Education

Thyroid Cancer Rising Among Women

Thyroid cancer is much more common in women than in men, and it is considered the fastest-rising cancer among all women, according to the National Cancer Institute.

It is unclear why more women are affected. However, there is a positive side to this statistic. Over the last three decades, there has also been a strong surge in the diagnosis of all types of thyroid cancers as a result of ultrasounds and fine-needle biopsies. And most of these cases were related to small papillary thyroid cancer tumors — the most common and treatable type.

Despite the higher rate of diagnosis, many women may be unaware of symptoms because the warning signs are either commonly associated with other conditions, or symptoms are not present at all.

This year, more than 60,000 Americans — of those more than 45,000 women — will be diagnosed with thyroid cancer, which typically targets people under age 55. About 2 percent of these cases hit children and teens, the American Cancer Society says.

“Some symptoms of thyroid problems are obvious; some are not,” said George Tershakovec, M.D., a general surgeon with the Baptist Health Medical Group. “If your neck looks enlarged or you notice a lump, bump or lesion on your neck, you may have a benign condition, or less likely, thyroid cancer.”

Most lesions of the thyroid are benign. But lumps in the neck should not be ignored and should be evaluated by a physician, Dr. Tershakovec said.

Lump in the Neck
Thyroid cancer usually doesn’t have early symptoms. But the key red flags to watch out for include a lump that can be felt on the neck, hoarseness or other changes in the voice, trouble swallowing, neck or throat pain, and swollen lymph nodes in the neck.

“A lump in your neck may be a sign of a type of thyroid cancer,”  Dr. Tershakovec said. “A complete physical examination should include the physician examining your neck. If a lump is found, an ultrasound may be ordered to evaluate the mass more fully. The best treatment may depend on the type of cancer and how advanced it is. Regardless of what is causing the lump in your neck, early detection and treatment is best.”

Many types of thyroid cancer are treatable and curable.

The Thyroid Gland
The thyroid gland is located in the lower front part of the neck. It is a butterfly-shaped gland that lies in front of the windpipe. The hormones it produces regulate the body’s metabolism.

When your thyroid doesn’t function properly— either producing too many hormones (hyperthyroidism) or too few (hypothyroidism) — it can affect many aspects of a person’s health, and in particular, weight, depression and energy levels.

Hypothyroidism, or the underproduction of hormones, is also on the rise and much more common in women.

Women and Hypothyroidism
There is no direct correlation between hypothyroidism and thyroid cancer, but both could involve an enlarged thyroid. And that can develop into a goiter (see below), thyroid nodules or bumps. About 10 percent of these nodules are found to be cancerous.

Fatigue and weight gain are common symptoms of hypothyroidism, said Baptist Health Medical Group internist Maryanne Samuel, D.O.

Hypothyroidism is five to eight times more common in women than men, Dr. Samuel said. And the condition can be treated with medication.

“Just because you’re fatigued,  doesn’t mean you have hypothyroidism,” Dr. Samuel said. “It can certainly point to it. You also may have unusual bowel changes, constipation and weight gain. It’s the full picture we have to look at. I wouldn’t hang my hat on one symptom. The entire picture leads us to a diagnosis.”

Dr. Samuel says that if medication doesn’t alleviate symptoms, she will likely refer a patient to an endocrinologist. (Often, women see their family physician or primary care doctor before being referred to an endocrinologist.)

With hypothyroidism or hyperthyroidism, the thyroid can also become enlarged, so much so that you can feel or see it. When this happens, it’s called a goiter.

Some goiters are diffuse, which means the entire thyroid gland is enlarged. In other cases, goiters are nodular, meaning that the thyroid has bumps in it. In most cases, lumps or bumps in the thyroid gland, known as thyroid nodules, are benign. In fact, thyroid nodules are cancerous in fewer than 10 percent of cases.

Standard treatments for thyroid cancer include surgery, radiation therapy (including radioactive iodine therapy), chemotherapy, thyroid hormone therapy and targeted therapy.

Thyroid Cancer Risk Factors
According to the National Cancer Institute, these are broadly accepted risk factors for thyroid cancer:

Gender and Age: For unclear reasons, thyroid cancers (like almost all diseases of the thyroid) occur about three times more often in women than in men. It can occur at any age, but the risk reaches its peak earlier for women (who are most often in their 40s or 50s when diagnosed) than for men (who are usually in their 60s or 70s).

A Diet Low in Iodine: Follicular thyroid cancers are more common in countries where diets are low in iodine. In the United States, most people get enough iodine.

Radiation: Exposure to radiation is a proven risk factor for thyroid cancer. Sources include certain medical treatments and radiation fallout from power plant accidents. Having had head or neck radiation treatments as a child is a risk factor for thyroid cancer. Risk depends on how much radiation was given.

Family History: Some inherited conditions have been linked to some types of thyroid cancer. Most people who develop thyroid cancer do not have an inherited condition or a family history of the disease. However, about one out of three medullary thyroid carcinomas (MTCs) result from inheriting an abnormal gene.

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