. So often times just looking in the mirror
and/or seeing a friend or loved one swallow and seeing a lump on one side move up and
down will give an indication that there’s an enlargement of the thyroid gland. Most
of the time enlargements of the thyroid gland are going to be benign, most of those are
not going to be cancerous. But it’s important when you see and feel one, it be evaluated.
The types of cancers that occur vary to some degree; there’s by far the most common type
is called papillary thyroid carcinoma. That’s what the vast majority of people who have
had thyroid cancer will have. It’s a very treatable form of cancer. The other types
of cancers, medullary carcinoma for example, is one that tends to run in families, tends
to be more of a genetic type of cancer. It’s not always; it’s certainly much more frequent
than others. Follicular carcinoma is another; what we love to gather with papillary to call
well differentiated thyroid cancer and it’s basically has the same risk factors, or similar
risk factors to papillary. And then there’s one that people may have read about or known
people have died of thyroid cancer very quickly and it’s called anaplastic thyroid cancer.
And it’s very important to understand that that is a completely separate entity. It’s
a very very aggressive cancer and one that moves very quickly but the vast vast majority
of cancers of the thyroid are not anaplastic.
We know that radiation exposure definitely is a risk factor; for example the folks that
lived near Chernobyl when that meltdown occurred in the mid-1980s, within four years we began
to see an increased incidence of thyroid cancer in very young people; people that were between
newborns and in fact others were pregnant to about five years of age. They had up to
a fifty-fold increased risk (50 times risk) that began to show up very early. Whether
that will continue to show in adults is not completely clear yet, but without a doubt,
the young people are at highest risk. So we know radiation exposure.
Treatment of thyroid cancer is primarily and fundamentally surgical. With the exception
of anaplastic cancer, the other three are treated with an operation that involves removal
of part or all of the thyroid gland, depending on the stage or the size of the lump. It may
also involve removal of lymph nodes in the area, such as those close to their trachea
in the esophagus or possibly out in the lateral neck around the jugular vein. It just depends
on the clinical situation. We then will use a thyroid hormone called Synthroid or Levothyroxine,
which is designed to replace the thyroid. But we also use it to suppress or decrease
the activity of any potential cells that may still be in the body. And so that’s another
form of therapy that we use.
And then afterwards, we follow people; it’s very important that they be followed. We see
them on a basis that’s a regular that involves physical examination, blood tests at times
and ultrasounds again to really get a good sense of what the, what I say “looking under
the hood”, so we can really get a good sense of what’s going on inside the neck and if
there’s anything to be concerned about.
Personally, I had thyroid cancer and I’ve only had to have half of my thyroid removed
because it was so small. Fortunately, I’ve not had other cancers that I treat so and
I’m happy to stay that way. One of the nice things is when we go through the biopsy and
talk about that, I can tell them what my experience was like. I do understand the anxiety of waiting
for results and the uncertainty; mine was uncertain, the diagnosis was uncertain at
the time of surgery.
I’m seven years from my diagnosis and most particularly young people that are diagnosed
will have an extremely high prognostic rate. So, for example, a young woman that is diagnosed
that doesn’t have evidence of spread into the heart or I’m sorry the lungs or bones,
would have on average about a 98 percent change of being alive and well at 20 years, so extremely
good prognosis. As the cancer is more advanced, that does drop off. But thyroid cancer, with
the exception of anapalastic and then somewhat less with medullary has a very good cure-rate
for most. It’s a still a cancer that needs to be dealt with and surgery, as I said, is
the treatment and follow-up is important. But people can generally anticipate a long
and healthy life.