What is your thyroid gland?

When is a thyroid gland abnormal?

What causes thyroid cancer?

What are the symptoms of thyroid cancer?

How is thyroid cancer diagnosed?

What is the treatment for thyroid cancer?

Where can I buy a home test kit for thyroid disease?

Where can I find more information about thyroids?

What is your thyroid gland? (top)

Your thyroid gland is one of the endocrine glands, which make hormones to regulate physiological functions in your body. The thyroid gland manufactures thyroid hormone, which regulates the rate at which your body carries on its necessary functions. Other endocrine glands are the pancreas, the pituitary, the adrenal glands, the parathyroid glands, the testes, and the ovaries.

The thyroid gland is located in the middle of the lower neck, below the larynx (voice box) and just above your clavicles (collarbones). It is shaped like a "bow tie," having two halves (lobes): a right lobe and a left lobe joined by an "isthmus.” You can't always feel a normal thyroid gland.

When is a thyroid gland abnormal? (top)

Diseases of the thyroid gland are very common, affecting millions of Americans. The most common diseases are an over- or under-active gland. These conditions are called hyperthyroidism (e.g., Grave's disease) and hypothyroidism. Sometimes the thyroid gland can become enlarged from over-activity (as in Grave's disease) or from under-activity (as in hypothyroidism). An enlarged thyroid gland is often called a "goiter." Sometimes an inflammation of the thyroid gland (Hashimoto's disease) will cause enlargement of the gland.

Patients may develop "lumps" or "masses" in their thyroid glands. They may appear gradually or very rapidly. Patients who had radiation therapy to the head or neck as children for acne, adenoids, or other reasons are more prone to develop thyroid malignancy. A doctor should evaluate all thyroid "lumps" (nodules).

What causes thyroid cancer? (top)

Thyroid cancer is more common in people who have a history of exposure of the thyroid gland to radiation, have a family history of thyroid cancer, and are older than 40 years of age. However, for most patients, we do not know the specific reason why they develop thyroid cancer.

Exposure of the thyroid to radiation causes thyroid cancer in susceptible patients, especially if the exposure occurred as a child. Many years ago (ie, in the 1940s and 1950s), radiation exposure included X-ray treatments for acne, inflamed tonsils, adenoids, lymph nodes, or an enlarged thymus gland. X-rays also were used to measure foot sizes in shoe stores. Currently, X-ray exposure is usually limited to treatment of serious cancers such as Hodgkin’s disease (cancer of the lymph nodes). Routine X-ray exposure (eg, dental X-rays, chest X-rays, mammograms) does not cause thyroid cancer.

What are the symptoms of thyroid cancer? (top)

Early thyroid cancer often does not cause symptoms. But as the cancer grows, symptoms may include:

·                 A lump, or nodule, in the front of the neck near the Adam's apple;

·                 Hoarseness or difficulty speaking in a normal voice;

·                 Swollen lymph nodes, especially in the neck;

·                 Difficulty swallowing or breathing; or

·                 Pain in the throat or neck.

These symptoms are not sure signs of thyroid cancer. An infection, a benign goiter, or another problem also could cause these symptoms. Anyone with these symptoms should see a doctor as soon as possible. Only a doctor can diagnose and treat the problem.

How is thyroid cancer diagnosed? (top)

If a person has symptoms that suggest thyroid cancer, the doctor may perform a physical exam and ask about the patient's personal and family medical history. The doctor also may order laboratory tests and imaging tests to produce pictures of the thyroid and other areas.  The exams and tests may include the following:

• Physical exam. The doctor will feel the neck, thyroid, voice box, and lymph nodes in the neck for unusual growths (nodules) or swelling.

• Blood tests. The doctor may test for abnormal levels (too low or too high) of thyroid-stimulating hormone (TSH) in the blood. TSH is made by the pituitary gland in the brain. It stimulates the release of thyroid hormone. TSH also controls how fast thyroid follicular cells grow.

• If medullary thyroid cancer is suspected, the doctor may check for abnormally high levels of calcium in the blood. The doctor also may order blood tests to detect an altered RET gene or to look for a high level of calcitonin.

• Ultrasonography. The ultrasound device uses sound waves that people cannot hear. The waves bounce off the thyroid, and a computer uses the echoes to create a picture called a sonogram. From the picture, the doctor can see how many nodules are present, how big they are, and whether they are solid or filled with fluid.

• Radionuclide scanning. The doctor may order a nuclear medicine scan that uses a very small amount of radioactive material to make thyroid nodules show up on a picture. Nodules that absorb less radioactive material than the surrounding thyroid tissue are called cold nodules. Cold nodules may be benign or malignant. Hot nodules take up more radioactive material than surrounding thyroid tissue and are usually benign.

• Biopsy. The removal of tissue to look for cancer cells is called a biopsy. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to know whether a nodule is cancerous.

The doctor may remove tissue through a needle or during surgery:

• Fine-needle aspiration. For most patients, the doctor removes a sample of tissue from a thyroid nodule with a thin needle. A pathologist looks at the cells under a microscope to check for cancer. Sometimes, the doctor uses an ultrasound device to guide the needle through the nodule.

• Surgical biopsy. If a diagnosis cannot be made from the fine-needle aspiration, the doctor may operate to remove the nodule. A pathologist then checks the tissue for cancer cells.

What is the treatment for thyroid cancer? (top)

People with thyroid cancer often want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, the shock and stress that people may feel after a diagnosis of cancer can make it hard for them to think of everything they want to ask the doctor. It often helps to make a list of questions before an appointment. To help remember what the doctor says, patients may take notes or ask whether they may use a tape recorder. Some also want to have a family member or friend with them when they talk to the doctor -- to take part in the discussion, to take notes, or just to listen

• Surgery. The primary therapy for all forms of thyroid cancer is surgery. The generally accepted approach is to remove the entire thyroid gland, or as much of it as can be safely removed. After surgery, patients need to be on thyroid hormone for the rest of their life. Often the thyroid cancer is cured by surgery alone, especially if the cancer is small. If the cancer is large within the thyroid or if it has spread to lymph nodes or if your doctor feels that you are at high risk for recurrent cancer, radioactive iodine can be used as a “magic bullet” to destroy thyroid cancer cells after removal of the thyroid gland by surgery.

• Radioactive iodine therapy. A major reason for the usually excellent prognosis for patients with papillary and follicular thyroid cancer is that radioactive iodine can be used as a magic bullet to seek out and destroy thyroid cancer cells with little or no damage to other tissues in the body. Thyroid cells normally concentrate iodine from the bloodstream to use to produce the thyroid hormones. By contrast, thyroid cancer cells usually take up only tiny amounts of iodine. However, high levels of thyroid stimulating hormone (TSH) can arouse thyroid cancer cells to take up significant amounts of iodine.

If your doctor recommends radioactive iodine therapy, high levels of TSH will be produced in your body by making you hypothyroid for a short time—either by not starting thyroid hormone pills after the thyroid gland is removed or by stopping your thyroid hormone pills if you are already on medication. Sometimes, to minimize your symptoms of hypothyroidism, your doctor may prescribe Cytomel™ (T3) to take while you are becoming hypothyroid. Also, you may be asked to go on a low iodine diet before the treatment to increase the effectiveness of the radioactive iodine. Once the TSH level is high enough, a whole body iodine scan is done by administering a small dose of radioactive iodine to determine if there are remaining thyroid cells that need to be destroyed. If enough cells show up on the whole-body iodine scan, a large dose of radioactive iodine (I131) is given, and then the thyroid pills are re-started. Radioactive iodine therapy has proved to be safe and well-tolerated, and it has even been able to cure cases of thyroid cancer that had already spread to the lungs.

Where can I find more information about thyroids? (top)

Click here for more information on thyroids from the American Thyroid Association.

	Enter your search terms Submit search form
	Web AllNetHealth.com