Thyroid Cancer: Symptoms You Shouldn’t Ignore

The thyroid gland is a small, butterfly-shaped organ located on the front of the neck. It regulates metabolism, body temperature, heart rate, and mood.

Thyroid cancer is one of the most common oncological conditions of the endocrine system. The good news is that, if detected early, it responds well to treatment. Let’s discuss this in more detail.

What is thyroid cancer, and who is at risk?

Thyroid cancer is a malignant tumor that develops from cells of the thyroid epithelium or the gland’s parafollicular C-cells. The tumor may remain localized within the organ for a long time, or it may aggressively invade neighboring tissues and metastasize.

Thyroid tumors are most commonly diagnosed in women aged 25 to 65. Women are affected approximately three times more often than men due to differences in hormonal profiles.

The risk group includes people who:

• Underwent radiation to the head and neck during childhood or adolescence
• Have close relatives with this diagnosis or multiple endocrine neoplasia
• Suffer from certain benign thyroid conditions-in particular, nodular goiter
• Live or have lived in regions with iodine deficiency.

Thyroid Cancer: Causes

In thyroid cancer, the causes are mostly associated with mutations in the DNA of thyroid cells, whether congenital or acquired over the course of a lifetime.

Risk factors:

• Ionizing radiation
• Heredity
• Iodine deficiency
• Hormonal factors (the influence of estrogens in women)
• Age and gender (the risk increases after age 40).

What are the symptoms of thyroid cancer?

In the early stages, the tumor does not cause pain or discomfort. Therefore, many patients learn of their diagnosis by chance during a routine ultrasound or an examination for another reason.

The most common symptom is a firm lump or swelling in the neck that gradually grows. Even if it doesn’t hurt, this is a reason to see a doctor immediately.

Other symptoms of thyroid cancer:

• Hoarseness that does not go away for no apparent reason
• Difficulty swallowing, a sensation of a “lump” in the throat
• Shortness of breath, a feeling of suffocation
• Enlarged lymph nodes in the neck
• Neck pain radiating to the ear.

Signs of thyroid cancer are often mistaken for a cold, laryngitis, or stress.

Symptoms of thyroid cancer in women are essentially no different from those in men.

Types of thyroid cancer

The classification of thyroid cancer is based on the type of cells from which the tumor develops. This determines the tumor’s behavior, its aggressiveness, and the treatment strategy.

• Papillary - accounts for about 80% of all cases. It grows slowly, responds well to treatment, and has a favorable prognosis even in the presence of lymph node metastases.
• Follicular - spreads through the bloodstream to the lungs and bones. It also responds well to radioactive iodine therapy.
• Medullary - develops from parafollicular C-cells that produce calcitonin. It can be sporadic or hereditary.
• Anaplastic - the rarest and most aggressive type. It grows rapidly and responds poorly to treatment. It accounts for less than 2% of cases but is responsible for the majority of fatalities.

Thyroid cancer according to ICD-10 is coded under heading C73. This is an international classification used by doctors to standardize diagnoses and for statistical reporting.

Types of thyroid cancer are also classified according to the TNM system: T - tumor size, N - lymph node involvement, M - presence of distant metastases. This classification helps determine the stage of the disease and develop a treatment plan.

How is thyroid cancer detected?

Diagnosis begins with a clinical examination and medical history review. First, the doctor palpates the thyroid gland and regional lymph nodes.

Thyroid ultrasound is the primary and most accessible method of initial diagnosis. If thyroid cancer is suspected, ultrasound allows for determining the size, structure, and nature of the tumor: clarity of the edges, presence of calcifications, and degree of vascularization.

Fine-needle aspiration biopsy (FNAB) - under ultrasound guidance, the doctor extracts cells from the nodule using a thin needle. Cytological analysis determines the nature of the tumor.

Blood tests for hormones - TSH, T3, T4, as well as thyroglobulin and calcitonin. Elevated calcitonin may indicate a medullary type.

Scintigraphy allows for the assessment of the functional activity of the nodules: “hot” nodules are rarely malignant, while “cold” nodules require careful attention.

CT, MRI, or PET-CT scans are used to assess tumor spread, the condition of the lymph nodes, and to detect distant thyroid cancer metastases-in the lungs, bones, and liver.

Genetic testing is prescribed when hereditary forms of the medullary type are suspected.

Why is it important to see an endocrinologist in a timely manner?

In the first stage of papillary or follicular thyroid cancer, the 10-year survival rate exceeds 95-98%. In the fourth stage, the picture is radically different.

An endocrinologist is the first specialist you should consult. They will order the necessary tests and refer you to an oncologist or surgeon. The specialists at the Oncare clinic have experience managing patients with thyroid diseases-from initial diagnosis to post-treatment follow-up.

If you experience discomfort in your neck or notice any lump in the thyroid gland, this is a reason to schedule an examination.

Treatment of Thyroid Cancer

The treatment strategy depends on the type of cancer, the stage, the patient’s age, and their overall health. Modern medicine offers several effective approaches, which are often combined.

• Surgical intervention is the primary and most common method. Depending on the extent of the lesion, a hemithyroidectomy (removal of one lobe) or a total thyroidectomy (removal of the entire gland) is performed. In cases of lymph node metastases, a neck dissection is performed.
• Radioiodine therapy (treatment with radioactive iodine I-131) is used after surgery to destroy residual thyroid cells or metastases. After total thyroidectomy, the patient receives thyroxine replacement therapy.
• External radiation therapy is used in cases where surgical removal is not possible, or for the anaplastic type, which does not respond to radioactive iodine.
• Targeted therapy-inhibits the growth of aggressive forms of cancer that do not respond to standard treatment.

If thyroid cancer is diagnosed, treatment requires a multidisciplinary approach: an endocrinologist, oncologist, surgeon, and radiologist-all these specialists must be involved in developing the treatment plan.

After treatment, the patient remains under long-term observation: they regularly undergo thyroglobulin tests and ultrasound scans. This allows for the timely detection of recurrence.

Thyroid Cancer Prognosis

Stage I-II papillary thyroid cancer has a 10-year survival rate of over 95%. Even with metastases to regional lymph nodes, the prognosis remains relatively favorable. Follicular thyroid cancer without distant metastases also responds well to treatment.

Medullary cancer has a slightly worse prognosis, especially in the hereditary form with early onset. Anaplastic cancer is the most aggressive: the median survival is measured in months, not years.

The absence of comorbidities, timely medical attention, and appropriately selected treatment significantly improve the chances of recovery.

Prevention and “Check-up”

To prevent the development of cancer, follow these simple tips:

• Consume enough iodine. Use iodized salt, eat seafood, saltwater fish, and dairy products. The daily requirement for an adult is 150-200 mcg of iodine.
• Avoid unnecessary radiation exposure. Inform your doctor about any previous procedures involving X-ray radiation to the neck area.
• If there have been cases of cancer or medullary thyroid cancer in your family, consult a geneticist and an endocrinologist regarding a personalized screening plan.

A thyroid “check-up” includes an ultrasound of the gland and a blood test for TSH. It is recommended once a year for all women over 35 and men over 45, as well as for those in high-risk groups.

In the early stages of thyroid cancer, symptoms are virtually imperceptible. Preventive screening is the only reliable way to detect the disease before it becomes a problem.