About the Thyroid
The thyroid is a small gland located in the front of the neck beneath the voice box (larynx). The thyroid has two lobes connected by a thin piece of tissue called the isthmus. The thyroid contains follicular cells that use iodine from your diet to make thyroid hormone. Thyroid hormone regulates your body’s metabolism by affecting heart rate, blood pressure, body temperature and weight. The C cells of the thyroid make calcitonin that plays a minor role in regulating calcium levels in the body.
Four tiny parathyroid glands are located behind the thyroid on its surface. The parathyroid glands are very important in maintaining a normal calcium level in the body.
About Thyroid Cancer
Thyroid cancer begins when cells in the thyroid gland grow and divide uncontrollably to form a tumor that can invade blood and lymph vessels.
The diagnosis of thyroid cancer is increasing faster than any other malignancy, partly due to increased detection of small tumors with ultrasound, CT scans and PET scans. It is estimated that there will be about 48,020 new cases of thyroid cancer diagnosed in 2011 in the United States. Thyroid cancer is one of the most curable cancers with excellent survival rates in the majority of cases. There are nearly 500,000 cancer survivors in the United States.
Some cells in the thyroid may grow and divide faster than others to form a nodule. Most thyroid nodules are not malignant but about 5-10% are malignant.
The Thyroid Cancer Team includes, among others you might see:
Thomas Galloway, MD
Many patients with early thyroid cancer have no noticeable symptoms. As the cancer grows, a swelling or lump on the front of the neck is often the first symptom. Thyroid nodules are common and are usually painless. The vast majority of them are benign.
Other less common symptoms of thyroid cancer may include:
- trouble swallowing
- persistently swollen glands in the neck
- difficulty breathing
- pain in the throat or neck that does not go away
- a cough that does not go away and is not due to a cold
Symptoms of thyroid cancer may be similar to those of other medical conditions. If you are concerned about a symptom on this list, you should see your doctor.
If you have symptoms that suggest thyroid cancer, your doctor will help you find out whether they are from thyroid cancer or some other cause. Your doctor will ask about your personal and family medical history. You may have one or more of the following tests:
- Physical exam: Your doctor may examine your neck for lumps or large lymph nodes.
- Blood Tests: Tests of the thyroid function such as the thyroid-stimulating hormone (TSH) or calcitonin may be checked.
- Ultrasound: The ultrasound uses sound waves to create a picture of the thyroid. It is the best way to see the thyroid and the neck lymph nodes in great detail. Sometimes the appearance on the ultrasound can tell us whether a nodule is more likely to be cancerous.
- Thyroid Scan: Your doctor may order a scan of your thyroid to see if any of the nodules absorb iodine. You swallow a small amount of radioactive iodine that travels to your thyroid. Nodules that absorb more iodine than the rest of the thyroid are called “hot” nodules and usually do not require biopsy since they are rarely cancer.
- Fine Needle Aspiration (FNA) Biopsy: A biopsy is the only sure way to diagnose thyroid cancer. The blood tests and ultrasound pictures are used to determine which nodule(s) require biopsy. Using the ultrasound device to locate the suspicious nodule(s), a very fine needle can remove a sample of the tissue. A pathologist checks the samples for cancer cells with a microscope.
- Surgery: Sometimes the cells obtained from the FNA biopsy do not provided enough information to tell if the nodule is benign or cancerous. In those cases, the lobe containing the nodule must be removed surgically to determine the diagnosis.
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