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Causes and Types of Thyroid Disorders And Cancer | Endocrinology

Thyroid disorders and cancer

It occurs in thyroid cancer cells – a butterfly-shaped gland at the base of your neck, just below your Adam’s apple. Your thyroid makes hormones that regulate your heart rate, blood pressure, body temperature, and weight. Thyroid cancer may not cause any symptoms at first. But as it grows, it causes pain and swelling in the neck.

There are many types of thyroid cancer. Some grow very slowly and others are very aggressive. Most cases of thyroid cancer can be cured with treatment. Thyroid cancer rates appear to be increasing. Some doctors believe this is because new technology allows them to detect small, previously undeveloped thyroid cancers.

Symptoms of thyroid cancer

It’s common for people with thyroid cancer to have fewer or no symptoms. These are often diagnosed by a routine physical exam of the neck. They can also be detected accidentally by X-rays or other imaging scans done for other reasons. People may experience the following symptoms or signs. Sometimes people do not have any of these changes. Or, the symptom may be caused by a different medical condition that is not cancerous.

In front of the neck, a lump near Adam’s apple.

  • Blunt
  • Swelling of the glands in the neck.
  • Difficulty swallowing
  • Difficulty breathing
  • Throat or neck pain
  • The cough persists and is not caused by a cold.

If you are concerned about any changes you may experience, speak with your doctor. Among other things, your doctor may ask how often and how often you experience symptoms. This helps identify the cause of the problem called a diagnosis. Other thyroid problems such as goiter; Or a condition not related to the thyroid, such as an infection.

If cancer is diagnosed, symptom relief is an important part of cancer care and treatment. This is called palliative or supportive care. It often begins after diagnosis and continues throughout treatment. Be sure to talk to your healthcare team about any symptoms you are experiencing, including new symptoms or changes in symptoms.

How common is thyroid cancer?

This is rare cancer accounting for less than 1% of all cancer cases in the UK. Every year approximately 2,700 people in the UK are diagnosed. It is most common in people 35 to 39 years old and in people 70 and older.

Women are 2 to 3 times more likely to develop, than men. It is not clear why, but it may be the result of hormonal changes associated with the female reproductive system.

Who gets it?

This is more common in women than in men. Women have between the ages of 40 and 50, while men who have it are usually between the ages of 60 and 70. Follicular thyroid cancer is more common in whites than blacks and more women than men. You can still get this if you are young. Papillary thyroid cancer, for example, occurs most often in people between the ages of 30 and 50.

Types of thyroid cancer

Thyroid cancer is classified into types based on the cells found in the tumor. Its type is determined when a sample of tissue from your cancer is examined under a microscope. The type of thyroid cancer is considered to determine its treatment and prognosis.

Types of thyroid cancer:

  • Papillary thyroid cancer: The most common form of thyroid cancer, papillary thyroid cancer, arises from follicular cells that produce and store thyroid hormones. Papillary thyroid cancer can occur at any age, but most often affects people between the ages of 30 and 50. Doctors sometimes refer to papillary thyroid cancer and follicular thyroid cancer together as thyroid cancer.
  • Follicular thyroid cancer: Follicular thyroid cancer also arises from the follicular cells of the thyroid. It usually affects people over 50 years of age. Hartley cell cancer is a rare and more aggressive type of follicular thyroid cancer.
  • Anaplastic thyroid cancer: This is a rare thyroid cancer that begins in follicular cells. It grows quickly and is very difficult to treat. Anaplastic thyroid cancer usually occurs in adults 60 years of age or older.
  • Medullary thyroid cancer: It begins in thyroid cells called C cells, which make a hormone called calcitonin. Calcitonin levels in the blood indicate medullary at a very early stage. Some genetic syndromes increase the risk of medullary thyroid cancer, although this genetic link is unusual.
  • Other rare varieties: Another very rare cancer that begins in the thyroid is thyroid lymphoma, which begins in the cells of the thyroid immune system, and thyroid sarcoma, which begins in the cells of the thyroid connective tissue.

Causes of thyroid cancer

In most cases, the cause is unknown. However, some things increase the chances of developing your condition. The cause is unclear.

It occurs when cells in your thyroid undergo genetic changes (mutations). Mutations allow cells to grow and multiply rapidly. Cells also lose the ability to die, just like normal cells. The abnormal thyroid cells have accumulated from a tumor. The abnormal cells can attack nearby tissues and spread to other parts of the body (metastasize).

Risk factors of thyroid cancer

Factors that increase the risk:

  • The female gender is more common in women than in men
  • Exposure to high levels of radiation. Radiation therapy treatments to the head and neck increase the risk

Some hereditary genetic syndromes. Genetic syndromes that increase the risk, and include familial medullary thyroid cancer, multiple endocrine neoplasms, Cowden’s syndrome, and familial adenomatous polyposis.

Recurrent thyroid cancer: Despite treatment, even if the thyroid is removed, it will return. This happens when microscopic cancer cells cross the thyroid before being removed.

  • Lymph nodes in the neck
  • Small pieces of thyroid tissue remain during surgery
  • Other areas of the body, such as the lungs and bones.
  • Recurrent thyroid cancer can be treated. Your doctor may recommend regular blood tests or thyroid scans to check for recurring signs.

Diagnosis of thyroid cancer

A type of blood test called a thyroid function test measures hormone levels in the blood and can rule out or confirm other thyroid problems. Fine needle aspiration cytology (FNAC) is used if nothing else appears to be causing a thyroid lump. More evidence is needed if the FNAC results are incomplete or if more information is needed to make your treatment more effective.

Treatment for thyroid cancer

Treatment options depend on your type and stage, and your general health, and your preferences. Most of those can be cured with treatment. Treatment may not be needed right away

Very small thyroid cancers that have a low risk of spreading throughout the body do not require immediate treatment. Instead, you can often consider active surveillance with cancer control. Your doctor may recommend blood tests and an ultrasound exam of your neck once or twice a year. In some people, cancer never grows and does not require treatment. In others, the increase can eventually be detected and treatment started.

  • Surgery
  • Parathyroid glands
  • Open the Parathyroid Glands pop-up dialog

Most people have surgery to remove the thyroid. Your doctor may recommend any operations based on the type of thyroid cancer, the size of the cancer, whether the cancer has spread beyond the thyroid, and the results of an ultrasound examination of the entire thyroid gland.

Operations used to treat thyroid cancer:

Remove all or most of the thyroid (thyroidectomy). An operation to remove the thyroid gland involves the removal of thyroid tissue (total thyroidectomy) or thyroid tissue (near the entire thyroidectomy). The surgeon often leaves small borders of thyroid tissue around the parathyroid glands, which can help control calcium levels in the blood.

Removal of a portion of the thyroid (thyroid lobectomy). During a thyroid lobectomy, the surgeon removes half of the thyroid. This may be recommended if you have slow-growing thyroid cancer in one part of the thyroid and there are no suspicious nodules in other areas of the thyroid.

Removal of lymph nodes in the neck (lymph node dissection). By removing the thyroid, the surgeon can also remove nearby lymph nodes in the neck. These can be tested for signs of cancer.

Thyroid surgery can increase the risk of bleeding and infection. Damage to the parathyroid glands can also occur during surgery, which can lead to lower levels of calcium in your body. The nerves connected to the vocal cords may not function normally after surgery, which can lead to laryngeal paralysis, numbness, voice changes, or shortness of breath. Treatment improves or reverses nerve problems.

Thyroid hormone therapy: After a thyroidectomy, you can take the medicine levothyroxine (Levoxyl, Synthroid, others) for life. This action has two benefits: it supplies the missing hormone normally produced by the thyroid, and it suppresses the production of thyroid-stimulating hormone (TSH) from the pituitary gland. High levels of TSH can trigger the growth of the remaining cancer cells.

Radioactive iodine: Radioactive iodine treatment uses large doses of radioactive iodine. Radioactive iodine treatment is often used to destroy healthy thyroid tissue that remains after a thyroidectomy, as well as microscopic areas of thyroid cancer that have not been surgically removed. Radioactive iodine treatment is also helpful, which can come back after treatment or spread to other parts of the body.

Radioactive iodine treatment comes as a capsule or liquid that is swallowed. Radioactive iodine is taken up primarily by thyroid cells so the risk of damaging other cells in your body is low.

Side effects can include:

  • Dry mouth
  • Oral pain
  • Inflammation of the eye
  • Altered sense of taste or smell
  • Fatigue

Most of the radioactive iodine is excreted in the urine during the first days after treatment. You will be told what precautions to take at this time to protect other people from radiation. For example, you may be asked to temporarily avoid close contact with other people, especially children, and pregnant women.

External radiation therapy: Radiation therapy can also be delivered externally to a specific point on your body (external beam radiation therapy) using a machine that targets high-energy rays, such as X-rays and protons. During treatment, you lie on a table while a machine moves around you. External beam radiation therapy may be recommended if surgery is not an option and your cancer is growing after treatment with radioactive iodine. Radiation therapy may also be recommended after surgery if your cancer is at risk of recurrence.

Chemotherapy: Chemotherapy is the treatment of cancer by using chemicals to kill cancer cells. Chemotherapy is usually given through an IV. The chemicals travel throughout the body and destroy rapidly growing cells, including cancer cells. Chemotherapy is not commonly used, but it is sometimes recommended for people with anaplastic. Chemotherapy can be combined with radiation therapy.

Targeted drug treatment: Targeted drug therapies target specific abnormalities in cancer cells. By preventing these abnormalities, targeted therapeutic therapies can cause cancer cells to die. Drug treatment targets the signals that tell cancer cells to grow and divide. It is commonly used in advanced cancer.

Alcohol injection in cancers: Alcohol ablation is the injection with alcohol to ensure accurate injection placement using ultrasound-like imaging. This procedure reduces thyroid cancer. Alcohol ablation may be an option if your cancer is very small and surgery is not an option. It is sometimes used to treat recurrent cancer of the lymph nodes after surgery.

Supportive (palliative) care: Palliative care is specialized medical care that focuses on relieving pain and other symptoms of a serious illness. Hospice professionals will work with you, your family, and your other doctors to provide additional support to complete your ongoing care. Palliative care can be used when other aggressive treatments such as surgery, chemotherapy, or radiation therapy are performed. Most of it is offered at the beginning of cancer treatment. When palliative care is used in conjunction with all other appropriate therapies, people with cancer can feel better and live longer.

Palliative care is provided by a team of specially trained doctors, nurses, and other professionals. Palliative care teams aim to improve the standard of living for people with cancer and their families.

Prevention of thyroid cancer

Doctors do not know the cause, so there is no way to prevent, in those with an average risk of developing the disease.

Prevention for high-risk people: Thyroid surgery to prevent cancer (immune thyroidectomy) may be considered in adults and children with a genetic mutation that increases the risk of medullary thyroid cancer. Discuss your options with a genetic counselor who can explain your thyroid cancer risk and your treatment options.

Prevention for people close to nuclear power plants: Sometimes a drug that blocks the effects of radiation on the thyroid is given to people who live near nuclear power plants. Medicines (potassium iodide) can be used in the event of an accident in a nuclear reactor. If you live within 10 miles of a nuclear power plant and are concerned about safety precautions, contact your local or state emergency management department for more information.

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Procedures

Thyroid Removal Surgery (Thyroidectomy) Overview | Endocrinology

What is thyroidectomy?

A thyroidectomy is a surgical procedure to remove all or part of the thyroid gland and is used to treat diseases of the thyroid gland including:

  • Thyroid cancer
  • Hyperthyroidism (overactive thyroid gland)
  • Large goiters or thyroid nodules causing symptomatic obstruction such as difficulty swallowing or breathing.
  • Multinodular goiter

Thyroidectomy is traditionally a minimally invasive surgery that is performed through a small horizontal incision in the front of the neck. The entire thyroid gland may be removed or just a lobe, part of a lobe, and the isthmus or other structures. Depending on the extent of the operation, patients may need to take levothyroxine, an oral synthetic thyroid hormone.

Thyroidectomy without mutilation

For a select group of patients who are concerned about the possible cosmetic effects of a neck scar, we offer “scarless” thyroidectomy, a technique of removing the thyroid using small oral incisions that removes the scar from the neck. In this procedure, the surgeon accesses the thyroid gland through the patient’s mouth, known as the “transoral” approach. UCSF endocrine surgery is amongst the first programs in the world to pioneer this technique.

A new hybrid procedure using a transoral and submental technique (TOaST) offers patients an additional option, a refinement that combines the transoral approach with a small incision easily hidden just below the chin, offering the following benefits:

  • The decrease in postoperative complications and patient discomfort.
  • The ability to accommodate larger thyroid samples
  • Maintain practically all the cosmetic benefits of traditional surgery without scars.

Types of thyroid surgery

There are several different types of thyroid surgery. The most communal are lobectomy, subtotal thyroidectomy, and total thyroidectomy.

  • Lobectomy: Sometimes a nodule, inflammation, or swelling affects only half of the thyroid gland. When this occurs, a doctor will remove only one of the two lobes. The part left behind must retain part or all of its function.
  • Subtotal thyroidectomy: A subtotal thyroidectomy eliminates the thyroid gland but leaves a small amount of thyroid tissue. This preserves some of the thyroid function. Many people who have this type of surgery develop hypothyroidism, a condition that occurs when the thyroid does not produce enough hormones. This is treated with daily hormonal supplements.
  • Total thyroidectomy: A total thyroidectomy removes all of the thyroid and thyroid tissue. This surgery is suitable when nodules, swelling, or irritation affect the entire thyroid gland or when cancer is present.

Risks of thyroidectomy

Thyroidectomy is generally a safe surgical procedure. However, some people have major or minor complications. Possible complications include:

  • Hemorrhage (bleeding) under the neck wound: If this occurs, the wound protrudes and the neck swells, possibly compressing the internal structures of the neck and interfering with breathing. This is an emergency.
  • Thyroid storm: If thyroidectomy is performed to treat a very overactive gland, there may be an increase in thyroid hormones in the blood. This is a very rare complication because medicines are given before surgery to avoid this problem.
  • Recurrent laryngeal nerve injury: Because this nerve innervates the vocal cords, the injury can cause vocal cord paralysis and produce a hoarse voice, either in the short or long term.
  • Injury to a part of the superior laryngeal nerve: If this occurs, the singing patients may not be able to reach high notes and the voice may lose some projection.
  • Infection in the wound
  • Hypoparathyroidism: If the parathyroid glands cannot be protected or are damaged through surgery, the person may not be able to make enough parathyroid hormone. The parathyroid hormone helps keep blood calcium levels within the normal range. Low production of parathyroid hormone causes low levels of calcium in the blood.

Why is it for

Your doctor may indorse a thyroidectomy if you have conditions such as:

  • Thyroid cancer: Cancer is the most common cause of thyroidectomy. If you have thyroid cancer, removing most, if not all, of your thyroid is likely a treatment option.
  • Non-cancerous enlargement of the thyroid (goiter): Removal of all or part of the thyroid gland is an option if you have a large goiter that is uncomfortable or causes difficulty in breathing or swallowing, or in some belongings if the goiter is causing hyperthyroidism.
  • Overactive thyroid (hyperthyroidism): Hyperthyroidism is a disorder in which the thyroid gland produces too greatly thyroxine hormone. If you have problems with antithyroid medications and do not want radioactive iodine therapy, thyroidectomy may be an option.
  • Suspicious or indeterminate thyroid nodules: Some thyroid nodules cannot be identified as cancerous or non-cancerous after testing a sample from a needle biopsy. Doctors may recommend that people with these nodules have a thyroidectomy if the nodules are at increased risk of being cancerous.

Prevention

Most people with thyroid cancer have no known risk factors, so most cases of this disease cannot be prevented.

Exposure to radiation, especially in childhood, is a known risk factor for thyroid cancer. Because of this, doctors no longer use radiation to treat less serious illnesses. Imaging tests, such as X-rays and CT scans, also expose children to radiation, but in much lower doses, so it is not clear how much they might increase the risk of thyroid cancer (or other cancers). If there is an increased risk, it is probably small, but to be safe, children should not have these tests unless absolutely necessary. When needed, they should be performed using the lowest dose of radiation that still provides a clear image.

Genetic testing can be done to look for gene mutations found in familial medullary thyroid cancer (MTC). Because of this, most familial cases of TCM can be prevented or treated early by removing the thyroid gland. Once the disease is exposed in a family, the rest of the family associates can be tested for the mutated gene.

If you have a family history of TCM, it is important that you see a doctor who is familiar with the latest advances in genetic counselling and genetic testing for this disease. Removing the thyroid gland in children who carry the abnormal gene will likely prevent cancer that could otherwise be fatal.

Thyroidectomy complications

  • Hypocalcemia (3-5%): Most communal cause of airway obstruction after 24 hours
  • Hematoma (1-2%): Most communal cause of airway obstruction within 24 hours
  • Recurrent injury of the laryngeal nerve (0.77%): Usually causes unilateral damage, stridor, hoarseness
  • Wound infection (0.2-0.5%)