September is Thyroid Cancer Awareness Month, however there are many South Africans who are still rather unaware of what the thyroid is and what to look out for. Being armed with the facts greatly increases the opportunity for early detection and diagnosis – a patient’s best chance for recovery. 

Dr. Justus Apffelstaedt, specialist surgeon with an interest in breast, thyroid and parathyroid health management, has offered some insights to help ‘demystify’ thyroid cancer this September.  

What is the thyroid? 

The thyroid is a small gland located at the base of the neck. It is part of our endocrine system – the glands that produce hormones to regulate our metabolism, growth and development, as well as our tissue function, sexual function, reproduction, sleep, and even our mood.

It releases two important hormones into our bloodstream, namely triiodothyronine (T3) and tetraiodothyronine (T4), produced with iodine, which the gland takes from the foods we eat, as a necessary constituent. 

The thyroid, small as it is, is a crucial gland. It affects, directly or indirectly, almost every function in our bodies: our temperature, our digestive system and mental development.

How prominent is thyroid cancer? 

While thyroid dysfunction is fairly common, diseases of the thyroid such as hypothyroidism and hyperthyroidism are rarely cancerous and can usually be well-managed. 

On the other hand, while thyroid cancer has a low incidence within the general population, it is still one of the more common cancers. Fortunately, with early detection, there is a high survival rate especially when a patient is diagnosed early. 

Like many cancers, thyroid cancer can have a genetic component. People with a family history of thyroid cancer, especially medullary thyroid cancer or a pheochromocytoma tumour, may have higher chances of developing thyroid cancer. As in the case of breast cancer, a genetic test can be advised to determine if the patient carries genes that increase the potential risk of having the disease.

What are the symptoms of thyroid cancer? 

A key factor in early diagnosis is that doctors must not ignore patients who present early symptoms. Symptoms vary, however some of the symptoms can be fairly generic and include: 

  • The appearance of a lump in the neck.
  • Pain in the neck and throat.
  • Swollen lymph nodes. 
  • A persistent cough not linked to a cold.
  • Difficulty in breathing.
  • Pain and difficulty swallowing.
  • The appearance of lump or growth in the neck.
  • Constant voice changes and hoarseness.

The abovementioned signs and symptoms are not always closely related to thyroid cancer but, if they are present, medical advice is recommended.

Thyroid ultrasounds can often find changes in the thyroid, but this test is not recommended as a screening test for thyroid cancer unless a person is at increased risk, such as because of a family history. 

Patients are therefore often diagnosed when seeing a doctor for lump or swelling in the neck, or the cancer can be diagnosed following a blood test or an ultrasound for another health issue. 

How is thyroid cancer usually treated? 
The choice of treatment depends on the type of thyroid cancer, the size of the cancer, the patient’s age and whether the cancer has spread to lymph nodes or other organs.

Surgery is generally the main treatment of thyroid cancer, except for some specific types of thyroid cancers. If thyroid cancer is diagnosed by a fine needle biopsy, surgery to remove the tumour and all or part of the remaining thyroid gland can be recommended.

In conclusion, the advice is to remain vigilant about your overall health and to consult your doctor with any concerns. If your doctor is unhappy with the symptoms presented, you should be referred to a specialist for further investigation and diagnosis in order to assess the appropriate treatment.

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