Thyroid nodules (used to describe both solid and cystic lumps in the thyroid) are common. If we ultrasound everyone in the population, over half of people will have a thyroid nodule. Only 5% of thyroid nodules are cancer (malignant) so we have to be selective about which thyroid nodules we investigate.
Overview of Thyroid cancer – what is it and why is it a growing global health concern
The thyroid is a small butterfly shaped gland that makes and releases thyroid hormones. It’s found at the front of your neck in the lowest part, just above the small hollow where your collar bones meet. You can’t usually feel a thyroid gland that is normal.
Thyroid cancer is when abnormal cells in the thyroid gland start to divide and grow in an uncontrolled way. Without treatment, cancer cells can eventually grow into surrounding healthy tissues and may spread to other areas of the body.
We are finding more and more thyroid cancers each year, and this increase is mostly due to us finding the smaller papillary thyroid cancers that we sometimes find when scanning the body for other reasons. The larger or more aggressive types of thyroid cancer are not on the rise. The global medical community are currently evaluating the need to identify and treat these smaller, less aggressive cancers, as treatment can lead to side effects whereas the small cancer itself may not affect quality of life or life expectancy.
Risk factors for thyroid cancer
You have an increased risk of thyroid cancer if a close or first degree relative has thyroid cancer. Having radiation treatment to the neck as a child, or radiation exposure such as proximity to nuclear accidents like Chernobyl can also increase your risk. There are also rare genetic conditions that can lead to thyroid cancer, and obesity can increase your risk.
Symptoms to look out for
No two individual cases of thyroid cancer are the same and it often causes symptoms that go unnoticed or are mistaken for other health problems. The most common symptom of thyroid cancer is a lump in the neck which usually causes painless enlargement of the gland known as a goitre while other symptoms may include difficulty speaking, swallowing and breathing, neck swelling, voice hoarseness, chronic cough, and pain in the throat or neck area.
Diagnosis of thyroid cancer with ultrasound
If you notice any of these symptoms, the best and most simple test is an ultrasound scan. This scan can look at your thyroid in detail and identify any lumps (nodules) in the thyroid. The radiologist should use a grading system, based on how the nodule looks on ultrasound, to estimate the chance of cancer, and to advise if a further test is necessary.
Further testing would include a fine needle aspiration of the thyroid nodule. This can usually indicate if a thyroid nodule is cancer or not.
Many patients benefit from early diagnosis as it helps doctors to determine the best possible treatment plan. There are several options available including surgery to remove the tumour and/or lymph nodes, radiation therapy and targeted drug therapy. In some cases, a combination of treatments may be recommended in order to achieve the desired results. It is important to speak with your doctor so that you can learn more about these treatments and make an informed decision about which one is right for you.
Prevention – dietary changes and ultrasound screening options
Most thyroid cancers develop without any cause, therefore it is difficult to prevent thyroid cancer. Obesity is a risk factor, so a healthy diet can help. It is important to be aware of your own personal risk factors such as a history of thyroid cancer in the family, or previous radiation exposure, and seek early help if you notice a lump in the neck.
Screening with ultrasound is not performed routinely in the UK due to the high chance of picking up a thyroid nodule and the very small chance this could be malignant. We also know that small thyroid cancers do not tend to affect your life expectancy.
In conclusion, thyroid cancer is something to be aware of, particularly if you have risk factors like a family history or radiation exposure. If you suspect that a lump in your neck may be an early sign of thyroid cancer, it’s important to take proactive steps and seek medical care. While the vast majority of thyroid lumps are not cancerous, the only way to know for sure is with proper testing, so book an ultrasound of your thyroid today and discuss any questions or concerns with your radiologist.
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