Thyroid Cancer
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An Accidental Lifesaver
A true story of how a patient's bike accident led to
the discovery of thyroid cancer
By Laura Lee Bloor
MedicineNet.com
Reviewed by William C. Shiel Jr., MD, FACP, FACR
 When Ken Brown* broke his left clavicle in a dirt-bike accident, he never
imagined it might help save his life.
In November of 2006, Ken went to Jawbone Desert, Calif., with a group of
friends to ride dirt bikes. The getaway weekend took a turn for the worse when
Ken wrecked his bike, going about 60 mph. Ken was lucky that his only injury was
the broken collarbone (clavicle).
The emergency room doctor prescribed hydrocodone/acetaminophen (Vicodin) to
manage Ken's pain until he could be seen by a surgeon who specialized in
shoulders. Within a week of the accident, Ken had surgery to repair his
clavicle, using a plate and screws.
The surgery went smoothly, or so Ken thought, until he started experiencing
numbness in his pinky finger afterward. Over the next couple of weeks, the
numbness traveled up his elbow and caused painful muscle spasms in his arm and
back.
Brown went to his doctor who determined that he did not have carpal tunnel
syndrome but couldn't find an explanation for the numbness. He referred Ken to a
neurologist.
Within the next few days, Ken visited the neurologist who ordered a spinal
MRI scan of his neck. When the neurologist contacted Ken about his MRI results,
he asked if Ken was aware of a lump in his thyroid area. "No," Ken said. The
neurologist was concerned about the lump, known as a nodule, especially with its
large size of 3 cm.
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What is the thyroid?
The thyroid is a gland in the neck. It has two kinds of cells that make
hormones. Follicular cells make thyroid hormone, which affects heart rate,
body temperature, and energy level. C cells make calcitonin, a hormone that
helps control the level of calcium in the blood.
The thyroid is shaped like a butterfly and lies at the front of the neck,
beneath the voice box (larynx). It has two parts, or lobes. The two lobes
are separated by a thin section called the isthmus.
A healthy thyroid is a little larger than a quarter. It usually cannot be
felt through the skin. A swollen lobe might look or feel like a lump in the
front of the neck. A swollen thyroid is called a goiter. Most goiters are
caused by not enough iodine in the diet. Iodine is a substance found in
shellfish and iodized salt.
What is cancer, and what are the types of thyroid cancer?
Cancer is a group of many related diseases. All cancers begin in cells, the
body's basic unit of life. Cells make up tissues, and tissues make up the organs
of the body.
Normally, cells grow and divide to form new cells as the body needs them.
When cells grow old and die, new cells take their place.
Sometimes this orderly process goes wrong. New cells form when the body does
not need them, and old cells do not die when they should. These extra cells can
form a mass of tissue called a growth or tumor. Growths on the thyroid are
usually called nodules.
Thyroid nodules can be benign or malignant:
- Benign nodules are not cancer. Cells from benign nodules do not spread to
other parts of the body. They are usually not a threat to life. Most thyroid
nodules (more than 90 percent) are benign.
- Malignant nodules are cancer. They are generally more serious and may
sometimes be life threatening. Cancer cells can invade and damage nearby tissues
and organs. Also, cancer cells can break away from a malignant nodule and enter
the bloodstream or the lymphatic system. That is how cancer spreads from the
original cancer (primary tumor) to form new tumors in other organs. The spread
of cancer is called metastasis.
The following are the major types of thyroid cancer:
- Papillary and follicular thyroid cancers account for 80 to 90 percent of all
thyroid cancers. Both types begin in the follicular cells of the thyroid. Most
papillary and follicular thyroid cancers tend to grow slowly. If they are
detected early, most can be treated successfully.
- Medullary thyroid cancer accounts for 5 to 10 percent of thyroid cancer
cases. It arises in C cells, not follicular cells. Medullary thyroid cancer is
easier to control if it is found and treated before it spreads to other parts of
the body.
- Anaplastic thyroid cancer is the least common type of thyroid cancer (only 1
to 2 percent of cases). It arises in the follicular cells. The cancer cells are
highly abnormal and difficult to recognize. This type of cancer is usually very
hard to control because the cancer cells tend to grow and spread very quickly.
If thyroid cancer spreads (metastasizes) outside the thyroid, cancer cells
are often found in nearby lymph nodes, nerves, or blood vessels. If the cancer
has reached these lymph nodes, cancer cells may have also spread to other lymph
nodes or to other organs, such as the lungs or bones.
When cancer spreads from its original place to another part of the body, the
new tumor has the same kind of abnormal cells and the same name as the primary
tumor. For example, if thyroid cancer spreads to the lungs, the cancer cells in
the lungs are thyroid cancer cells. The disease is metastatic thyroid cancer,
not lung cancer. It is treated as thyroid cancer, not as lung cancer. Doctors
sometimes call the new tumor "distant" or metastatic disease.
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