Thyroid cancer (thyroid carcinoma)

Thyroid cancer (or thyroid carcinoma) occurs when multiple cells of the thyroid gland degenerate. This means that these cells transform into cancer cells due to genetic changes and multiply in an uncontrolled manner. As the condition progresses, the cancer cells displace the healthy tissue. In addition, cancer cells are often unable to maintain their original function, such as the production of thyroid hormones.

In general, thyroid disorders are very common, whereas thyroid cancer is rare, with women three times more likely to develop thyroid cancer than men.

Many people complain of nodules in the thyroid gland. Fortunately, however, most cases are not thyroid cancer, but benign tissue growths. Although these nodules grow in an uncontrolled way and therefore require treatment, they do not penetrate the surrounding tissue – unlike thyroid cancer.

Symptoms

Causes

Diagnosis

Treatment

Aftercare

FAQs

Contact a clinic near you

Cell types

The thyroid gland contains various cell types, each of which have different functions. In the case of thyroid cancer, it is therefore necessary to differentiate which cell type the tumour originates from and how it develops in order to be able to assign the thyroid cancer to one of the four types.

Papillary, follicular and anaplastic thyroid carcinoma originate from the hormone-producing thyroid cells known as thyrocytes. In contrast, medullary thyroid carcinoma arises from a cell type located in the thyroid gland (so-called C cells).

Symptoms

In its early stages, the symptoms of thyroid cancer are hardly noticeable. In fact, it often goes unnoticed until the tumour begins to press on the trachea and oesophagus, for example, or damages adjacent nerve tracts.

Possible symptoms of thyroid cancer include:

persistent hoarseness
Horner’s syndrome, which is caused by damage to the nerve tracts. Here, the pupil of one eye becomes constricted, the eyeball appears sunken and the eyelid droops.
breathing difficulties
difficulty swallowing
swollen lymph nodes on the throat
muscle cramps or sensory disturbances
severe diarrhoea
asymmetrical, rapidly growing swelling on the throat

Causes

Causes of thyroid cancer include:

ionising radiation,
medical irradiation of the neck area,
genetic predisposition; or
iodine deficiency and an associated increase in thyroid-stimulating hormone (TSH)

Diagnosis

If thyroid cancer is suspected, the doctor will start by asking the patient questions about their medical history, followed by a physical examination. First the doctor will thoroughly palpate the thyroid, the neck area and the lymph nodes to detect any abnormal changes. This is normally followed by a blood test to measure the concentration of the thyroid hormones T3 and T4 as well as the hormone TSH (thyroid-stimulating hormone).

In the course of further diagnostics, the doctor may also refer the patient for

an ultrasound examination (sonography),
thyroid scintigraphy (a nuclear medicine procedure that uses radioactive material to show the metabolic activity and blood circulation of the thyroid gland),
a fine-needle biopsy ( FNB), where a fine hollow needle is inserted into the thyroid nodules under ultrasound control to take a tissue sample,
an X-ray,
a CT scan,
an MRI scan and/or
a laryngeal endoscopy

Treatment

The type of treatment for thyroid cancer depends on the type of thyroid cancer and the extent to which the cancer has already progressed.

In principle, the range of treatments available include:

surgical treatment (partial or complete surgical removal of the thyroid gland = thyroidectomy)
radioiodine therapy (postoperatively, the patient is given radioactive iodine, with the aim of destroying any hormone-producing thyroid cells that are still present)
chemotherapy and/or
radiotherapy

Aftercare

After treatment is completed, patients who have had thyroid cancer are advised to undergo life-long follow-up care in order to detect any possible return of the cancer as early as possible. This mainly involves regular ultrasounds of the neck area.

In addition, it is important to carry out regular measurements of various laboratory values that are only produced by thyroid tissue. If these can be detected again in the body after complete removal of the thyroid gland, this is indicative of renewed tumour growth (these laboratory values are called tumour markers).

FAQs

At what age can thyroid cancer occur?

Generally speaking, thyroid cancer can occur at any age. It is much more common in women than in men. The average age of those diagnosed with the disease is 55 years for men and 52 years for women.

What are the warning signs of thyroid cancer?

A new, rapidly growing nodule in the thyroid gland may be the first sign of thyroid cancer. In addition, medical clarification is required if the thyroid gland becomes enlarged and forms a struma (goitre), or if the thyroid suddenly grows and feels harder, either in whole or in part. The same applies if a new goitre emerges within a few weeks or months. For this reason, it is generally recommended that any unusual swelling of the throat be examined by a doctor.