Complete Guide to Thyroid Cancer: Signs and Treatments

Your thyroid gland is located at the base of your neck, just below your Adam's apple. It sits on top of your windpipe and below your voice box (larynx). Thyroid cancer happens when cells in your thyroid gland change and start to grow abnormally. A group of these cancer cells can form a tumour. Thyroid cancer can affect how your thyroid works and cause symptoms. It is shaped like a butterfly because the gland is in two halves. The halves are connected by a narrow bridge of thyroid tissue, known as the isthmus. The two halves are called the lobes of the thyroid. The thyroid is part of a network of glands that make up your endocrine system. In the United Kingdom, people prefer to select private clinics, such as Consultant ENT, where patients get a clear explanation and guidance about precaution measures and the right treatment for their condition.

What are the types of thyroid cancer?

The most common type of thyroid cancer is called differentiated thyroid cancer (DTC). 

There are two main types:

Papillary thyroid cancer

Papillary thyroid cancer is the most common type of thyroid cancer, accounting for about 4 out of 5 thyroid cancer diagnoses. It is more common in women aged 35 to 45. It is a slow-growing species with a high cure rate.

Follicular thyroid cancer

Follicular thyroid cancer accounts for about 1 in 5 thyroid cancer diagnoses. It grows slowly and is usually found in older people.

What are thyroid hormones?

Your thyroid makes hormones that keep your heart rate, blood pressure, body temperature, and weight at the right levels. The thyroid gland releases separate hormones:

• T3, which is known as triiodothyronine 
• T4, which is known as thyroxine 

Calcitonin

The T3 and T4 hormones help regulate the body's metabolic rate. The metabolic rate is how fast the various processes of the body work, such as how quickly the body burns calories.

Excess levels of T3 and T4 in the body would make someone feel overactive and cause them to lose weight. Not enough T3 and T4 would make someone feel 'slow' and sluggish, and cause them to gain weight. Calcitonin helps control the levels of calcium in your blood. Calcium is a mineral that has many important functions, such as building strong bones.

What increases the risk of thyroid cancer?

The cause of thyroid cancer is unknown. But there are certain things called risk factors that can increase your chance of developing the disease. These include:

• Age
• Sex
• If you get certain benign thyroid diseases
• Low iodine
• Radiation
• Radiotherapy as a child
• Family history of thyroid cancer
• Inherited a faulty gene

An overactive or underactive thyroid does not increase your risk of developing thyroid cancer. 

Having a risk factor doesn’t mean you will get cancer. Sometimes people with no risk factors get the disease. If you’re worried, talk to the Best ENT surgeon or speak to one of our ENT private clinics. 

Reducing your risk of thyroid cancer

The most important thing you can do to reduce your risk of thyroid cancer is to: Symptoms of thyroid cancer.

• A painless or painful lump in your neck, which gradually gets bigger
• Difficulty in swallowing or breathing
• Changes to your voice, including hoarseness
• Symptoms may be vague at first - thyroid cancer usually grows very slowly. 

All these symptoms can be caused by conditions other than cancer, and most lumps in the front of the neck are not cancerous. It’s still important to go to the GP and get any unusual changes checked.

What are the stages of thyroid cancer?

Staging means finding out how big the cancer is and if it has spread to other parts of your body. Staging will help your doctor plan the best treatment for you. 

TNM staging system

The staging system normally used is called TNM. This stands for:

Node (N) Is there cancer in the lymph nodes?

N0: No lymph nodes are affected. 

• N1: Some lymph nodes near where the airways join the lungs are affected. 
• N2: Some lymph nodes in the centre of the chest or where the trachea enters the lung are affected. 
• N3: Some lymph nodes on the opposite side of your chest to where the tumour is, or near your collarbone, are affected.

Metastasis (M): Has the cancer spread?

M0: The cancer has not spread to other parts of the body.  

• M1: The cancer has spread to other parts of the body.  

Number staging

Your doctor often uses the TNM information to give your cancer a number stage, from 1 to 4.  A higher number means a more advanced cancer. 

Knowing the stage and grade of your cancer helps your team to plan the best treatment for you. 

What are the grades of thyroid cancer?

Grading describes how quickly the cancer may grow and spread. 

• Low-grade thyroid cancer: The cancer cells look only slightly abnormal, much like normal thyroid cells. The tumor is usually slow-growing and less likely to spread than high-grade thyroid cancer.
• High-grade thyroid cancer: The cancer cells look fairly or very abnormal and are more likely to grow quickly.

Staging and grading can be hard to understand, so ask the Best ENT surgeon for more information if you need it.

How is thyroid cancer treated?

Treatment for thyroid cancer includes surgery, radioactive iodine therapy, and thyroid hormone therapy. The right treatment plan for you will depend mainly on the type of thyroid cancer you have and the stage of your cancer. Your doctor will recommend the best treatment for you.

Surgery for thyroid cancer

Surgery aims to remove the cancer and the area close to it. Surgery is the most common treatment for thyroid cancer. There are different ways of doing surgery for thyroid cancer. The best type for you will depend on the stage of your cancer. 

• Total thyroidectomy - Removing the entire thyroid gland.
• Lobectomy or partial thyroidectomy
• Removing lymph nodes

Side effects of thyroid surgery

With all surgeries, there is a small risk of bleeding and infection. 

It is also common to feel tired or weak for a few weeks after your surgery. The time it takes to heal is different for everyone. You will have a small scar across the front of your neck just above your collarbone. The scar will look red or dark at first, but will fade with time. It is usually very neat and hardly noticeable. Other possible side effects:

• Hoarse voice
• Fall in blood calcium levels
• Neck stiffness
• Thyroid hormones
• Radioactive iodine therapy

This therapy can destroy tiny amounts of normal thyroid tissue or cancer cells, if any, left behind after surgery. It is usually given after surgery for papillary or follicular thyroid cancer. It reduces the risk of the cancer recurring or spreading elsewhere. You may have to wait several weeks to recover after surgery before having this treatment. Not all patients need radioactive iodine therapy. You will be referred to a specialist centre for this treatment if you need it. Read more about radioactive iodine therapy.

Talking to your doctor

Ask any questions you have, and let your doctor know if you are having any problems. Tell them about any new symptoms, aches, or pains you have, or if you are finding it hard to cope. It can help to write down what you want to say beforehand, so you don’t forget anything.

If you have a problem between appointments, if you are between check-ups and have a symptom or problem that is worrying you, call your Thyroid surgeon near me for advice or to arrange an earlier outpatient appointment if necessary.