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Thyroid Cancer
What department should thyroid cancer see?
Firstly, thyroid cancer is the most common malignant tumor in the neck area. Therefore, it is recommended to consult with the most professional oncology department for diagnosis and treatment when the disease occurs. If thyroid cancer is operable, surgery can be performed by the head and neck surgery department. After surgical treatment, if radiotherapy and chemotherapy are needed, it is still recommended to see an oncologist for treatment and specific therapies. Thus, different departments may be consulted during different stages of the disease, but the primary recommendation is still to seek treatment from the oncology department.
The Differences between Thyroiditis, Hyperthyroidism, and Thyroid Cancer
Thyroiditis, hyperthyroidism, and thyroid cancer are clinically distinct conditions. Thyroiditis refers to inflammatory changes in the thyroid, either autoimmunity-related, suppurative or due to inflammation. Hyperthyroidism broadly refers to a functional change, which can result from various thyroid changes caused by diseases, including external damage and inflammation, leading to symptoms of hyperthyroidism. However, these manifestations should not be confused with each other, with the latter more closely related to autoimmune thyroiditis. Thyroid cancer, on the other hand, is a malignant alteration that also occurs in the thyroid gland but is not closely related to thyroiditis or hyperthyroidism. Generally, thyroid cancer is malignant, while thyroiditis and hyperthyroidism are benign, chronic conditions.
Late-stage symptoms of thyroid cancer
Differentiated thyroid cancer, in its advanced stages, can exhibit noticeable symptoms due to large nodules or invasion of surrounding organs. For example, a massive nodule pressing on the trachea can cause breathing difficulties, including respiratory distress. Compression of the esophagus can lead to swallowing difficulties, and pressure on the recurrent laryngeal nerve may result in symptoms like hoarseness. Even very few benign thyroid nodules can cause edema and inflammation by compressing these nerves. Therefore, differentiation and distinctive treatment are essential, along with a pathological diagnosis. Medullary thyroid cancer also presents specific symptoms, including persistent diarrhea, endocrine syndromes, and other accompanying conditions such as pheochromocytoma, multiple mucosal neuromas, and symptoms and signs caused by parathyroid adenomas.
Early symptoms of thyroid cancer
Differentiated thyroid cancer often has no symptoms in the early stages, with only incidental palpation of nodules of various sizes and textures on the front of the neck. Some patients may find abnormalities during routine physical examinations through imaging studies, and symptoms may appear only in the later stages. The second point concerns the characteristics of medullary thyroid cancer, which exhibits specific symptoms early on, such as persistent, watery diarrhea. Additionally, this cancer involves an endocrine syndrome, where tumor cells secrete calcitonin and adrenocorticotropic hormone, potentially leading to facial flushing, elevated blood pressure, and reduced blood calcium. This may be associated with other conditions such as pheochromocytoma, multiple mucosal neuromas, and parathyroid adenomas, which can also cause corresponding symptoms.
Early symptoms of thyroid cancer
Early symptoms of thyroid cancer: First, differentiated thyroid cancer often exhibits no symptoms in its early stages, only accidentally discovered nodules that vary in size and texture on the front of the neck. Some patients are only diagnosed during routine physical exams or through imaging studies, with clinical symptoms being relatively rare. However, more symptoms and signs may appear in the later stages. Second, medullary thyroid cancer presents some unique symptoms, such as persistent diarrhea, typically watery, and a syndrome involving the endocrine system. Patients may exhibit facial flushing, elevated blood pressure, and decreased blood calcium levels, accompanied by other conditions, such as parathyroid adenomas, multiple mucosal neuromas, and pheochromocytomas, which also manifest specific symptoms.
Is thyroid cancer without lymph node metastasis considered early stage?
Thyroid cancer, if it has not metastasized to lymph nodes, generally falls under early-stage. Once thyroid cancer is diagnosed, surgical removal is the primary treatment choice. Postoperative treatments vary depending on the different pathological types of thyroid cancer. For the most common type, papillary carcinoma, if the surgery is radically curative, further treatment may not be necessary, and merely supplementing thyroid hormones suffices. In cases such as follicular carcinoma, undifferentiated carcinoma, or medullary carcinoma, even after surgically radical removal, postoperative treatment often requires further radiotherapy or treatment with Iodine-131, depending on the surgical pathology results. (The use of medications should be carried out under the guidance of a professional doctor.)
Characteristics of thyroid cancer lymph node enlargement
Thyroid cancer is a type of malignant tumor. However, if it is detected early, diagnosed early, and treated early, it generally has a relatively good prognosis compared to other malignant tumors. Once a patient is afflicted with this disease, it is crucial to seek treatment promptly. Without treatment, thyroid cancer can spread to lymph nodes. Initially, the cancerous lymph nodes may invade surrounding blood vessels and nerves, leading to symptoms such as hoarseness. If it compresses the throat area, it can cause discomfort in the throat accompanied by breathing difficulties and coughing while drinking. If the optimal time for treatment is missed, cancer cells can spread, potentially moving not only to the lungs but also to the respiratory system and bones, among other distant sites.
How is thyroid cancer diagnosed?
The first point is the diagnostic process for differentiated thyroid cancer. Initially, most patients may not have symptoms, while a minority might show symptoms due to invasion of surrounding organs. Ultrasound examination is the preferred method for diagnosing thyroid nodules. Ultrasound can clarify the number, nature, and location of thyroid nodules, as well as provide information on whether there are abnormally enlarged lymph nodes in the neck. It has a relatively high accuracy in identifying the nature of thyroid nodules. Currently, the most accurate test for determining the nature of thyroid nodules remains the fine needle aspiration cytology, which has a diagnostic sensitivity of 83-92% and specificity of 80-92%, but it is not 100% conclusive. The second point is about the diagnosis of medullary thyroid cancer. Besides the tests common for thyroid cancers, additional tests for medullary thyroid cancer can include fine needle aspiration, ultrasound, and some serological tests, such as calcitonin and carcinoembryonic antigen tests.
What are the clinical manifestations of thyroid cancer?
For patients with thyroid cancer, the most common clinical manifestation is thyroid nodules, and most patients do not have obvious clinical symptoms, only being incidentally discovered during physical examinations. In rare cases, patients may seek medical attention due to enlarged cervical lymph nodes. As the condition progresses, the neck mass gradually enlarges, becomes firmer, and its mobility decreases during swallowing. In some rapid developments, it may invade surrounding tissues, leading to late-stage symptoms such as hoarseness, difficulty breathing, and difficulty swallowing. When the cervical sympathetic nerve is compressed, it can cause pain in the ears, occipital region, and shoulders. In the case of medullary carcinoma, which can produce serotonin and calcitonin, patients may sometimes experience symptoms such as diarrhea, palpitations, facial flushing, or decreased blood calcium levels.
Can people with normal thyroid function get thyroid cancer?
Thyroid function and thyroid cancer are not necessarily related. It is possible to have thyroid cancer even when thyroid function is normal. Clinically, thyroid cancer is usually detected by color ultrasound. Clinicians will classify thyroid nodules based on their size, texture, growth direction, presence of blood flow signals, clarity of boundaries, infiltration of surrounding tissues, and enlargement of nearby lymph nodes. Nodules classified as categories one to three generally have a benign tendency, and regular follow-up appointments are sufficient. If the nodules are classified as categories four to five, they are suggestive of malignancy, and it is recommended to perform thyroid fine needle aspiration or surgery to determine the pathological type of the nodules.