It most often attacks women 40+. These symptoms could be signs of thyroid cancer

The biggest problem in patients struggling with thyroid cancer is too late diagnosis. This is often because thyroid cancer has no specific symptoms. Therefore, as emphasized by prof. dr hab. Marcin Barczyński, it is worth carrying out a self-examination from time to time: raise your head and while swallowing observe the area of ​​your thyroid gland in the mirror.

1. Almost half of Poles have thyroid nodules, but only about 2 percent are malignant
2. Thyroid cancer occurs in patients of all ages, but it mostly affects people between 40 and 50 years of age. Women are more at risk. The cause of the disease is not fully known
3. One of the known risk factors is obesity and insulin resistance. – Adipose tissue can serve as a storehouse of environmental toxins – explains prof. dr hab. Marcin Barczyński, endocrinologist
4. Ionizing radiation also contributes to the formation of malignant changes
5. You can find more such articles on the Onet homepage.

Nodular lesions of the thyroid gland are common to almost half of the Polish population. Although a definite minority of them, only 1-2%, are malignant, it is the malignant neoplasm of this gland that is currently the sixth most common in women. It accounts for 4% of all malignant neoplasms diagnosed in Poland.

What do we know about the risk factors and symptoms of thyroid cancer? How is its diagnosis and treatment carried out, whether it must always be associated with invasive surgery, says prof. dr hab. Marcin Barczyński, specialist in general and oncological surgery, with European sub-specialization in endocrine surgery from SCM clinic in Krakow.

Thyroid cancer – incidence and risk factors

Thyroid cancer occurs in patients of all ages, but it mostly affects people between 40 and 50 years of age. As prof. dr hab. Marcin Barczyński, its etiology is not fully known to medicine. Little is known about the factors that predispose to this disease. On the other hand, it is assumed that the mere presence of benign changes carries the risk of more serious problems. Women are also particularly vulnerable to the disease.

As a specialist from the SCM Clinic in Krakow explains, the incidence rate is several times higher among women for whom past pregnancies constitute an additional burden. The reasons for this state of affairs are not fully understood, but it is assumed that women are subject to much greater hormonal influence than men, which in this case may be of key importance.

Ionizing radiation also contributes to the formation of malignant changes. Therefore, the formerly growing incidence of thyroid cancer in Poland was associated with the Chernobyl disaster, which, however, has never been proven. On the other hand, it was estimated that during his lifetime, a statistical Pole would receive a dose of about 0,9 mSv from the Chernobyl fallout, i.e. 0,5 percent of the dose that would be irradiated from natural sources. For comparison, the annual background radiation dose (mainly due to radon present in homes) is approx. 3 mSv. The widespread use of radiological examinations in medicine, especially computed tomography, is also important. Such a single abdominal CT scan is associated with a dose of about 10 mSv. However, it should be clearly stated that the performance of such a test is considered safe as long as it is medically justified.

1. A factor that drastically increases the risk of diabetes, heart attack and cancer

A diet rich in micronutrients is extremely important for maintaining the thyroid in a proper condition. Necessary for the proper functioning of this gland are micronutrients and trace elements such as iodine, iron, zinc, selenium, B vitamins, as well as C and D.

Thyroid cancer – symptoms and diagnosis

The biggest problem in patients struggling with thyroid cancer is too late diagnosis. This is often because thyroid cancer has no specific symptoms. Therefore, as emphasized by prof. dr hab. Marcin Barczyński, it is worth carrying out a self-examination from time to time. It allows you to check whether there are any nodules or asymmetries within the thyroid gland, and whether we feel any clear hardening under the fingers.

To do it, just raise your head and watch your thyroid gland in the mirror while swallowing. Then, in the same pose, you should carefully touch this part of the neck – explains the oncologist. In addition, regular preventive examinations, such as an ultrasound of the thyroid gland, are also important. It allows you to look closely at this gland and evaluate it in terms of size, structure, as well as the presence of any nodules and their phenotype. The change that should be worrying, usually has irregular boundaries, is hypoechoic and has microcalcifications – adds the specialist.

If the disease is already at a high stage, it often causes symptoms such as breathlessness, hoarseness and difficulty swallowing. This is due to the large size of the tumor infiltrating the surrounding cervical structures.

Fine needle aspiration biopsy (FNAB) is a necessary step after the diagnosis of a thyroid tumor or suspicious focal lesions.

1. Thyroid biopsy – when to do and how is it done? [WE EXPLAIN]

The cytological examination of the sample enables a preliminary diagnosis to be made, which in turn allows for the selection of the optimal procedure in a given case. This means – further observation or possible surgery. Fine-needle aspiration biopsy consists in aspiration of the cell suspension together with the intercellular fluid from the examined lesion through puncture. Therefore, not tissue samples are taken, but only cells. Then the material is subjected to cytological examination, and during the analysis, the pathologist assesses their appearance, without assessing the tissue structure.

Fine-needle biopsy is most often performed during ultrasound (then we are talking about fine-needle aspiration biopsy – FNAB). Thanks to the control provided by the ultrasound equipment, the material can be collected with high precision, even in the case of small lesions. Due to the thin needles used for the procedure, it is performed without anesthesia. It is a simple and quick test with extremely rare complications.

Fine needle aspiration biopsy will not be replaced by blood tests. However, it may be helpful to measure the concentration of calcitonin – a hormone secreted by the C cells of the thyroid. A significant increase in its concentration may indicate the diagnosis of medullary thyroid cancer.

1. The first symptoms of thyroid cancer. They must not be ignored

How do we treat thyroid cancer?

Treatment for thyroid cancer is complex. Its basis is the excision of the entire organ or one lobe (depending on the size of the tumor), as well as the metastatic lymph nodes in the neck. The surgical procedure is complemented by the administration of radioactive iodine, the task of which is to destroy the remnants of the diseased tissue along with metastases. There is also a group of patients who qualify for the treatment of suppressive TSH with the use of L-thyroxine – a hormone secreted by the thyroid gland.

Surgical treatment of thyroid cancer – surgery without scarring?

The thyroid gland is located prominently on the neck. Hence, it is not surprising that patients, especially female patients, are concerned about scars that may remain after surgery on this gland. Therefore, as in other surgical fields, the aim is to minimize the invasiveness of procedures in thyroid surgery. This is to improve the cosmetic effects of the operations performed.

As prof. dr hab. Marcin Barczyński, in Poland, thyroidectomy procedures are performed through the oral vestibule (TOETVA). – These types of operations do not leave any scars on the skin, and their effectiveness and safety is the same as in the case of traditional cuts. Of course, for this type of surgery, the patient must first be qualified.

1. What does the thyroid test look like?

What’s more, during such a procedure, as in the case of traditional ones, neuromonitoring is also used. It is a technology that allows you to avoid another of the common postoperative complications of the thyroid gland, i.e. problems with the voice. – Due to the fact that the thyroid gland adheres to the larynx, hoarseness or weakening of the volume of voice may be a side effect after surgery, which results from damage to the mobility of the vocal cords. In most cases, these problems are temporary, but there are also cases of permanent voice damage, which is associated with the need for phoniatric rehabilitation. The solution to this problem may be prevention, i.e. surgery using neuromonitoring of the laryngeal nerves – explains the SCM Clinic specialist.

What does the operation using neuromonitoring look like? The patient is intubated using a tube with a so-called integrated electrodes placed between the vocal folds. The tube with electrodes is attached to the monitor, and during the procedure, the doctor uses a probe to monitor the condition of the nerves responsible for the voice, while stimulating with low-intensity current of the tissue, which allows locating the nerves. This electrode can also be applied to the vagus nerve, allowing automatic control of whether the nerve’s reflex arc, which produces voice, is preserved.

As it turns out, the most common, highly differentiated thyroid cancer (i.e. papillary and follicular cancer) has a very good prognosis. This is indicated by the fact that despite the increase in the incidence in recent years, the number of deaths caused by this disease remains at a constant, relatively low level. We owe it to the access to detailed diagnostics and the continuous development of ways to combat this disease.

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Information about the specialist:

Prof. Marcin Barczyński, MD, PhD is a specialist in general and oncological surgery, with a sub-specialization in endocrine surgery at SCM clinic in Krakow. He is the president of the European Society of Endocrinologist Surgeons.

Read also:

1. The research you need to do if you suspect you have Hashimoto’s disease
2. The first symptoms of hypothyroidism. Don’t miss out
3. What happens in your body when you consume too little selenium?

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