Thyroid Cancer

Overview

The most common presentation of pancreatic cancer include

• Thyroid cancer refers to cancer that develops within the thyroid, a gland found at the front of the neck.
• The thyroid is primarily made up of two types of cells:
  • Follicular cells – these produce and store the hormones T3 (triiodothyronine) and T4 (thyroxine) and the protein Tg (thyroglobulin)
  • Parafollicular cells (C-cells) – these produce the hormone calcitonin, which helps control calcium levels in the body
• Thyroid cancer is often classified by the type of cell the cancer develops from and can be differentiated or undifferentiated thyroid cancers

Classification

The four types of thyroid cancer include:

• Papillary thyroid cancer – slow-growing cancer that develops from the follicular cells in the thyroid. This is the most common type of thyroid cancer, accounting for 70-80% of all thyroid cancer diagnoses
• Follicular thyroid cancer – cancer that also develops from the follicular cells in the thyroid. This accounts for 15-20% of all thyroid cancer cases and includes Hürthle cell carcinoma
• Medullary thyroid cancer – an often hereditary cancer that develops from the parafollicular cells in the thyroid. This accounts for 4-5% of all thyroid cancer diagnoses and can be associated with tumours in other glands
• Anaplastic thyroid cancer – rare fast growing cancer that develops from the follicular or parafollicular cells in the thyroid. This accounts for 1-2% of all thyroid cancer cases and typically occurs in people over the age of 60

What are the signs and symptoms?

Some of the significant symptoms are:

• Most commonly, a lump or a swelling in the neck
• Difficulty in swallowing
• Change in voice or hoarseness in voice
• Irritating cough without any symptom of cold or other reason
• Breathing difficulty often with a wheezing sound while breathing

Treatment options

• Solitary thyroid nodules that are malignant, suspicious or indeterminate on FNA, require surgery
• Patients with suspicious nodule need to undergo hemithyroidectomy with intra operative frozen section and based on the report if malignant, may need total thyroidectomy
• Diagnosed cases of differentiated thyroid cancers may need total thyroidectomy + neck dissection of central compartment as required
• Radioiodine remnant ablation and therapy is done for a few cases of differentiated thyroid cancer
• Adjuvant external beam radiotherapy for differentiated thyroid cancer should be considered for patients with a high risk of recurrence
• Newer targeted therapies are advised for recurrent or metastatic radio iodine refractory thyroid cancers