What are the facts about thyroid cancer

Clinic for Internal Medicine IHematology, oncology and stem cell transplantation

What is Thyroid Cancer?

Different forms of thyroid cancer or thyroid cancer are rare and account for about 1% of all malignant tumor types. The mean age of onset is around 55 years. Women are more than twice as likely to be affected as men.

causes

Benign enlargements of the thyroid, also known as goiter or goiter and mainly caused by iodine deficiency, can lead to changes in the thyroid tissue and the formation of lumps if persisted over a long period of time. So-called "cold knots", whose names are based on their hormone inactivity, should give particular cause for caution. These can degenerate over time.

A previous radiation therapy due to another illness may also be involved in the development of thyroid cancer. Genetic predispositions for the development of thyroid cancer are known. Various hereditary syndromes are described in which, in addition to the thyroid gland, other organs are affected by malignant changes. One example of this is the so-called MEN-2 syndrome (MEN [link to pheochromocytoma and MEN] = multiple endocrine neoplasia), which is characterized by the simultaneous degeneration of endocrine organs such as the pituitary gland, the parathyroid gland, the pancreas or the adrenal gland.

diagnosis

The symptoms of a thyroid tumor are caused by the anatomical location of the thyroid gland and its relationship to neighboring structures. Possible signs are a palpable, possibly hard and rough lump in the thyroid area, palpable changes in the thyroid gland with known goiter, a feeling of pressure in the throat area, shortness of breath, difficulty swallowing, coughing, enlarged lymph nodes in the throat area or persistent hoarseness.

If thyroid cancer is suspected, a detailed medical discussion and a thorough physical examination of the patient are first carried out. This often includes an ENT examination including a mirror examination of the larynx (laryngoscopy). A blood sample is taken to check the function of the thyroid gland and the hormones it produces, and to look for tumor markers that can typically be elevated in thyroid cancer. To confirm the diagnosis, a tissue sample (biopsy) is obtained for examination by the pathologist.

If you suspect a medullary Thyroid carcinoma, a certain form of thyroid cancer, genetic analyzes are carried out, which should also be carried out in the case of positivity, i.e. mutation detection, in family members who have not yet been examined.

Imaging procedures, including ultrasound examinations, x-rays, and computed or magnetic resonance imaging (CT / MRI), are also performed to determine the extent of the tumor. Scintigraphy, in which a radioactive substance (iodine or technetium) is administered intravenously and accumulates almost exclusively in thyroid tissue, is of particular importance. An insufficient storage of the substance (cold lump) is typical of thyroid cancer. A reflection of the trachea and esophagus (tracheoscopy / esophagoscopy) may also be necessary.

therapy

The choice of therapy depends on the subtype and degree of spread of the thyroid cancer and consists of different approaches, which are often used in combination. These include surgery, radiation, chemotherapy, and hormone treatment. Radioiodine therapy should be mentioned as a special therapy option and special form of radiation, which can be used for those thyroid tumors that take part in iodine metabolism.

For further information, please contact Prof. Dr. Catfish.