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Thyroid Cancer Treatment Information
for Patients
CancerNet from the National Cancer Institute
Information from PDQ for Patients
DESCRIPTION
Cancer of the thyroid is a disease in which cancer (malignant) cells are
found in the tissues of the thyroid gland. The thyroid gland is at the base
of the throat. It has two lobes, one on the right side and one on the left.
The thyroid gland makes important hormones that help the body function
normally.
Cancer of the thyroid is more common in women than in men. Most patients
are between 25 and 65 years old. People who have been exposed to large
amounts of radiation, or who have had radiation treatment for medical
problems in the head and neck have a higher chance of getting thyroid
cancer. The cancer may not occur until 20 years or longer after radiation
treatment.
A doctor should be seen if there is a lump or swelling in the front of
the neck or in other parts of the neck.
If there are symptoms, a doctor will feel the patient's thyroid and check
for lumps in the neck. The doctor may order blood tests and special scans to
see whether a lump in the thyroid is making too many hormones. The doctor
may want to take a small amount of tissue from the thyroid. This is called a
biopsy. To do this, a small needle is inserted into the thyroid at the base
of the throat and some tissue is drawn out. The tissue is then looked at
under a microscope to see whether it contains cancer.
There are four main types of cancer of the thyroid (based on how the
cancer cells look under a microscope): papillary, follicular, medullary, and
anaplastic. The chance of recovery (prognosis) depends on the type of
thyroid cancer, whether it is just in the thyroid or has spread to other
parts of the body (stage), and the patient's age and overall health. Some
types of thyroid cancer grow much faster than others.
The genes in our cells carry the hereditary information from our parents.
An abnormal gene has been found in patients with some forms of thyroid
cancer. If medullary thyroid cancer is found, the patient may have been born
with a certain abnormal gene which may have led to the cancer. Family
members may have also inherited this abnormal gene. Tests have been
developed to determine who has the genetic defect long before any cancer
appears. It is important that the patient and his or her family members
(children, grandchildren, parents, brothers, sisters, nieces and nephews)
see a doctor about tests that will show if the abnormal gene is present.
These tests are confidential and can help the doctor help patients. Family
members, including young children, who don't have cancer, but do have this
abnormal gene, may reduce the chance of developing medullary thyroid cancer
by having surgery to safely remove the thyroid gland (thyroidectomy).
Once cancer of the thyroid is found (diagnosed), more tests will be done to
find out if cancer cells have spread to other parts of the body. This is
called staging. A doctor needs to know the stage of the disease to plan
treatment.
The following stages are used for papillary cancers of the thyroid:
Cancer is only in the thyroid and may be found in one or both lobes.
In patients younger than 45 years of age:
- Cancer has spread beyond the thyroid.
In patients older than 45 years of age:
- Cancer is only in the thyroid and larger than 1 centimeter (about 1/2
inch).
Cancer is found in patients older than 45 years of age and has spread
outside the thyroid (but not outside of the neck) or has spread to the lymph
nodes.
Cancer is found in patients older than 45 years of age and has spread to
other parts of the body, such as the lungs and bones.
The following stages are used for follicular cancers of the thyroid:
Cancer is only in the thyroid and may be found in one or both lobes.
In patients younger than 45 years of age:
- Cancer has spread beyond the thyroid.
In patients older than 45 years of age:
- Cancer is only in the thyroid and larger than 1 centimeter (about 1/2
inch).
Cancer is found in patients older than 45 years of age and has spread
outside the thyroid (but not outside of the neck) or to the lymph nodes.
Cancer is found in patients older than 45 years of age and has spread to
other parts of the body, such as the lungs and bones.
Other types or stages of thyroid cancer include the following:
Cancer is less than 1 centimeter (about 1/2 inch) in size.
Cancer is between 1 and 4 centimeters (about 1/2 to 1 1/2 inches) in size.
Cancer has spread to the lymph nodes.
Cancer has spread to other parts of the body.
There is no staging system for anaplastic cancer of the thyroid. This type
of cancer of the thyroid grows faster than the other types.
Recurrent disease means that the cancer has come back (recurred) after it
has been treated. It may come back in the thyroid or in another part of the
body.
There are treatments for all patients with cancer of the thyroid. Four types
of treatment are used:
- surgery (taking out the cancer)
- radiation therapy (using high-dose x-rays or other high-energy rays to
kill cancer cells)
- hormone therapy (using hormones to stop cancer cells from growing)
- chemotherapy (using drugs to kill cancer cells)
-
Surgery is the most common treatment of cancer of the thyroid. A doctor may
remove the cancer using one of the following operations:
- Lobectomy removes only the side of the thyroid where the cancer is
found. Lymph nodes in the area may be taken out (biopsied) to see if
they contain cancer.
- Near-total thyroidectomy removes all of the thyroid except for a small
part.
- Total thyroidectomy removes the entire thyroid.
- Lymph node dissection removes lymph nodes in the neck that contain
cancer.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink
tumors. Radiation for cancer of the thyroid may come from a machine outside
the body (external radiation therapy) or from drinking a liquid that
contains radioactive iodine. Because the thyroid takes up iodine, the
radioactive iodine collects in any thyroid tissue remaining in the body and
kills the cancer cells.
Hormone therapy uses hormones to stop cancer cells from growing. In
treating cancer of the thyroid, hormones can be used to stop the body from
making other hormones that might make cancer cells grow. Hormones are
usually given as pills.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken
by pill, or it may be put into the body by a needle in the vein or muscle.
Chemotherapy is called a systemic treatment because the drug enters the
bloodstream, travels through the body, and can kill cancer cells outside the
thyroid.
Treatment of cancer of the thyroid depends on the type and stage of the
disease, and the patient's age and overall health.
Standard treatment may be considered because of its effectiveness in
patients in past studies, or participation in a clinical trial may be
considered. Not all patients are cured with standard therapy and some
standard treatments may have more side effects than are desired. For these
reasons, clinical trials are designed to find better ways to treat cancer
patients and are based on the most up-to-date information. Clinical trials
are ongoing in many parts of the country for some patients with cancer of
the thyroid. To learn more about clinical trials, call the Cancer
Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at
1-800-332-8615.
Treatment may be one of the following:
- 1. Surgery to remove one lobe of the thyroid (lobectomy),
followed by hormone therapy. Radioactive iodine also may be given
following surgery.
2. Surgery to remove the thyroid (total thyroidectomy).
Treatment may be one of the following:
- 1. Surgery to remove the thyroid (total thyroidectomy).
2. Surgery to remove one lobe of the thyroid (lobectomy),
followed by hormone therapy. Radioactive iodine also may be given
following surgery.
Treatment may be one of the following:
- 1. Surgery to remove one lobe of the thyroid (lobectomy) and
lymph nodes that contain cancer, followed by hormone therapy.
Radioactive iodine also may be given following surgery.
2. Surgery to remove the thyroid (total thyroidectomy).
Treatment may be one of the following:
- 1. Surgery to remove the thyroid (total thyroidectomy).
2. Surgery to remove one lobe of the thyroid (lobectomy) and
lymph nodes that contain cancer, followed by hormone therapy.
Radioactive iodine also may be given following surgery.
Treatment may be one of the following:
- 1. Surgery to remove the entire thyroid (total thyroidectomy)
and lymph nodes where cancer has spread.
2. Total thyroidectomy followed by radiation therapy with
radioactive iodine or external beam radiation therapy.
Treatment may be one of the following:
- 1. Surgery to remove the entire thyroid (total thyroidectomy)
and lymph nodes or other tissues around the thyroid where the cancer has
spread.
2. Total thyroidectomy followed by radioactive iodine or external
beam radiation therapy.
Treatment may be one of the following:
- 1. Radioactive iodine.
2. External beam radiation therapy.
3. Hormone therapy.
4. A clinical trial of chemotherapy.
Treatment may be one of the following:
- 1. Radioactive iodine.
2. External beam radiation therapy.
3. Hormone therapy.
4. A clinical trial of chemotherapy.
Treatment will probably be surgery to remove the entire thyroid (total
thyroidectomy) unless the cancer has spread to other parts of the body. If
lymph nodes in the neck contain cancer, the lymph nodes in the neck will be
removed (lymph node dissection). If the cancer has spread to other parts of
the body, chemotherapy may be given.
Treatment may be one of the following:
- 1. Surgery to remove the thyroid and the tissues around it.
Because this cancer often spreads very quickly to other tissues, a
doctor may have to take out part of the tube through which a person
breathes. The doctor will then make an airway in the throat so the
patient can breathe. This is called a tracheostomy.
2. Total thyroidectomy to reduce symptoms if the disease remains
in the area of the thyroid.
3. External beam radiation therapy.
4. Chemotherapy.
5. Clinical trials studying new methods of treatment of thyroid
cancer.
The choice of treatment depends on the type of thyroid cancer the patient
has, the kind of treatment the patient had before, and where the cancer
comes back. Treatment may be one of the following:
- 1. Surgery with or without radioactive iodine.
2. External beam radiation therapy to relieve symptoms caused by
the cancer.
3. Chemotherapy.
4. Radioactive iodine.
5. Radiation therapy given during surgery.
6. Clinical trials.
TO LEARN MORE..... CALL 1-800-4-CANCER
To learn more about cancer of the thyroid, call the National Cancer
Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237);
TTY at 1-800-332-8615. By dialing this toll-free number, you can speak with
a trained information specialist who can answer your questions.
The Cancer Information Service also has booklets about cancer that are
available to the public and can be sent on request. The following booklet
about thyroid cancer may be helpful:
- In Answer to Your Questions About Thyroid Cancer
The following general booklets on questions related to cancer may be
helpful:
- What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care
About Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again
There are many other places where people can get material and information
about cancer treatment and services. The social service office at a hospital
can be checked for local and national agencies that help with getting
information about finances, getting to and from treatment, getting care at
home, and dealing with problems.
For more information from the National Cancer Institute, please write to
this address:
- National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
Date Last Modified: 07/1998
If you want to know more about cancer and how it is treated, or if you if
you wish to know about clinical trials for your type of cancer, you can call
the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained
information specialist can talk with you and answer your questions.
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