Cancer of the Thyroid

The thyroid gland is found inside the front of the lower neck which wraps around the front part of the trachea (windpipe). Your metabolism—the rate at which every part of the body works—is controlled by the thyroid through thyroid hormone, a chemical that carries messages from the thyroid to the rest of the body through the bloodstream.

Thyroid cancer usually appears as small lumps or nodules within the thyroid gland. The thyroid gland may also be enlarged. Thyroid cancer occurs more often in people who have undergone radiation to the head, neck or chest. It can also occur in people without any known risk factors. Thyroid cancer is the fastest-increasing cancer in both men and women, and occurs more frequently in females.

On average, thyroid cancer has a 97 percent survival rate at the five year mark.

Read more about cancer of the thyroid.

Our otolaryngologists are part of a multidisciplinary team that specialize in using the latest minimally invasive surgical approaches to treat recurrent and advanced thyroid cancers at Dana-Farber Brigham Cancer Center's Head and Neck Cancer Program.

Otolaryngology - Thyroid Cancer Surgeons

Thyroid Cancer Types

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 tumors.

Thyroid Cancer Risk Factors

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

Thyroid Cancer Symptoms

  • 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.

Thyroid Cancer 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.

Thyroid Cancer Treatment

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.

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