There are several types of cancer that can affect the thyroid gland. This month I’m going to talk about Hurthle (HEERTH-hul) cell cancer. It is a rare cancer that is also called Hurthle cell carcinoma or oxyphilic cell carcinoma. Hurthle cell cancer can be more aggressive than other types of thyroid cancer. Surgery to remove the thyroid gland is the most common treatment.
While Hurthle cell cancer doesn't always cause symptoms, it is sometimes detected during a physical examination, or an imaging test done for some other reason.
Signs and symptoms of Hurthle cell cancer may include:
These signs and symptoms don't necessarily mean you have Hurthle cell cancer. They may be indications of other medical conditions -- such as inflammation of the thyroid gland or a noncancerous enlargement of the thyroid (goiter).
The best thing to do at this time would be to make an appointment with us at Palmetto Endocrinology so we can address any signs or symptoms that worry you.
It's not clear what causes Hurthle cell cancer.
Doctors know that cancer begins when a cell develops errors in its DNA -- the genetic material that contains instructions for biochemical processes in your body. When DNA is altered or damaged, these genes may not function properly, causing cells to grow out of control and eventually form a mass (tumor) of cancerous (malignant) cells.
Factors that increase the risk of developing thyroid cancer include:
Some possible complications of Hurthle cell cancer include:
Tests and procedures used to diagnose Hurthle cell cancer include:
Treatment for Hurthle cell cancer usually requires surgery to remove the thyroid. Radiation therapy and chemotherapy may be options.
Total or near-total removal of the thyroid (thyroidectomy) is the most common treatment for Hurthle cell cancer. During a thyroidectomy, the surgeon removes all or nearly all of the thyroid gland and leaves tiny edges of thyroid tissue near small adjacent glands (parathyroid glands) to lessen the chance of injuring them. The parathyroid glands regulate your body's calcium level.
Surrounding lymph nodes may be removed if there's suspicion that the cancer has spread to them.
After surgery, your doctor will prescribe the hormones to replace the hormones produced by your thyroid. You'll need to take these hormones for the rest of your life.
Radioactive iodine therapy involves swallowing a capsule that contains a radioactive liquid. Radioactive iodine therapy may be recommended after surgery because it can help destroy any remaining thyroid tissue, which can contain traces of cancer. Radioactive iodine therapy may also be used if Hurthle cell cancer has spread to other parts of the body.
Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. During radiation therapy, you're positioned on a table and a machine moves around you, delivering the radiation to specific points on your body. Radiation therapy may be an option if cancer cells remain after surgery and radioactive iodine treatment or if Hurthle cell cancer spreads.
Targeted drug treatments use medications that attack specific abnormalities within cancer cells. Targeted therapy may be an option if your Hurthle cell cancer returns after other treatments or if it spreads to distant parts of your body.
Targeted drug therapy is an active area of cancer research. Doctors are studying many new targeted therapy drugs for use in people with thyroid cancer.
A diagnosis of Hurthle cell cancer can be challenging and frightening. With time you'll find strategies to help you manage the stress and anxiety of a cancer diagnosis. Until then, here are some ideas to help you cope: