Examination and Diagnosis
The examinations and operations required for the diagnosis of thyroid cancer include.
1. Physical examination. The doctor will examine physical changes in the thyroid gland and ask about relevant risk factors, such as overexposure to radiation and family history of thyroid tumors.
2. Blood tests. Blood tests to help determine if the thyroid is functioning normally.
3.Thyroid tissue sampling. For a fine needle aspiration biopsy, the doctor inserts a thin needle through the skin into the thyroid nodule. Ultrasound imaging is commonly used to guide the fine needle into the nodule with precision. The doctor uses the fine needle to take a sample of the suspected thyroid tissue. The sample is analyzed in a laboratory for the presence of cancer cells.
4. Imaging exam. You may need one or more imaging tests to help your doctor determine if the cancer has spread beyond the thyroid. Imaging tests include computed tomography (CT), ultrasonography, positron emission tomography (PET) or ultrasound.
5. Genetic testing. Some patients with medullary thyroid cancer may have genetic variants associated with other endocrine tumors. Your doctor may recommend genetic testing because of your family history to identify the genes that cause an increased risk of cancer.
Treatment and medication
Thyroid cancer treatment options depend on your type and stage of thyroid cancer, your overall health status and preferences. Most cases of thyroid cancer can be cured with treatment.
Surgery
Most patients with thyroid cancer have all or most of their thyroid gland removed through surgery.
Thyroid cancer surgery includes.
1. Total or near-total thyroid removal (thyroidectomy). In most cases, doctors recommend total thyroidectomy to treat thyroid cancer. The surgeon will make an incision in the patient’s neck to access the thyroid gland. In most cases, the surgeon will leave a small piece of thyroid tissue around the parathyroid gland to reduce the risk of parathyroid damage. Sometimes the surgeon prefers to perform a subtotal thyroidectomy
2. Clearance of the cervical lymph nodes. When removing the thyroid, the surgeon also removes the enlarged lymph nodes in the neck and takes samples for cancer testing
3. partial thyroidectomy (thyroid lobectomy). In some cases, such as when the thyroid cancer is very small, the surgeon may recommend removal of only one side of the thyroid (lobe).
Thyroid surgery carries the risk of bleeding and infection. The parathyroid glands may also be damaged during surgery, which can lead to low blood calcium in the body. There is also a risk of accidental injury to the nerves associated with the vocal cords, which can cause vocal cord paralysis, hoarseness, low voice, or difficulty breathing.
Thyroid hormone therapy
After thyroidectomy, the thyroid hormone medication levothyroxine (Levothroid, Synthroid, etc.) should be taken for life. This medication has two benefits: it replenishes the hormone originally provided by the thyroid gland and inhibits the pituitary gland from producing thyroid stimulating hormone (TSH). High levels of TSH
can stimulate the growth of residual cancer cells. You will need to have your thyroid hormone levels checked every few months until your doctor determines the right dose for you. You may also continue to have your blood checked annually.
Radioactive iodine
Radioactive iodine therapy uses high doses of a radioactive iodine agent. Radioactive iodine therapy is often used after thyroidectomy to destroy other remnants of normal thyroid tissue and in areas of thyroid cancer that were not removed microscopically during surgery. Radioactive iodine therapy is also used in the treatment of thyroid cancer that has recurred or spread to other parts of the body after treatment. Thyroid iodine treatment requires swallowing capsules or liquid. Radioactive iodine is first taken up by thyroid cells and thyroid cancer cells, so there is little risk of it damaging other cells in the body.
Side effects may include.
1. nausea.
2. dry mouth.
3. dry eyes.
4. altered sense of taste or smell.
5. pain in areas where thyroid cancer cells have spread, such as the neck or chest.
Most radioactive iodine will be excreted in the urine a few days after treatment. Your doctor will tell you the precautions you need to take during radioactive iodine treatment to protect others from radiation. For example, you may be asked to avoid close contact with other people, especially children and pregnant women, for a while.
External radiation therapy
External radiation therapy can also be administered through equipment, where high-energy rays are administered after precise positioning outside the body (external radiation therapy). This therapy takes a few minutes per session, five days a week, for about five weeks. During treatment, you lie flat on the table and there are instruments that will go around you. If you are unable to have surgery and the cancer continues to progress despite radioactive iodine treatment, then consider the option of external radiation therapy. External radiation therapy can also be used to delay the progression of bone metastatic cancer.
Chemotherapy
Chemotherapy is a type of drug treatment in which chemical drugs are used to kill cancer cells. Chemotherapy is usually administered by intravenous infusion. Chemotherapy drugs reach the body and kill fast-growing cells, including cancer cells. Chemotherapy is not a routine treatment for thyroid cancer, but may be beneficial for patients for whom other treatments have not worked.
Injection of alcohol into the tumor
Alcohol ablation involves injecting alcohol into small thyroid cancers with the help of imaging techniques such as ultrasound to ensure precise injection. This treatment is beneficial for cancers that are not easily manipulated by surgery. If your thyroid cancer recurrence is limited to a small area of the neck, your doctor may recommend alcohol ablation therapy.
Targeted drug therapy
Targeted drug therapy uses a number of drugs that attack specific vulnerabilities in cancer cells. Targeted drugs used to treat thyroid cancer include.
1. Cabozantinib (Cometriq) (XL184).
2. Sorafenib (Doxorubicin).
3. vandetanib (Caprelsa).
These drugs target identify growing and dividing cancer cells. They are used in patients with advanced thyroid cancer.