September is Thyroid Cancer Awareness Month

I am a survivor of thyroid cancer. I was very fortunate in that when I was a Fellow at the Medical University of South Carolina, I attended an extracurricular seminar on ultrasound procedures. By the merest coincidence, one of the people being used as a patient did not show up that day. I volunteered to be a patient for an ultrasound and a nodule was found. Several days later, I had a fine needle biopsy done and it revealed cancer in an early form. Two operations later, I was “cancer free.”

However, my experience is completely not normal. If I had not attended that seminar, if I did not act on the nodule seen that day immediately, if I did not decide to have the second surgery and adopted a ‘wait and see’ attitude, the outcome would have been different. Several years down the road (probably around 2021), I would have noticed a lump at the base of my throat. Even though I would be able to have an ultrasound and FNA quickly, things probably would have ended differently.

Thyroid cancer begins with cancerous cells originating in the thyroid gland or thyroid tissue. Fortunately, this cancer has a high rate of survival, resting near 97%. However, this does not mean it should be taken lightly. The most insidious aspect of thyroid cancer is its ability to spread to other systems and organs. Depending on the type of cancer, it can move aggressively to other regions in the body or more slowly.

• Papillary carcinoma is the most common form of thyroid cancer and originates in the follicular cells (the cells responsible for secreting thyroid hormones). Nearly 80% of all thyroid cancer cases fall within this category. Fortunately, papillary carcinoma is slow-growing. However, if left unchecked it can spread to the lymph nodes found in the neck. As the cancer spreads to more systems it becomes increasingly difficult to treat.
• Follicular carcinoma is the second most common form of thyroid cancer responsible for 10-15% of all thyroid cancer cases. This brand of cancer also originates in the follicular cells. While it is less likely to infect the lymph nodes it is notably more likely to invade and attack other organs. Follicular carcinoma is more frequently seen among those living in areas with low iodine intake. If you live within the United States or another location where food is frequently iodized you have a much lower risk of developing this specific type of thyroid cancer.
• Medullary cancer is even less common and is generated within the upper central lobe of the thyroid. It spreads more aggressively to the lymph nodes than the previously mentioned forms, making it especially dangerous.
• Anaplastic thyroid cancer is the rarest but also the most harmful as it is more likely to impact other organs. This can cause widespread damage resulting in significantly inhibited health and higher risk of mortality. Anaplastic thyroid cancer usually requires a thyroidectomy. This is generally followed by bouts of radiation. If the cancer spreads to other areas such as the trachea it may become inoperable.

As you can see, even though thyroid cancer is considered one of the least threatening forms of cancer a person may develop, it can irreparably damage your health.

Who Is At Risk?

Now that we are more familiar with the condition itself, your next step in greater thyroid cancer awareness is knowing the risk factors associated with it. Even though cancer is not fully understood there are various indicators that can warn you of greater thyroid cancer susceptibility.

• If you are between the ages of 20 and 55 it is particularly important to familiarize yourself with thyroid cancer as two-thirds of all thyroid cancer cases occur within that age range.
• If you or your family has a history of thyroid dysfunction including Hashimoto’s thyroiditis and goiter you are more likely to develop thyroid cancer.
• Being a woman increases your risk of developing thyroid cancer. Roughly 75% of thyroid cancer cases are found among women. However, as a man you still need to be vigilant and aware of thyroid cancer.
• Iodine deficiency can result in thyroid dysfunction and increase your risk of developing thyroid cancer.
• Other conditions that may run in your family, such as adenomatous polyposis, Gardner syndrome, Cowden disease, and type I Carney complex, may contribute greatly to the development of thyroid cancer.

If you are free of these risk factors, you have a notably lower risk of developing thyroid cancer. However, it does not mean that you are immune to this devastating illness. Knowing the signs of thyroid cancer, even if you do not possess an increased risk of developing it, may help you save the life of yourself and others.

Recognizing Thyroid Cancer

Thyroid cancer doesn’t always have obvious symptoms. For this reason, it is important that you take responsibility of your thyroid and take the proper precautions. Being vigilant and watchful for the following symptoms can help you identify thyroid cancer early. Common symptoms to keep an eye out for include:

• Pain and swelling around the neck
• Enlarged lymph nodes
• Sensations of fullness around the neck
• Changes in voice
• Chronic cough
• Difficulty breathing and/or swallowing

The most easily identifiable symptom of thyroid cancer is a lump, growth, or nodule in the neck. By conducting a simple check for yourself you may be able to detect this defining aspect. The following steps lay out an easily conducted self-examination for thyroid cancer.

• Stand in front of the mirror in a manner that allows you to easily see your neck
• Tilt your neck backwards while keeping your throat in sight
• Swallow a small amount of water, using a straw if needed
• Actively look for lumps or enlargements above the collar bone but below the area of the Adam’s Apple
• Repeat this action while using your other hand to feel for enlargements or bulges
• If you see or feel a lump pursue medical attention to get a doctor’s opinion

Even though this method can catch thyroid cancer on occasion it cannot replace a doctor’s professional analysis and examination. It is important to regularly visit your doctor to acquire appropriate thyroid testing. If you have any issues, please make an appointment with us at Palmetto Endocrinology. We are ready to help.

Author

Joseph Mathews, MD, FACP, FACE, ECNU, CCD Joseph W. Mathews M.D., a board certified Endocrinologist and Medical Director of Palmetto Endocrinology, was born and raised in South Carolina. He earned his Bachelor of Science in Biology from the College of Charleston, Cum Laude. He then achieved his M.D. at the Medical University of South Carolina where he also completed his residency in Internal Medicine and a Fellowship in Endocrinology, Diabetes, and Metabolism. Dr. Mathews is also a Fellow of both the American College of Endocrinology and the American College of Physicians, holds an Endocrine Certification in Neck Ultrasound (ECNU) and is a Certified Clinical Densitometrist (CCD). He has extensive experience performing ultrasound guided fine needle aspiration biopsies. His practice includes a range of specializations including prescribing and fitting patients with insulin pumps. Dr. Mathews' practice has drawn patients from out of state to benefit from his expertise in thyroid disorders, diabetes, cortisol problems and their Endocrine disorders.