What You Need to Know About Thyroid Cancer

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Most people know very little about their thyroid at all, let alone the health problems that can affect it. (The thyroid gland is in your neck, by the way.) But thyroid cancer is being talked about today more than ever, thanks to celebs like Brooke Burke-Charvet and Sophia Vergara, who both had the disease, and Robert Ebert, who died in 2013 after fighting thyroid and salivary cancer for years.
It’s also being diagnosed now more than ever, as well: Rates of thyroid cancer have increased three-fold in the last three decades in the United States; by some measures, it’s considered the fastest-growing cancer among women. For Thyroid Cancer Awareness Month, we talked with Hossein Gharib, M.D., professor of medicine at the Mayo Clinic College of Medicine and President of the American Thyroid Association. Here’s what he thinks everyone should know about this disease.

Diagnosis rates are up—but incidence isn’t

Just because more cases of thyroid cancer are being caught by doctors doesn’t mean we’re getting more of it. The increase in diagnoses is mostly due to better detection of small papillary thyroid cancers by ultrasound and biopsy technology, says Dr. Gharib. This sounds like a good thing, but it’s not without controversy: “Some consider this overdiagnosis of disease that is not clinically important,” he says, noting that many thyroid cancers are slow growing and not life-threatening. “Therefore, some patients undergo unnecessary treatment.”

Symptoms are subtle—or non-existent

Some thyroid diseases—like hypothyroidism, or underfunctioning thyroid—can cause fatigue and weight gain. But thyroid cancer is usually symptom-free, says Gharib. “It is commonly diagnosed when a patient presents with a thyroid lump or nodule,” he says. “Nodules are usually discovered incidentally, by the patient or by a doctor.”

Thyroid cancer is almost always treatable

Thyroid cancer is sometimes described as a “good” type of cancer to have (if there is such a thing) because most patients can be treated and live a relatively normal life. In fact, the 25-year survival rate for patients with papillary thyroid cancer, the most common type, is 95%.

…But some forms are more aggressive than others

The age and family history of a patient, and the size of his or her tumor (as well as whether it’s spread to other organs), may determine how treatable, or how dangerous, the disease is. The type of cancer is important, too: “Follicular thyroid cancer accounts for only 10% but has a more guarded prognosis,” says Dr. Gharib, “and anaplastic thyroid cancer, a rare tumor, is very aggressive with very high mortality.”

Patients need follow-up care

Treatment usually involves removing the entire thyroid, an organ that produces vital hormones our bodies need to function properly. Because of this, thyroid cancer survivors need to take medication (usually via a daily pill) for the rest of their lives to replace these hormones. And because thyroid cancer frequently spreads to the lymph nodes, many patients experience recurrences and require a second or third surgery, says Dr. Gharib.

Radiation exposure is a risk factor

Thyroid cancer is more common in women, people with a family history, and people who have been exposed to radiation, especially as children. (X-rays deliver radiation in small doses, and are generally considered safe, although children should be exposed only when necessary.) A Japanese study recently revealed that 57 children living near the Fukushima nuclear power plant that was damaged in 2011 have been diagnosed with thyroid cancer, and 46 are suspected to have the disease, as well.

A lump doesn’t mean cancer

Discovering a nodule on your neck is not an automatic diagnosis of thyroid cancer, says Dr. Gharib, and up to half of all adults have them. Of these, only about 5 percent are malignant. “Thyroid cancer is uncommon,” he says. “When a nodule is discovered, referral to an endocrinologist is important for a careful evaluation.” And as long as it’s confirmed as benign, simple observation and follow-up is likely all the care you’ll need.

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