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9 Things You Need To Know About Thyroid Cancer
- Thyroid cancer diagnoses are on the rise
- Mortality rates are slowly getting worse
- Thyroid cancer is most common among women, and is often diagnosed at a young age
- Most forms of thyroid cancer are easily treated
The speed of your metabolism, how fast your heart beats: These and many more of your body’s functions are controlled by hormones produced in your thyroid, a butterfly-shaped gland that sits between your neck and the top of your breastbone.
Sometimes, most often in women, the thyroid gets out of whack. In fact, the majority of thyroid cancers (about 75 percent, by some estimates) occur in women, says John Morris, M.D., past president of the American Thyroid Association (ATA) and an endocrinologist at the Mayo Clinic.
Morris explains that, while thyroid cancer and autoimmune diseases like hyperthyroidism (an overactive thyroid) and hypothyroidism (an underachieve thyroid) are indeed significantly more common in women than in men, no one quite understands why just yet. And, FYI, thyroid issues like hypothyroidism are linked to an increased risk of thyroid cancer.
Fortunately, thyroid cancer remains relatively rare, with about 64,000 new diagnoses in 2019 compared to the more than 240,000 breast cancer and 135,000 colon cancer diagnoses that year, according to the ATA. What’s more, most cases are diagnosed early on and have a very low mortality rate.
Still, experts say it’s important to keep thyroid cancer on your radar. “Your primary-care physician should palpate your thyroid gland at each routine visit," says Jochen Lorch, M.D., director of the Thyroid Cancer Center at the Dana-Farber Cancer Institute. "Screening is also easy to do yourself, so thyroid cancer is generally easy to diagnose at early stages. And if you catch it early on, it’s usually not a problem at all."
Here are nine things all women need to know about thyroid cancer.
Thyroid cancer diagnoses have tripled in the last decade
Thyroid cancer is the most rapidly-increasing cancer diagnosis in the U.S., according to the American Cancer Society (ACA). “Over the last 10 to 15 years, the frequency has increased three to five-fold. And in some parts of the world, more than that,” says Morris. Morris says at least some of that spike is due to increased screening along with improved imaging techniques.
Watch a hot doctor explain what to do about a thyroid condition:
Mortality rates are low... but rising
Survival rates for papillary thyroid cancer, the most common type, reach 100 percent for stages I and II; 93 percent for stage III, and 51 percent for stage IV, according to the ACA. Unfortunately, those numbers are getting worse. "If you look at mortality rates, those have also slightly inched up, not at the same rate as new diagnoses, but there is a trend,” Lorch says, noting that advanced and aggressive thyroid cancers are becoming more prevalent.
So why are mortality rates rising? “There must be some kind of environmental factor,” Lorch says. While there are theories that increased exposure to chemicals and pesticides may be to blame, Lorch says there's not enough research to pinpoint the problem just yet.
Thyroid cancer is a young woman's problem
According to the ACA, thyroid cancer is more commonly diagnosed at a young age than most other types of cancers. While that’s in part due to increased incidental findings, the other part of the explanation is the cancer itself, says Lorch.
“Compared to other cancers, thyroid cancer is relatively simple. There’s not a lot of genetic mutations that drive it,” he says. Breast or colon cancer are typically the result of five to 10 genetic mutations; with thyroid cancer, there’s often just one genetic mutation at fault.
Because just one mutation can result in cancer, the age at which thyroid cancer is diagnosed is often younger, he explains.
Related: The Symptoms Of Colon Cancer That Every Young Woman Should Know
The most common symptom of thyroid cancer is a lump
While a goiter, or lump in your thyroid, is the most common symptom of thyroid cancer, according to the ATA, over 90 percent of all thyroid goiters are benign and could be linked to another condition like hypothyroidism or iodine deficiency.
Either way, it’s a good idea to check in with your primary-care doctor, who can examine the lump manually with their hands and, if they suspect a problem, recommend an ultrasound. Other symptoms of thyroid cancer are very rare and usually associated with a more advanced or aggressive form of the disease, says Morris. These can include hoarseness, pain in the thyroid, and trouble swallowing that doesn’t go away for weeks to months.
Some people live with thyroid cancer for their whole lives
As of 2013, more than 630,000 patients were living with thyroid cancer in the United States, according to the ATA, and less than 2,000 people die from thyroid cancer each year.
Because 70 to 80 percent of all thyroid cancers are papillary thyroid cancer, which tends to grow slowly or not at all, thyroid cancer may never even cause problems. “The majority of patients would live out the rest of their lives without even knowing they had cancer,” says Morris.
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Most thyroid cancers are not inherited
You’ve heard about the BRCA test for breast cancer. There’s no such test for most cases of thyroid cancer. “A great majority [of thyroid cancer cases] are not predictable by genetic testing,” says Morris. While one rare strain of thyroid cancer can be traced with a genetic test, for almost all cases, including papillary thyroid cancer, doctors don’t recommend routine genetic screening because most thyroid cancer tends not to be inherited.
Preventative screening is rarely recommended
Thyroid screening is usually only recommended for people who have a history of radiation exposure involving the head or neck (for, say, throat or brain cancer), says Morris. Otherwise ultrasound screening is only suggested if you have two or more people in your immediate family who have been diagnosed with thyroid cancer. “There’s a negative side to screening in that you find cancers that are not important,” says Morris—and you get treatments that aren't necessary.
To check for a lump in your thyroid, tip your chin up in the mirror and swallow: if you see a lump that moves up and down at the notch between the base of your neck and the top of your breastbone, it could be worth checking in with your doctor.
Related: 9 Reasons Why You've Got Period Symptoms But No Period
Thyroid cancer doesn’t change how well your thyroid works
In most cases, thyroid cancer doesn’t affect how well your thyroid does its job. “Most of the time, it continues to function normally,” says Morris. “It’s still there and functioning normally even though cancer is present.”
Unlike hyper- and hypothyroidism, thyroid cancer does not cause symptoms such as weight changes, heart palpitation, and thinning hair.
If there’s a lump in your thyroid, doctors will often check your levels of thyroid stimulating hormone (TSH) as a screening method. If your levels are out of whack, that's a sign that you're dealing with a thyroid condition other than cancer, says Lorch.
You may not need treatment
In the past, doctors treated thyroid cancer by removing the entire gland, requiring patients to take hormone replacement pills every day for the rest of their lives. People were also usually put on radioactive iodine, which can potentially damage the salivary glands leading to loss of taste and dry mouth. That’s not the case today.
Related: 'I Was Radioactive': Here's What It's Really Like to Get Treated for Thyroid Cancer
Most often, doctors avoid radioactive iodine and sometimes don’t perform surgery at all, just surveillance—especially with common small papillary thyroid cancers. “Patients become concerned when they hear the word ‘cancer’ applied to a lump in body, but we spend a lot of time explaining why it’s not the same as being diagnosed with cancers in other parts of the body. Treatments can have consequences and side effects,” says Morris.
Even with more advanced cancers requiring surgery, most people don’t need radioactive iodine, Morris adds. “In the vast majority of cases for papillary thyroid cancer, surgery approaches a 100 percent cure rate, even if it’s spread to local lymph nodes. But it’s still critical to diagnose and find early on,” adds Lorch. In the rare event that advanced metastatic cancer requires further treatment, it’s usually with chemo treatments that can help shrink and slow the growth of tumors.
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