Diagnosis and treatment for thyroid cancer?

Diagnosis of thyroid cancer:

The doctor, often a GP (general practitioner, primary care physician) at first, will examine the patient’s neck and throat and ask questions regarding symptoms.

Blood test – called a thyroid function test, measures specific blood hormone levels. If thyroxine and triiodothyronine levels are too high, the thyroid gland is overactive for some reason. If thyroid stimulating hormone (TSH) levels are too high, it means the thyroid gland is underactive – TSH is produced by the pituitary gland in order to stimulate the thyroid gland.

Fine-needle aspiration cytology (biopsy) – a small needle passes into the swelling in the patient’s neck and a sample of cells is removed and then examined under a microscope. The biopsy will determine whether the lump is cancerous, and what type of cancer it is.

Imaging scans – the doctor may also order a CT or MRI scan.

Surgery (biopsy) – if the needle aspiration is inconclusive, a small sample of the thyroid gland may need to be surgically removed and examined.


Treatment for thyroid cancer?

The doctor may recommend surgery, radioactive iodine and/or  radiotherapy. In most cases, especially during the early stage of the cancer, treatment is effective and the thyroid cancer is cured.

Surgery – common surgeries include:

  • Thyroidectomy – the surgical removal of part or all of the thyroid gland. During this operation, the surgeon may also remove the lymph nodes in the neck.
  • Lobectomy (hemithyroidectomy) – the surgical removal of a lobe (one of the wings of the thyroid gland).
  • Tracheostomy – making an incision on the front of the neck and opening a direct airway through an incision in the trachea (windpipe), allowing the patient to breathe.

After surgery the patient may experience pain when swallowing and will be on a special diet of soft foods.

There is a risk of damage to the vocal cords from surgery, which can change the patient’s voice (hoarseness). There may also be breathing difficulties. If the parathyroid glands, which help regulate blood calcium levels, are affected, the patient may need to take calcium supplements – usually the parathyroid glands recover after some time.

Thyroid hormone therapy – if the thyroid gland is completely or partially removed, the patient will need to take replacement hormone tablets for the rest of his/her life. The patient will need regular blood tests to make sure hormone levels are right.

Radioactive iodine – after surgery the patient may receive a course of radioactive iodine therapy, which is aimed at preventing thyroid cancer recurrence (stops the cancer form coming back). After treatment patients will be on a low-iodine diet. Pregnant women should not receive radioactive iodine treatment.

External radiation therapy (radiotherapy) – usually only used for medullary or anaplastic thyroid cancers.

Chemotherapy – usually only used to treat anaplastic thyroid cancer that has metastasized (spread to other parts of the body).

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