Women Three Times More Likely to Develop Thyroid Cancer

Meet your thyroid. It’s that small butterfly-shaped gland located at the base of your neck near your voice box. But what exactly does it do? Despite its small size, experts say the thyroid plays an outsized role in your overall health by producing hormones that help regulate your heart rate, blood pressure, temperature, metabolism and more.

“Your thyroid makes sure that your brain, heart and other organs and muscles are all working properly,” says Robert Udelsman, M.D., chief of endocrine surgery and director of the Endocrine Neoplasia Institute at Baptist Health Miami Cancer Institute. “So, when there’s a problem with your thyroid, it can also be a problem for the rest of your body.”

How common is thyroid cancer?

Sometimes, noncancerous tumors, called nodules, can form on the thyroid, causing symptoms that may require treatment. “Thyroid nodules are common and most patients can be followed safely by their doctors,” says Dr. Udelsman. “Ideally, they should see an endocrinologist, who can screen for these nodules, decide what needs to be biopsied and then refer them to us for treatment if it is determined to be cancerous.”

Robert Udelsman, M.D., chief of endocrine surgery and director of the Endocrine Neoplasia Institute at Baptist Health Miami Cancer Institute

Thyroid tumors form in the tissue of the thyroid gland and generally grow slowly, Dr. Udelsman says. According to the American Cancer Society (ACS), thyroid cancer is the fifth-most common cancer in women and the most common cancer in women aged 20 to 34. About two percent of cases occur in children and teens. The ACS estimates that 44,020 new cases of thyroid cancer will be diagnosed this year (12,500 in men and 31,520 in women) and roughly 2,170 people will die from the disease.

But thanks to advances in technology and treatment options, thyroid cancer is highly treatable and the overall survival rate is more than 95 percent.

“Until recently, the rate of new thyroid cancers was growing faster than for any other cancer in the U.S.,” Dr. Udelsman notes. “This was largely because more thyroid tumors were being found during imaging tests such as CT or MRI scans done for other medical problems. These sophisticated imaging machines can sometimes detect small thyroid tumors that otherwise might never have been found.”

Are there different types of thyroid cancer?

Dr. Udelsman says there are four different types of thyroid cancer, ranging in severity from mild to aggressive:

·      Papillary: The most common type of thyroid cancer, accounting for 75-85% of all thyroid cancer cases.

·      Follicular: A less common type of thyroid that includes Hürthle cell thyroid cancer and tends to be more aggressive.

·      Medullary: This includes both spontaneous and familial forms of the disease.

·      Anaplastic: The most aggressive type of thyroid cancer – and maybe of all cancers – with a poor prognosis.

What are the symptoms of thyroid cancer?

“The most common symptom of thyroid cancer is no symptom at all,” says Dr. Udelsman. “Many patients are asymptomatic and only learn they have cancer after a routine physical or ultrasound detects a nodule that turns out to be cancerous.”

Dr. Udelsman says symptoms of thyroid cancer include:

• Constant cough not connected to a cold
• Difficulty breathing
• Hoarseness or other voice changes that linger
• Lump in the neck that may grow quickly
• Pain in the front of the neck that may extend to the ears
• Swelling in the neck
• Trouble swallowing

How is thyroid cancer typically treated?

Thyroid tumors usually respond well to treatment – if they’re diagnosed early and treated quickly.

“The vast majority of thyroid tumors can be treated successfully through surgery,” Dr. Udelsman says. “When it comes to surgery, the operation must be tailored to the individual case.  Other treatment modalities include radio frequency or alcohol ablation; however, these are not yet standard of care.  In some patients, a program of active surveillance can be considered for asymptomatic patients with small tumors.”

There are two types of surgery for thyroid tumors, according to Dr. Udelsman. The first, a thyroid lobectomy, entails removing one side of the thyroid gland, while some cases may require removing the entire gland with a total thyroidectomy.

“Depending on the situation, the surgeon at the same time might remove abnormal lymph nodes near the thyroid gland,” Dr. Udelsman says, noting that it’s better to do one operation rather than two staged operations. “More aggressive cancers may require a combination of surgery and radiation therapy. Chemotherapy or immunotherapy are rarely indicated.”

Recovery from surgery is “amazingly easy” for most patients, says Dr. Udelsman. “We keep total thyroidectomy patients overnight for observation, but 85 percent of our lobectomy patients go home the same day and are able to return to work within one week.”

Can thyroid cancer be prevented?

There is no sure way to prevent thyroid cancer, unfortunately, says Dr. Udelsman. “Anyone can get thyroid cancer, but there are some steps you can take to reduce your cancer risk. These include:

• Avoid exposure to radiation. Being exposed to high levels of radiation increases your risk of thyroid cancer.

• Know your family history. If thyroid cancer runs in your family, you have an increased risk.

Why seek treatment for thyroid tumors at Miami Cancer Institute?

Dr. Udelsman says the deep experience at Miami Cancer Institute allows them to take even the most challenging and complex cases, including those that many other physicians are reluctant to take on.

“We perform up to16 thyroid surgeries a week and we do them very well,” says Dr. Udelsman, who has performed more than 10,000 thyroid surgeries in his career. “Our team is robust and includes experienced surgeons, endocrinologists, anesthesiologists, pathologists and imaging doctors as well as radiation and medical oncologists. We may not be able to cure every patient. However, we have the team and requisite resources to treat every patient as well as their families.”