Thyroid Cancer (cont.)
What are symptoms of thyroid cancer?
Early thyroid cancer often does not cause symptoms. But as the cancer grows,
symptoms may include:
These symptoms are not sure signs of thyroid cancer. An infection, a benign
goiter, or another problem also could cause these symptoms. Anyone with these
symptoms should see a doctor as soon as possible. Only a doctor can diagnose and
treat the problem.
How is thyroid cancer diagnosed?
If a person has symptoms that suggest thyroid cancer, the doctor may perform
a physical exam and ask about the patient's personal and family medical history.
The doctor also may order laboratory tests and imaging tests to produce pictures
of the thyroid and other areas.
The exams and tests may include the following:
- Physical exam—The doctor will feel the neck, thyroid, voice box, and lymph
nodes in the neck for unusual growths (nodules) or swelling.
- Blood tests—The doctor may test for abnormal levels (too low or too high)
of thyroid-stimulating hormone (TSH) in the blood. TSH is made by the pituitary
gland in the brain. It stimulates the release of thyroid hormone. TSH also
controls how fast thyroid follicular cells grow.
If medullary thyroid cancer is suspected, the doctor may check for abnormally
high levels of calcium in the blood. The doctor also may order blood tests to
detect an altered RET gene or to look for a high level of calcitonin.
- Ultrasonography—The ultrasound device uses sound waves that people cannot
hear. The waves bounce off the thyroid, and a computer uses the echoes to create
a picture called a sonogram. From the picture, the doctor can see how many
nodules are present, how big they are, and whether they are solid or filled with
fluid.
- Radionuclide scanning—The doctor may order a nuclear medicine scan that
uses a very small amount of radioactive material to make thyroid nodules show up
on a picture. Nodules that absorb less radioactive material than the surrounding
thyroid tissue are called cold nodules. Cold nodules may be benign or malignant.
Hot nodules take up more radioactive material than surrounding thyroid tissue
and are usually benign.
- Biopsy—The removal of tissue to look for cancer cells is called a biopsy.
A biopsy can show cancer, tissue changes that may lead to cancer, and other
conditions. A biopsy is the only sure way to know whether a nodule is cancerous.
The doctor may remove tissue through a needle or during surgery:
- Fine-needle aspiration: For most patients, the doctor removes a sample of
tissue from a thyroid nodule with a thin needle. A pathologist looks at the
cells under a microscope to check for cancer. Sometimes, the doctor uses an
ultrasound device to guide the needle through the nodule.
- Surgical biopsy: If a diagnosis cannot be made from the fine-needle
aspiration, the doctor may operate to remove the nodule. A pathologist then
checks the tissue for cancer cells.
A person who needs a biopsy may want to ask the doctor the following
questions:
- What kind of biopsy will I have?
- How long will the procedure take? Will I be awake? Will it hurt?
- Will I have a scar on my neck after the biopsy?
- How soon will you have the results? Who will explain them to me?
- If I do have cancer, who will talk to me about treatment? When?
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