What is thyroid cancer and what are its symptoms? Thyroid cancer is the most common endocrine-related tumor. Thyroid cancer usually has nodules or lumps and most patients do not have any symptoms; a few can have pain, difficulty swallowing, or hoarseness. Treatment is very effective because most patients can be treated safely and effectively. Causes of thyroid cancer Thyroid cancer is more commonly seen in people with a history of radiation therapy to the thyroid area, a family history of thyroid cancer, and in people over the age of 40. What are the types of thyroid cancer? Papillary carcinoma, follicular carcinoma, medullary carcinoma, and undifferentiated carcinoma. Papillary carcinoma is the most common, accounting for 70-80% of cases, and can be seen at any age. Follicular carcinoma accounts for 10-15% and generally develops at an older age than papillary carcinoma. Medullary carcinoma accounts for 5-10% and is commonly seen in people with a family history of medullary carcinoma and can be diagnosed by genetic testing. Undifferentiated carcinoma accounts for less than 5%, and the overall treatment outcome is poor. What are the treatment measures for thyroid cancer? The most radical treatment for thyroid cancer is surgery plus lifelong postoperative thyroid hormone. Patients with low risk of recurrence can be treated with surgery alone. However, for patients with high malignancy (e.g. undifferentiated carcinoma, undifferentiated carcinoma, partially medullary carcinoma) and post-surgical residual thyroid cancer, a combination of radiotherapy and chemotherapy can be considered. Radioactive iodine treatment Radioactive iodine is like a “magic bullet” that can destroy residual thyroid cancer cells after surgery. To ensure the effectiveness of radioactive iodine treatment, the patient’s TSH level must be maintained at a high level at the time of treatment. To achieve this, the patient must be off thyroxine to artificially cause hypothyroidism for a period of time. A low iodine diet also helps radioactive iodine enter the thyroid cancer cells. Systemic iodine imaging is first performed when TSH is sufficiently high. If there is sufficient cellular imaging, radioactive iodine can be given (I131), after which oral thyroxine is restarted. Radioactive iodine therapy is usually well tolerated with few side effects. What is follow-up for thyroid cancer patients? Regular follow-up visits are essential for all thyroid cancer patients. Follow-up visits include a detailed medical history, physical examination, ultrasound, and testing of blood T4 and thyroglobulin. Thyroglobulin is a marker of thyroid cancer recurrence. Patients with thyroid cancer may need several whole body iodine scans with the aim of determining whether there are residual cancer cells in the body, which requires you to stop taking thyroid hormone or intravenous synthetic human TSH 2 weeks prior to the examination to facilitate better iodine uptake in the residual cancer sites. Prognosis of thyroid cancer Overall, the prognosis of thyroid cancer is good, especially if the patient is under 40 years old and has a small primary focus. Most patients with thyroid cancer can be cured. Even if they cannot be cured, they can survive with the tumor for a long time and without significant symptoms. For patients whose cancer cells cannot be destroyed by surgery and radioactive iodine treatment, new treatments such as tumor vaccine and gene therapy will emerge with the development of medical science.