How does thyroid cancer occur?

Thyroid cancer usually manifests as a thyroid nodule that causes no symptoms. However, as it grows it is possible to cause some symptoms. There are 4 types of thyroid cancer:

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What are the symptoms and signs of thyroid cancer?

The most common symptoms are:

  • Palpable nodule
  • Difficulty in swallowing
  • Hoarseness
  • Difficulty in breathing
  • Neck pain
  • Swollen cervical lymph nodes
  • Weight loss
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What is the incidence of thyroid cancer?

Thyroid cancer has increased dramatically in the last 3 decades worldwide. In Greece, the incidence of thyroid cancer in 2020 was 8.5 per 100,000 people. For the same year, thyroid cancer was the 5th most common cancer in women, and women are 3 times more likely to be diagnosed with thyroid cancer than men.

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What is the age of onset of thyroid cancer?

Thyroid cancer can occur at any age, but 2/3 of cases occur between the ages of 20-55 years. On the other hand, medullary thyroid cancer can occur very early, even in infancy.

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If I have a thyroid nodule, does that mean I might have cancer?

90-96% of thyroid nodules are benign. Therefore, a thyroid nodule should be evaluated by an endocrinologist and depending on its characteristics, investigated further.

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What are the risk factors?

The main risk factors for thyroid cancer are:

  • Exposure to radiation to the head or neck during childhood
  • Radiation exposure due to a nuclear accident
  • Family history of thyroid cancer
  • Genetic syndromes of thyroid cancer
  • Female sex
  • White race
  • Age 22-55 years
  • Endemic goiter
  • Hashimoto’s thyroiditis
  • Obesity
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How is thyroid cancer diagnosed?

Diagnosis of thyroid cancer includes: physical examination, history taking, blood tests, thyroid ultrasound, needle aspiration of thyroid cells for cytology (FNA) and in some cases genetic testing. However, confirmation is only possible with a biopsy obtained by surgical removal of part or all of the thyroid gland. Sometimes more imaging studies such as a CT scan is needed.

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How is thyroid cancer treated?

The treatment of thyroid cancer depends on the type of cancer, stage, comorbidities, age and the patient’s preference and is co-decided by a multidisciplinary team of doctors, usually consisting of an endocrinologist, surgeon of endocrine glands, radiologist, pathologist, nuclear medicine physician and oncologist. Common treatments include:

  • partial or total removal of the thyroid (thyroidectomy),
  • radioactive iodine,
  • thyroid hormone suppression therapy
  • radiation,
  • targeted drug therapy
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Is thyroid cancer curable?

Thyroid cancer mostly grows slowly, has very high cure rates and is usually curable. For every 100 patients diagnosed with thyroid cancer, 98 are still alive 5 years after diagnosis. Survival rates from thyroid cancer are higher for patients with localised disease.

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