Thyroid cancer or thyroid carcinoma is a cancer that is not very common. However, thyroid cancer is mostly malignant in nature, so medical treatment seems to be absolutely necessary, otherwise the disease can lead to death. The causes are not yet fully known. However, it is assumed that there is iodine deficiency or previous diseases of the thyroid gland. Likewise, hereditary causes are also possible.
What is thyroid cancer?
Thyroid cancer, also known as thyroid carcinoma in medical terminology, is a malignant tumor that affects the cells of the thyroid gland. Medicine distinguishes the following four types of carcinoma, depending on the cells from which it has developed: follicular carcinoma, papillary carcinoma, medullary carcinoma and anaplastic carcinoma. This cancer is one of the rather rare types of cancer; about 5,000 people are diagnosed with thyroid cancer in Germany every year. Women are affected by this disease significantly more often than men.
Causes
The far-reaching causes of the disease thyroid cancer have not yet been clarified. However, there are some factors that definitely favor this disease. Iodine deficiency is stated as one of the most common causes of thyroid cancer. Therefore, it is important, especially in the diet to ensure that the body is supplied with enough iodine. Some previous diseases of the thyroid gland can also cause the onset of thyroid cancer. Some ionizing radiations can also lead to the onset of this disease. For example, the Chernobyl reactor disaster or the atomic bomb disasters of Hiroshima or Nagasaki produced a huge amount of such dangerous radiation. Likewise, however, this is also hereditary; genetic factors thus play just as much a role in the development of this disease.
Symptoms, complaints and signs
Thyroid cancer can go unnoticed for a long time. Enlargement of the organ is usually first noticed by breathing difficulties. There is then shortness of breath and difficulty swallowing, as well as hoarseness and swelling in the respiratory tract. The lymph nodes also swell, which can result in cough and fever symptoms. Occasionally, the swellings of the lymph nodes and thyroid gland are palpable from the outside. They are accompanied by an increasing feeling of pressure and pain. Certain forms of thyroid cancer progress more quickly than others. It usually takes months or even years before the first symptoms are noticed. By then, the disease is usually well advanced and the cancer may have already spread to surrounding areas of the body. If the cancer is detected and treated in time, the tumor can often be removed before it metastasizes. Associated symptoms subside once the growth is removed. Untreated thyroid cancer continues to progress and eventually leads to the patient’s death. Prior to this, the tumor metastasizes to surrounding areas of the body. As a result, the original signs of the disease initially increase – shortness of breath, changes in voice color, and nonspecific general symptoms such as pain, fever, and nerve disorders occur. The exact nature and severity of symptoms depends on the location of the tumor.
Disease progression
Thyroid Cancer
The course of thyroid cancer varies quite a bit from case to case. In the early stages, however, there are usually hardly any symptoms. Only when the tumor has visibly enlarged do patients notice a kind of nodule in the area of the thyroid gland. This can become so large that it can exert pressure on the esophagus and trachea, causing the patient problems when eating or breathing. Finally, as the disease progresses, it can get to the point where nerve pathways are also damaged and paralysis of the vocal cords occurs. As a result, some thyroid cancer patients often have a hoarse voice. The so-called Horner’s syndrome, on the other hand, is characterized by a constriction of the pupil, as already noted, and, in the further course, a sinking back of the eyeball into the eye socket. This causes the upper eyelid to droop on the affected side. By means of ultrasound, thyroid cancer can usually be clearly diagnosed. The so-called scintigraphy, an imaging procedure, is also frequently used. During thyroid puncture, the doctor sticks a fine needle into the suspicious lump and removes tissue.Laryngoscopy and bone scintigraphy are other necessary measures to rule out the possibility that metastases have migrated to the lungs or other adjacent organs.
Complications
Thyroid cancer can cause a number of complications as it progresses. As a result of the disease, paralysis of the vocal folds, voice changes, and hormonal imbalances cannot be ruled out. In addition, physical deficits and permanent damage to the kidneys, liver and heart may occur. Severe disease can lead to chronic pain, which, in conjunction with the disease itself, can also cause psychological discomfort. Affected individuals are often depressed and sometimes suffer from panic attacks. Various complications can occur during the treatment of thyroid carcinoma, depending on the type of treatment. For example, radiation therapy can cause acute side effects such as gastrointestinal discomfort, fatigue, and hair loss. In the long term, damage to the mucosa and discoloration of the skin are conceivable. Very rarely, radiotherapy itself can cause cancer. Chemotherapy can have similar consequences. In addition, there are possible organ damage, reproductive dysfunction, and infections. Radioiodine therapy may cause temporary changes in bone marrow and blood counts, as well as edema and disturbances in lacrimal gland function. Surgery may be associated with bleeding, nerve injury, wound healing problems, and other complications. In addition, prolonged discomfort may occur due to medication administration.
When should you see a doctor?
If symptoms such as persistent hoarseness, hair loss, or repeated constipation occur, thyroid cancer may be underlying. A visit to the doctor is recommended if the symptoms become more severe and cannot be relieved by rest and quiet. If weight gain occurs, it is best to consult a doctor immediately. People who do not eat a balanced diet and who specifically take in too little iodine have an increased risk of developing thyroid cancer. There is also a risk of developing a tumor in the thyroid gland after exposure to radioactive radiation. People who have undergone radiation treatment for cancer should inform the doctor if the above symptoms are noticed. There is also an increased risk if there is a family history of the disease. Regular screening examinations are indicated. Thyroid cancer is treated by an internist. Other contacts are the family doctor and, depending on the symptoms, various specialists. As part of the therapy, nutritionists and, if necessary, physiotherapists must also be consulted to support the patient in implementing the physician’s instructions. Advanced cancer is treated as an inpatient in a specialist clinic.
Treatment and therapy
Treatment of thyroid cancer depends on how advanced the disease is. In most cases, however, this treatment consists of a combination of surgery and radiation. Not infrequently, hormone therapy is also used. This is usually necessary if the patient’s entire thyroid gland had to be removed and he or she now has to take thyroid hormones. However, for smaller tumors that are less than one centimeter in diameter, it is usually not necessary to remove the entire thyroid gland. Chemotherapy, which is usually used for most cancers, has not been effective for thyroid cancer because these types of tumors often do not respond to the drugs. However, if thyroid cancer is detected early enough, there is a very good chance of cure.
Follow-up
Aftercare for thyroid cancer begins in the hospital, with the attending physician preparing the patient for life without a thyroid gland through detailed discussions. Most important is the consistent intake of thyroid hormones at the prescribed dosage. This is determined and checked by regular blood tests. Through this thyroid hormone replacement therapy, affected individuals can usually lead a normal life. Recurrence of thyroid cancer is rare, but with appropriate follow-up examinations, recurrence can be detected and fought early.Initially, these examinations are performed every three to six months by an endocrinologist, a nuclear medicine specialist or in a hospital; if the patient is symptom-free, the intervals can later be extended to one year. In addition to a detailed interview, a physical examination is performed; important information is also provided by the thyroglobulin level in the blood, a sonography and, if necessary, a whole-body scintigraphy. The attending physician decides which examinations are necessary: the follow-up regimen depends on the type and spread of the tumor and the therapy performed. If metastasis to the lungs is suspected, the physician may order chest X-rays or positron emission tomography (PET). For psychological support after cancer, psycho-oncological care may be sought, and sharing with others affected in a support group is also helpful.
What you can do yourself
Thyroid cancer belongs in the treatment of the specialized doctor, but is also accessible to self-help in everyday life. The main point here is to alleviate the consequences of treatments and also to deal with the psychological management of the disease. Due to the rarity of thyroid cancer, it is advisable to exchange information in self-help groups, which can help with tips and provide valuable information sharing among like-minded people. Forums on the Internet and thyroid disease associations are also often helpful. After therapy, a supply of thyroid hormones is often necessary. These cannot be ideally adjusted immediately. Therefore, weight, as well as mood swings, must be closely monitored in order to respond adequately. Physical reactions can also be noted and reported to the doctor with a view to targeted adjustment. These range from heart palpitations to digestive problems. Going for regular blood tests to check the level of thyroid hormones is also very important for the patient. A healthy lifestyle supports recovery after therapies and the patient’s well-being. This includes sufficient sleep and a balanced diet with adequate drinking. Fluids are very important, especially after neck surgery. It makes swallowing food much easier. Care should also be taken to protect the vocal cords immediately after surgery.
