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Thyroid cancer
Thethyroidglandisinthethroat,belowthelarynx(Adamsapple).Itcomprisestwolobesthatsit oneithersideofthewindpipe,joinedatthefrontbyanisthmus.Thethyroidglandsecretes hormonesthatregulatemanymetabolicprocesses,suchasgrowthandenergyexpenditure. Aroundoneoutofevery1,000peoplewillbeaffectedbythyroidcancer,withwomenslightlymore susceptiblethanmen.Riskfactorsincludechronicgoitre,familyhistory,genderandexposureto radiation,particularlyifthedosesweregivenspecificallytotheheadandneck.Inthe1950s, radiationtherapywasoftenusedtotreatproblemsoftheadenoidsandtonsils.Nuclearfalloutis alsoassociatedwiththyroidcancer.Therearedifferenttypesofthyroidcancer,categorisedby malignancy,growthrateandthetypeofcellsaffected.Recoverydependsonvariousfactors includingtheageandgeneralhealthoftheperson,thetypeandlocationofthecancer,andhow farthecancerhasadvancedbeforecommencementoftreatment. Symptoms Thesymptomsofthyroidcancerdependonthetype,butmayinclude: Swellingofthethroatasthethyroidglandenlarges Hoarsevoice Voicechanges Persistentcough Gastrointestinaldisturbances,suchasdiarrhoeaorconstipation.

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Different types Thetypesofthyroidcancerare: Papillary carcinoma-themostcommonformofthyroidcancer,whichaccountsfor70to 80percentofcases.Thiscanceraffectsthecellsthatproducethyroidhormone.Itgrows slowly. Follicular carcinoma-thiscanceralsoaffectsthyroidhormone-producingcells.However, itgrowsmorequickly.Thiscanceraccountsforaround10percentofthyroidcancers. Medullary carcinoma-thistypeofcancertendstoruninfamilies.Thesymptomsmay mimicthoseofCushingssyndrome.Itdoesnotinvolvethyroidhormone-producingcells andaccountsfor5to10percentofthyroidcancers. Anaplastic carcinoma-thisisthemostaggressiveandmalignantformofthyroidcancer. Ittendstogrowrapidlyandblockthewindpipe.Itgenerallyoriginatesinbenignorlow gradecancerousthyroidtumoursandaccountsforaround7percentofthyroidcancers. Thyroid lymphoma-thisoccurswhenwhitebloodcells(lymphocytes)invadethethyroid andbecomecancerous.Thisaccountsforaround4percentofthyroidcancers.

Risk factors Anyonecandevelopthyroidcancer,regardlessofageorgender.Someoftheriskfactors associatedwiththyroidcancerinclude: Radiation exposure-highdosesofradiationwereusedduringthe1950stotreat disordersofthethroatandskin.Absorbedradioactivefalloutfollowingnuclearaccidentsis alsoariskfactor. Chronic goitrepersistentenlargementofthethyroidgland. Family history-asusceptibilitycanbeinherited. Gender-morewomenthanmendevelopthyroidcancer.

Diagnosis methods Diagnosingthyroidcancerinvolvesanumberoftests,including: Physicalexamination

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Bloodtests Ultrasoundscans Examinationofthevocalcords Tissuebiopsy.

Treatment options Treatmentdependsonthetype,sizeandstageofthecancer,andthepatientsageandhealth. Optionsmayinclude: Surgery-thefavouredtreatmentforpapillary,follicularandmedullarycancers.The thyroidglandisremoved,eitherwholeorinpartdependingonthesizeofthecancerand howmuchoftheglandisaffected.Nearbylymphnodesmayalsoberemoved. Radiation therapy-Radioactiveiodineisusedtokillanyremainingthyroidhormoneproducingcells.Thisnormallyrequiresthepatienttostopthyroxinetreatmentforafew weekstocausethyroidstimulatinghormone(TSH)levelstoriseandtherebystimulatethe thyroidcellstoabsorbtheradioactiveiodine.Patientscanbecomesignificantlyhypothyroid duringthisperiod.Externalradiationisfrequentlyusedformedullaryandanaplastic cancer,andfortumourswhichdonotrespondtoradioactiveiodine. Hormone therapy-patientsrequirethyroidhormonereplacementintheformof thyroxinefollowingsurgery.Thedosesgivenaregenerallyhigherthanforother hypothyroidpatients,inordertosuppresstheproductionofthyroidstimulatinghormone andtherebysuppressthegrowthofthyroidcells. Chemotherapy-drugsthatkillcancercellsareusedforthecancersthatdonotinvolve thethyroidhormone-producingcells.

Genetic testing Medullarycarcinomahasbeenassociatedwithanabnormalgenethatcanbeinherited.Blood relativesofsomeonediagnosedwithmedullarycarcinomacanbegeneticallytested.Apersonwho hasthegene,butnotthecancer,mayelecttohavetheirthyroidglandremovedtoruleoutany possibilityofdevelopingthediseaseinthefuture. Where to get help Yourdoctor ThyroidAustraliaTel.(03)98882588 CancerCouncilVictoria,InformationandSupportServiceTel.131120

Things to remember Thethyroidglandregulatesmanybodilyfunctionsincludinggrowthandenergy expenditure. Therearefourdifferenttypesofthyroidcancer,whicharecategorisedaccordingtotheir malignancyandspeedofgrowth. Treatmentoptionsmayincludesurgerytoremovethethyroidglandandnearbylymph nodes,chemotherapy,radiationtherapyandhormonetherapy. Thyroidcancerisreadilytreatableandhasexcellentsurvivalrates.

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ThyroidAustralia

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