Diabetes, Hormones & Metabolism (Endocrinology)
Thyroid cancer is very treatable, and more than 95 percent of patients are cured of the disease after treatment, which includes surgical removal of the thyroid cancer followed by radioactive iodine treatment and a close surveillance program to monitor for cancer recurrence. Typically, there is no identifiable cause for thyroid cancer, although some people are at higher risk for developing the disease.
Many people have no symptoms when their thyroid cancer is discovered. Often a thyroid nodule is identified on another imaging study or on a routine physical exam done by the patient's primary care physician. Other patients may notice a lump in the center portion of the lower neck. If the nodule is large, local symptoms such as pressure or difficulty swallowing may occur. Thyroid cancer may also cause hoarseness of the voice; however, this is rare.
Diagnosis and Treatment
Most thyroid cancers are diagnosed by fine needle aspiration (FNA), or a combination of FNA and surgery. The treatment of thyroid cancer typically involves a combination of:
- Surgery. Surgery is the main therapy for thyroid cancer. Most thyroid cancers will require removal of the entire thyroid gland and any involved lymph nodes within the neck. However, small thyroid cancers may be treated by removing only one lobe or half of the thyroid. Surgery may involve removal of some of the lymph nodes surrounding the thyroid as well.
- Radioactive Iodine Treatment. Radioactive iodine is a specific form of iodine that destroys thyroid tissue and is used to treat any microscopic thyroid cancer that cannot be seen at the time of surgery. It is also used to treat thyroid cancer that may have spread outside of the thyroid gland to other parts of the body.
- Supplemental Thyroid Hormone. Following removal of the entire thyroid gland, thyroid hormone replacement in the form of oral thyroid hormone is necessary. This is the same hormone that the body makes and is used to restore the normal function of the thyroid, as well as suppress any regrowth of microscopic thyroid tissue.
Comprehensive Treatment for All Forms of Thyroid Cancer
Our highly experienced physicians with the Comprehensive Thyroid Program have tremendous skill and experience in diagnosing and treating patients with all forms of thyroid cancer.
- Medullary Thyroid Cancer. Montefiore is one of the leading medical centers in the region—if not the nation—in all aspects of this complex condition, which represents 5 to 10 percent of thyroid cancers. Montefiore has exceptional expertise, in multiple endocrine neoplasia, pancreatic neuroendocrine tumors and pheochromocytomas. Approximately 25 percent of these cancers are inherited as a result of a genetic mutation. Consequently, when appropriate, patients are referred for genetic testing and counseling.
- Papillary Thyroid Cancer. This is the most common type of thyroid cancer, comprising 80 percent of diagnoses. Prognosis is excellent, with a greater than 99 percent survival for Stage I cancers.
- Follicular Thyroid cancer. Also called Hurthle Cell cancer, this is the second most common form of thyroid cancer and represents approximately 10 percent of cases. Diagnosis is inconclusive by FNA alone and requires the removal of either all or part of the thyroid.
- Anaplastic Thyroid Cancer. This is a very aggressive, rare and difficult to treat disease that comprises only 1 to 2 percent of thyroid cancer diagnoses and occurs most often in people over the age of 60.
- Thyroid Lymphoma. This is also an extremely rare thyroid cancer that represents only an estimated 1 percent of cases and is treated medically.
Diagnosis and Treatment
Most thyroid cancers are diagnosed by FNA, or a combination of FNA and surgery. In the overwhelming majority of cases, the treatment of thyroid cancer typically involves a combination of surgery, radioactive iodine treatment and supplemental thyroid hormone.