Thyroid cancer usually presents as a nodule in the thyroid gland. The thyroid gland is located in the front part of your neck, just below the Adam’s apple, and it produces hormones that regulate your metabolism, body temperature, cholesterol, menstrual cycle, heart rate and blood pressure.
Although thyroid cancer might not cause initial symptoms, it can eventually lead to swelling in your neck--you may feel a lump. You may also feel swollen lymph nodes, have problems swallowing, and develop a hoarse voice. There are many types of thyroid cancer; some are very slow growing, others are more aggressive, and most can be resolved with treatment. (In general, the 5-year survival rate for those diagnosed with thyroid cancer is 98%, although this depends upon the stage and type of thyroid cancer.)
Here, Arti Bhan, M.D., division head of endocrinology at Henry Ford Health, shares what to know about thyroid cancer.
Q: The number of thyroid cancer cases is quickly growing in the United States and around the world. Can you explain why?
A: This is partly due to the increased rate of detection. We now use more sensitive diagnostic procedures, such as CT or MRI scans, to evaluate unrelated medical conditions. This allows us to detect small thyroid nodules that might not have otherwise come to light.
Aside from this increased rate of detection, there has also been a true increase in rates of thyroid cancer. It’s not entirely clear why, but exposure to certain environmental elements (like radiation and flame-retardant chemicals) may be a culprit.
Although not common in the U.S., a diet low in iodine can also be a risk factor for thyroid disease, and iodine therapy is one treatment for thyroid cancer.
Q: If rates of thyroid cancer are higher, does this mean more people are dying from it?
A: Fortunately, the risk of dying from the more common varieties of thyroid cancer is quite low and the vast majority of patients do very well. Despite a rise in the incidence of thyroid cancer, the mortality rate has remained stable.
However, the social and economic impact of the growing rate of thyroid cancer is not trivial.
Q: There is some debate that thyroid cancer is being over-diagnosed, and that most of these tumors do not warrant treatment. Is this true?
A: It is correct to say that some thyroid cancers are quite low risk and treatment can actually cause harm (such as complications associated with surgery to remove the thyroid). However, there isn’t a good way to predict how a tumor will behave and so most patients get treated with surgery.
There is a push from national societies (like the American Cancer Society and American Thyroid Association) to vigilantly observe smaller cancers instead of immediately doing surgery. The American Thyroid Association published guidelines in 2015 that help physicians decide in which instances to perform less invasive surgery, and in which instances to carefully use radioactive iodine therapy (which uses radioactive iodine to kill thyroid cells).
Q: What is new in the diagnosis and treatment of thyroid cancer?
A: These are exciting times in the thyroid cancer realm. When a thyroid nodule is diagnosed, a fine needle biopsy is recommended. This is now enhanced with molecular testing, which helps to predict the tumor’s behavior and prevents unnecessary surgery. Also, newer drugs are being used for aggressive thyroid cancers that have become resistant to radioactive iodine, which is the mainstay treatment after surgery.
For more information about cancer treatment at Henry Ford or to make an appointment with one of our cancer specialists, visit henryford.com/cancer or call 1-888-777-4167.
Dr. Arti Bhan is the division head of endocrinology for Henry Ford Health and sees patients for diabetes, thyroid disorders and other conditions at Henry Ford Medical Center in Detroit, Henry Ford Medical Center in Novi and the Henry Ford Cancer in Detroit.
