Thyroid Cancer: How to Recognize This Highly Curable Disease

A diagnosis of cancer can be an overwhelming experience, but gaining a clear understanding of the condition is a critical first step. While thyroid cancer is becoming more frequently diagnosed, physicians with Baptist Health Cancer Care say it’s important to know that most cases are highly treatable and have excellent cure rates.

The thyroid is a butterfly-shaped gland located in the lower front of the neck. It produces hormones that are essential for regulating the body’s metabolism, heart rate, temperature and weight. Thyroid cancer occurs when cells in this gland begin to grow abnormally.

“Less than 5% of thyroid cancers are aggressive; 95% are curable,” notes Rachel Slotcavage, M.D., an endocrine surgeon at the Eugene M. and Christine E. Lynn Cancer Institute, part of Baptist Health Cancer Care, at Boca Raton Regional Hospital. She specializes in the surgical treatment of benign and malignant thyroid and parathyroid conditions, adrenal gland tumors, and neuroendocrine pancreas disorders.  

Thyroid Cancer Prevalence and Risk Factors

In the United States, an estimated 44,020 new cases of thyroid cancer are expected in 2025, according to the American Thyroid Association (ATA). The condition is about three times more common in women than in men, and it is most often diagnosed in people between the ages of 30 and 60. Despite the number of new cases, the lifetime risk of developing thyroid cancer is low – approximately 1.1%.

Several factors can increase a person’s risk of developing thyroid cancer, according to Meghan Crawley, M.D., a head and neck surgical oncologist at Baptist Health Miami Cancer Institute. Risk factors for thyroid cancer include:

• Radiation Exposure: A significant risk factor is exposure of the head and neck to radiation, particularly during childhood.

• Family History: Certain genetic syndromes and a family history of thyroid cancer can increase risk.

• Age and Sex: Risk increases with age, and women are diagnosed more frequently than men.

• Personal Health History: A history of other thyroid conditions, such as an enlarged thyroid (goiter) or nodules, may be a factor.

“It is important to note that many people diagnosed with thyroid cancer have no identifiable risk factors,” Dr. Crawley says.

Thyroid Cancer Symptoms to Watch For

In its early stages, thyroid cancer often presents with no symptoms. Many cases are discovered incidentally during routine physical exams or imaging tests performed for unrelated reasons. Dr. Crawley points out that many small growths “can remain harmless for life.”

If and when symptoms do develop, they may include:

• A lump or nodule in the front of the neck that can be felt through the skin.

• Swelling in the neck.

• Hoarseness or other changes to the voice.

• Difficulty swallowing or breathing.

• Pain in the neck or throat.

• Swollen lymph nodes in the neck.

If you experience any of these symptoms, it is advisable to consult a healthcare provider for a thorough evaluation.

Diagnosing Thyroid Cancer

If a thyroid nodule is suspected, the diagnostic process is careful and methodical. “Ultrasound with lymph node mapping is the best first test,” says Dr. Slotcavage. This imaging test helps doctors assess the size and characteristics of the nodule.

If the ultrasound reveals concerning features, a fine-needle aspiration (FNA) biopsy is typically performed. This procedure involves using a thin needle to collect a small sample of cells from the nodule, which is then examined for cancer.

In some cases, molecular testing may be used on the biopsy sample. Dr. Crawley finds this “useful for indeterminate nodules” to help clarify the risk of cancer and guide decisions, potentially recommending a more limited surgery.

Modern Treatment Approaches for Thyroid Cancer

Treatment for thyroid cancer depends on the type, stage and aggressiveness of the cancer, as well as the patient’s overall health, Dr. Crawley notes. “The goal is to provide effective treatment while minimizing side effects and preserving quality of life,” she says.

1.     Surgery

“Surgery remains the mainstay treatment for most thyroid cancers but the treatment should always be tailored to the individual,” says Dr. Slotcavage. Depending on the situation, the procedure may involve:

• Lobectomy: Removal of one lobe (half) of the thyroid gland.

• Thyroidectomy: Removal of the entire thyroid gland.

Dr. Slotcavage notes that many patients “choose total thyroidectomy to avoid repeat surgery,” but the final decision is based on a careful discussion of risk tolerance and personal preference.

2.     Radioactive Iodine (RAI) Therapy

Following surgery, some patients with more advanced cancers may receive radioactive iodine (RAI) therapy. Because the thyroid absorbs iodine, this targeted treatment can destroy any remaining thyroid tissue or cancer cells. However, its use is becoming more selective, Dr. Slotcavage says. “Current ATA guidelines support RAI only for high-risk tumors. For many low-risk cases, surgery alone is curative,” she says.

3.     Thyroid Hormone Therapy

Patients who have their thyroid removed will need to take thyroid hormone replacement pills for the rest of their lives. This therapy also helps suppress certain hormones that could stimulate the growth of any remaining cancer cells.

4.     Observation or Active Surveillance

For very small, low-risk papillary thyroid cancers, active surveillance may be an option. This involves closely monitoring the cancer with regular checkups and imaging rather than immediate treatment.

A Focus on Personalized Care

The management of thyroid cancer is evolving. Both experts agree on the importance of personalizing care and avoiding overtreatment. “The future lies in treatment reduction, by avoiding over-testing and overtreatment, and adopting less invasive therapies,” says Dr. Crawley.

This patient-focused approach ensures that each person receives the most appropriate and effective care for their specific situation, leading to high cure rates and a positive long-term outlook. Dr. Slotcavage is “optimistic about tailoring therapies to tumor behavior, reassuring patients that most will be cured with one operation.”

Click here for more information about thyroid cancer and the services available at Baptist Health Miami Cancer Institute.

Meghan Crawley, M.D., head and neck surgical oncologist at Baptist Health Miami Cancer Institute

Rachel Slotcavage, M.D., endocrine surgeon at the Eugene M. and Christine E. Lynn Cancer Institute, part of Baptist Health Cancer Care, at Boca Raton Regional Hospital