Thyroid Cancer

Thyroid cancer imaging Thyroidectomy

What is thyroid cancer?

Thyroid cancer is a slow growing cancer with an excellent prognosis. It tends to occur in younger patients. A history of neck irradiation, family history of thyroid cancer or MEN syndrome, Gardner’s syndrome, Cowden’s syndrome and familial adenomatous polyposis (FAP) increases the risk of developing thyroid cancer.

What are the symptoms of thyroid cancer?

The symptoms of thyroid cancer include a painless neck lump, breathing or swallowing difficulties, feeling of a lump in the throat, change or hoarness of voice and swollen lymph nodes in the neck.

There are four main types of thyroid cancer:

1. Papillary thyroid cancer

Papillary thyroid cancer is the most common type (70-80%) and is a slow growing cancer. It may spread to local lymph nodes around the thyroid. Treatment is by surgery and radioactive iodine therapy.

2. Follicular thyroid cancer

Follicular thyroid cancer accounts for approximately 10% of all thyroid cancers. This tumor is less likely to spread by the lymph nodes but more likely to spread by the bloodstream. Treatment is by surgery and radioactive iodine therapy.

3. Medullary thyroid cancer

Medullary thyroid cancer arises from the parafollicular C cells and is rare, accounting for less than 5% of all thyroid cancer. Although it runs in families with the MEN syndrome, the majority of cases occur without any evidence of endocrine condition or family history. It spreads to the lymph nodes and treatment involves surgery and lymph node dissection.

4. Anaplastic thyroid cancer

Anaplastic thyroid cancer is extremely rare and is universally fatal with a poor prognosis.

How do you diagnose thyroid cancer?

As with thyroid nodules, suspected thyroid cancer needs to be investigated with ultrasound imaging and biopsy of suspicious thyroid nodules and regional lymph nodes. When dealing with a large neck mass, CT scan is helpful in providing better visualization of the gland and its adjacent structures.

How do you treat thyroid cancer?

A/Prof Terence Chua performs thyroidectomy via a neck incision and utilises the Medtronic NIM 3.0 Nerve Monitoring Systems to prevent and reduce the incidence of recurrent laryngeal nerve injury by employing it as an adjunct to visualization of the nerve and help confirm nerve integrity during thyroid surgery.