The thyroid gland is an organ located in the midline of the neck, weighing 20-25 grams and having an internal secretion function. The hormone made by the thyroid gland using iodine plays a role in the regulation of whole body metabolism.
Thyroid gland diseases are very common (about 3 out of every 10 people) in the community and usually do not show any symptoms. However, some of the thyroid gland nodules appear as cancer or can turn into cancer later on.
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What is thyroid cancer?
Thyroid cancers, one of the least common among all cancer types, are also the type of cancer that shows the most positive response to treatment. Thyroid cancer is the most common endocrine cancer after ovarian cancer.
Thyroid cancers account for less than 1 percent of all cancer cases. Although it is rare in children, it is in the top 5 among cancers seen after the age of twenties. Thyroid nodule occurs in one of 1000 people every year, while thyroid cancer occurs in one of 50,000 people.
Thyroid nodules are more common in women than men, but the incidence of cancer in nodules seen in men is higher than in women. The risk of developing thyroid cancers, which is 4.2 percent in the society, is about 0.7 percent in women and 0.25 percent in men throughout life.
They are lumps found within the thyroid gland. They can be single or multiple. Those that secrete hormones are called hot nodules, and those that do not secrete hormones are called cold nodules. The distinction is made by thyroid scintigraphy. Good-bad differentiation of nodules is made with fine needle biopsy. Simple benign nodules can be followed without removal.
thyroid gland inflammation
According to the duration of the disease, they are called acute, transient and chronic. Acute thyroiditis starts quickly and lasts short. Transient thyroiditis can last up to a year. Subacute thyroiditis, postpartum thyroiditis and radiation-induced thyroiditis are in this group. In chronic thyroiditis, the most well-known is Hashimoto’s thyroiditis. It can go on for life. It occurs due to autoimmune reasons. It is among the biggest causes of hypothyroidism in the community. Sometimes it can be seen together with thyroid cancer. Hormone drugs are used in its treatment.
How is thyroid cancer determined?
With the introduction of ultrasonography into routine practice, the rate of diagnostic approach to these nodules has increased in parallel with the increasing rate of detecting thyroid nodules. Thyroid cancer has become more detectable with fine needle aspiration biopsy. Studies have shown that the incidence of thyroid cancer, which can be detected by chance in adults, is as high as 6 percent.
Another important reason why the frequency of thyroid cancers seems to be increased is the detailed thin-section examination in the pathological examinations of cases operated for benign thyroid diseases. In this way, the probability of catching thyroid cancer increases from 5 percent to 13 percent.
What are the causes of thyroid cancer?
Radiation exposure of the head and neck region increases the incidence of thyroid cancer. It has been determined that the frequency of thyroid cancer increases after 20-25 years in people who received radiation around 200-700 rad in childhood. In a study, it was revealed that the frequency of thyroid cancer in people who received radiation around 500 rad was around 2 percent. After the Chernobyl nuclear power plant accident in Russia, there was a great increase in thyroid cancer in people living in that area. Thyroid cancer is 30 percent more common in cases that received radiation years ago for reasons such as acne, scalp problems, tuberculosis on the neck, fungal infections of the scalp, blood vessel tumors of the face, enlarged thymus, tonsillitis, sore throat, chronic cough, and excess hair. This type of treatment is no longer used today.
In addition, the risk of thyroid nodule and cancer increases in patients who are diagnosed with cancer in the head and neck region and irradiated to this area. If this type of treatment has been applied to you in the past, you should definitely consult your doctor and ask for the thyroid gland to be examined.
Thyroid cancer symptoms
Thyroid gland cancer usually does not cause symptoms. It may occur in patients followed for goiter or incidentally during examinations for another disease. Rarely, mass in the neck, hoarseness, difficulty swallowing; very rarely, it can occur with bone fractures or hyperthyroidism (toxic goiter). Up to 30 percent of patients with medullary cancer may have facial flushing, diarrhea, and fatigue.
Thyroid ultrasonography is the most effective method used today to determine whether a person has a thyroid nodule. The thyroid scintigraphy method, which was used in the past, is not used in the detection of nodules, but rather in the determination of activity.
In recent years, thyroid ultrasonography and fine needle aspiration biopsy can be performed in many cases due to the advancement of diagnostic methods and the development of technical possibilities in thyroid diseases. For this reason, the possibility of diagnosing even incipient thyroid cancers is very high today. However, it should be noted that thyroid nodules are detected at a rate of 50 percent in autopsy studies. In other words, there are still thyroid nodules in the community that cannot be detected even with ultrasound.
After detecting the nodule in the thyroid gland, if there is any doubt, fine needle aspiration biopsy of the nodule can reveal whether the thyroid nodules are malignant or not. Fine-needle aspiration is a low-risk, fast-resulting and easy-to-apply method in good hands. If the biopsy result is benign and the patient has no other complaints, thyroid nodules can be followed. If the biopsy result is suspicious or malignant, the treatment phase is started.
Thyroid cancer treatment methods
The most effective method of thyroid cancer treatment is surgery. Although it is thought that removal of only a part of the thyroid gland may be sufficient in thyroid cancer in some centers, the most reliable method is complete removal of the thyroid gland. This method reduces the possibility of recurrence and maximizes the effectiveness of non-surgical treatment methods such as radioactive iodine treatment after surgery. Complications such as hoarseness and low calcium that can be seen in thyroid surgery are minimized when the surgery is performed by an experienced team.
Radioactive iodine therapy can be applied to patients after surgery based on findings during surgery, pathological data of cancer, and the results of whole body scans performed after total thyroidectomy.