Written by Monique Atkinson and endorsed by Dr Hieu Nguyen
According to the Australian Institute of Health and Welfare, thyroid cancer has become more
prevalent. The number of people diagnosed with thyroid cancer in Australia nearly doubled
from 859 people in 1997 to 1657 people in 2006. The increase of the number of cases has
also been reported by the WA Cancer Registry. Thyroid cancer generally has a good
prognosis and is considered one of the most treatable cancers.
Symptoms/Signs of Thyroid Cancer
Most cases of thyroid cancer are discovered by accident when either a lump in the thyroid
gland can be seen or felt. Most people have no symptoms. In some people the following
symptoms can be caused by thyroid cancer, but it is important to remember that these
symptoms do not necessary indicate that you have thyroid cancer.
- Goitre (inflamed thyroid gland) or lump in the neck
- Difficulty in breathing
- Difficulty in swallowing
- Pain in the neck or throat
- Swollen lymph nodes in the neck
- Hoarse voice
Types of Thyroid Cancer
Well Differentiated Thyroid Cancers
- Papillary thyroid cancer is the most common thyroid cancer and grows slowly. It often
spreads to the lymph nodes in the neck. Papillary thyroid cancer has a very reasonable
prognosis, even if the cancer is found in the lymph nodes. Other prognostic factors are
age, gender, overall health etc. Papillary thyroid cancer is derived from follicular thyroid
cells and is also referred to as well-differentiated thyroid carcinoma.
- Follicular thyroid cancer is less common than papillary thyroid cancer, but still has a
good prognosis. The cancer can spread to the lymph nodes or other parts of the body.
Follicular thyroid cancer is derived from follicular thyroid cells and is also referred to as
well-differentiated thyroid carcinoma. It is not possible to diagnose follicular cancer by
FNA (fine needle aspiration), because the diagnosis requires the presence of capsular
and/or vascular invasion. A FNA can only provide cell samples and cannot provide
structure assessment of the tumour. Furthermore, the appearance of the cells can be
similar in the both benign and malignant follicular growth.
Undifferentiated Thyroid Cancers
- Medullary thyroid cancer is not common, but has a worse prognosis. This cancer is
derived from C cells (parafollicular cells) which produce the hormone calcitonin.
Medullary cancer can spread to the lymph nodes and other parts of the body. Treatment
includes surgery, radiotherapy and chemotherapy. This type of thyroid cancer can be
genetic. If one of your parents has MEN (multiple endocrine neoplasia) type IIA, MEN 2
IIB or familial medullary cancer, then there is a 50 % chance that you may develop
medullary thyroid cancer.
MEN IIA – may include medullary cancer, pheochromocytoma (usually benign tumour in
the adrenal glands) and overactive parathyroid glands (also known as
hyperparathyroidism).
MEN IIB – (also known as von Recklinghausen's disease) may include medullary cancer,
pheochromocytoma and neurofibromas (growths around the nerves).
- Anaplastic thyroid cancer is the least common thyroid cancer and has the worst
prognosis. This type of cancer is locally aggressive and often spreads to the lymph
nodes, bones and lungs. Palliative treatment involves surgery, a combination of
chemotherapy and external beam radiotherapy. Anaplastic thyroid cancer is referred to
as undifferentiated thyroid cancer. This cancer often develops from an undiagnosed
papillary or follicular tumour (differentiated cancer).
- Thyroid lymphoma is rare. Most patients with thyroid lymphoma have a goitre and
lymphocytic infiltration as seen in Hashimoto thyroiditis. Thyroid lymphoma is usually a
high grade B-cell lymphoma and usually affects middle aged people and older people.
Lymphoma means cancer of the lymph glands or white blood cells (lymphocytes).
Thyroid lymphoma is believed to originate in the lymphocytes in the goitre. The
diagnosis of thyroid lymphoma is confirmed by open biopsy (tissue from the thyroid
gland is removed for further examination). An open biopsy is done in an operating room
by a surgeon. Treatment involves external beam radiation and chemotherapy. A
thyroidectomy is not required.
Disclaimer The information provided is for educational purposes only and is not intended to be medical
advice. The contents must not be relied upon in place of advice and treatment from a qualified medical
practitioner. Thyroid WA Support Group Inc. and the author disclaim any liability whatsoever. Copyright ©
Monique Atkinson 2012
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