Cancer of the Thyroid

There are several types of thyroid cancer:

• Papillary thyroid cancer is the most common form of thyroid cancer, accounting for about 80 percent of all cases. It affects more women than men.
• Follicular thyroid cancer accounts for about 10 percent of thyroid cancer cases. It is slightly more aggressive and tends to spread through the bloodstream to other parts of the body. Still, the prognosis (outlook) is very good in most cases.
• Medullary thyroid cancer accounts for about 4 percent of thyroid cancers. It tends to spread through the lymphatic system and the bloodstream to other parts of the body, producing excessive amounts of the hormone calcitonin. It often has a genetic basis, and can be screened for with a blood test. Surgery is the most important part of treatment.
• Anaplastic thyroid cancer occurs most often among women and accounts for about 2 percent of thyroid cancer cases. This quick-growing cancer usually results in a large growth in the neck. It often arises in previously undiagnosed cases of papillary or follicular cancer. It has often spread to other parts of the body by the time it is found and is hard to treat effectively.
• Lymphoma can occur in the thyroid gland and is often treatable with chemotherapy and radiation.

Learn more about thyroid cancer.

Researchers have found risk factors that make you more likely to develop thyroid cancer. Learn if you are at risk for thyroid cancer.

• Lump or swelling over your thyroid or elsewhere in your neck
• Persistent cough, without symptoms of a cold
• Neck pain, especially in the front of your neck that can radiate up to your ears
• Hoarseness or other changes in your voice that are persistent
• Swollen neck or lymph nodes
• Trouble breathing that feels like you are breathing through a straw
• Trouble swallowing

The symptoms of thyroid cancer may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

Your head and neck surgeon may conduct the following tests to diagnose thyroid cancer:

• Neck exam
• Mirror or scope examination of your vocal cords
• Ultrasound
• Needle biopsy
• Blood tests
• CT-scan

Learn more about diagnostic tests and procedures for thyroid cancer.

Your otolaryngologist will base your treatment plan on the type of thyroid cancer you have. The majority of thyroid cancers are slow to grow and metastasize, but there are some types that can be very aggressive. Your doctor will treat these differently. Your doctor will also consider your age, your health, the size and location of your tumor, and other factors.

In most cases, there are three elements to the treatment of a thyroid cancer:

• Surgical removal of the thyroid and involved lymph nodes
• Thyroid hormone replacement after surgery
• Radioactive iodine treatment

Learn more about targeted treatments for specific types of thyroid cancer.

Surgical Treatment

Surgery is the first and main treatment for most thyroid cancers. Your otolaryngologist may use one of the following methods:

• Total thyroidectomy. Removal of the whole thyroid or parathyroid glands.
• Near-total thyroidectomy. Removal of nearly all the gland.
• Subtotal thyroidectomy. Most of the gland is removed.
• Thyroid lobectomy. Removal of one lobe of the thyroid and the isthmus.
• Lymph node excision. Removal of nearby lymph nodes.

Your surgeon may also remove lymph nodes near the cancer if they have known cancer cells or look suspicious. This procedure is called either a central compartment neck dissection or a lateral neck dissection depending on the extent of lymph node removal.