surgery for thyroid cancer
overview
- Thyroid cancer occurs in the cells of the thyroid — a butterfly-shaped gland located at the base of your neck, just below your Adam’s apple. Your thyroid produces hormones that regulate your heart rate, blood pressure, body temperature and weight.
- Thyroid cancer might not cause any symptoms at first. But as it grows, it can cause pain and swelling in your neck.
- Several types of thyroid cancer exist. Some grow very slowly and others can be very aggressive. Most cases of thyroid cancer can be cured with treatment.
- Thyroid cancer rates seem to be increasing. Some doctors think this is because new technology is allowing them to find small thyroid cancers that may not have been found in the past.
Types of thyroid cancer
Types of thyroid cancer include:
- Papillary thyroid cancer. The most common form of thyroid cancer, papillary thyroid cancer arises from follicular cells, which produce and store thyroid hormones. Papillary thyroid cancer can occur at any age, but most often it affects people ages 30 to 50. Doctors sometimes refer to papillary thyroid cancer and follicular thyroid cancer together as differentiated thyroid cancer.
- Follicular thyroid cancer. Follicular thyroid cancer also arises from the follicular cells of the thyroid. It usually affects people older than age 50. Hurthle cell cancer is a rare and potentially more aggressive type of follicular thyroid cancer.
- Anaplastic thyroid cancer. Anaplastic thyroid cancer is a rare type of thyroid cancer that begins in the follicular cells. It grows rapidly and is very difficult to treat. Anaplastic thyroid cancer typically occurs in adults age 60 and older.
- Medullary thyroid cancer. Medullary thyroid cancer begins in thyroid cells called C cells, which produce the hormone calcitonin. Elevated levels of calcitonin in the blood can indicate medullary thyroid cancer at a very early stage. Certain genetic syndromes increase the risk of medullary thyroid cancer, although this genetic link is uncommon.
- Other rare types. Other very rare types of cancer that start in the thyroid include thyroid lymphoma, which begins in the immune system cells of the thyroid, and thyroid sarcoma, which begins in the connective tissue cells of the thyroid.
Thyroid cancer typically doesn’t cause any signs or symptoms early in the disease. As thyroid cancer grows, it may cause:
- A lump (nodule) that can be felt through the skin on your neck
- Changes to your voice, including increasing hoarseness
- Difficulty swallowing
- Pain in your neck and throat
- Swollen lymph nodes in your neck
Treatment may not be needed right away:
- Very small thyroid cancers that have a low risk of spreading in the body might not need treatment right away. Instead, you might consider active surveillance with frequent monitoring of the cancer. Your doctor might recommend blood tests and an ultrasound exam of your neck once or twice per year.
- In some people, the cancer might never grow and never require treatment. In others, growth may eventually be detected and treatment can be initiated.
Surgery:
Most people with thyroid cancer undergo surgery to remove the thyroid. Which operation your doctor might recommend depends 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 exam of the entire thyroid gland.
Operations used to treat thyroid cancer include:
- Removing all or most of the thyroid (thyroidectomy). An operation to remove the thyroid gland might involve removing all of the thyroid tissue (total thyroidectomy) or most of the thyroid tissue (near-total thyroidectomy). The surgeon often leaves small rims of thyroid tissue around the parathyroid glands to reduce the risk of damage to the parathyroid glands, which help regulate the calcium levels in your blood.
- Removing a portion of the thyroid (thyroid lobectomy). During a thyroid lobectomy, the surgeon removes half of the thyroid. It might be recommended if you have a slow-growing thyroid cancer in one part of the thyroid and no suspicious nodules in other areas of the thyroid.
- Removing lymph nodes in the neck (lymph node dissection). When removing your thyroid, the surgeon may also remove nearby lymph nodes in the neck. These can be tested for signs of cancer.
