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Department: Artemis Cancer Institute
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Thyroid Cancer
Your body is made up of many types of cells. In normal course, cells grow, divide, and produce more cells to keep your body healthy. However, at times, this process goes wrong and cells become abnormal, forming more cells in an uncontrolled manner. These extra cells form a mass of tissue, called a growth or a 'tumour'. Tumours can be benign, which means not cancerous, or malignant, which means cancerous. Thyroid cancer occurs, when a malignant tumour forms in your thyroid gland.
WHAT IS THE THYROID GLAND ?
The thyroid gland is a butterfly-shaped gland located at the base of your neck, just below your Adam's apple. This gland produces hormones popularly known as 'thyroid hormones'.
WHO IS AT A RISK OF THYROID CANCER?
Females are more likely to have thyroid cancer at a ratio of three to one. Thyroid cancer can occur in any age group, although it is most common after 30 years of age and its aggressiveness increases significantly in older patients. Family history of thyroid cancers increases the risk. Radiation exposure is another risk factor.
SYMPTOMS OF THYROID CANCER
Early thyroid cancer often does not cause any symptoms. The earliest and the most common complaint is a lump or swelling over the thyroid gland. However all thyroid nodules are not cancerous. The other symptoms that can hint at thyroid cancer are :
HOW IS THYROID CANCER DIAGNOSED ?
If the symptoms point towards thyroid cancer, you should immediately see your doctor. Your doctor will ask you for a detailed medical history. After this, he will do a physical examination. During this your doctor will ask you to swallow, while he examines your thyroid because the thyroid moves up and down during swallowing, therefore, making it easier for your doctor to feel for any nodule.
To help determine whether a nodule is actually cancerous or not he will advise you some further tests:
Blood tests : To know whether the thyroid gland is functioning normally or not you will be advised a test that measures thyroid-stimulating hormone (TSH), a hormone made by the pituitary gland that regulated thyroid hormones.
Ultrasound : This test enables your doctor to see how many nodules are present, how big they are, and whether they are solid or filled with fluid.
Radionuclide scanning : In this test, a radioactive dye will be given as an injection. Nodules that absorb less radioactive materials than the surrounding thyroid tissue, are called cold nodules. Cold nodules may be benign or malignant. Hot nodules take up more radioactive materials than the surrounding thyroid tissue and are usually benign.
Biopsy : The removal of tissue, to look for cancer cells is called a biopsy. A biopsy is the only sure way to know whether a nodule is cancerous. Your doctor may remove the tissue with a needle or during surgery.
Fine-needle aspiration : Here your doctor removes a sample of tissue from a thyroid nodule with a thin needle. Your pathologist looks at the cells under a microscope to check for cancer. Sometimes, your doctor might use an ultrasound device to guide the needle to your nodule.
Surgical biopsy : If a diagnosis cannot be made from the fine needle aspiration, your doctor may operate to remove the nodule. Your pathologist then checks the tissue for cancer cells.
Imaging tests These tests are generally done to detect the spread of cancer.
CT Scan : A CT scan produces detailed cross-sectional images of your internal organs and identifies any spread of cancer to other organs.
MRI: This test uses a powerful magnetic field and radio waves to produce images of your body.
HOW IS THYROID CANCER TREATED?
Depending on the type and stage, thyroid cancer may be treated with
Some patients receive a combination of these treatments.
Surgery
This is the most common treatment for thyroid cancer. Your surgeon may remove all or a part of the thyroid. The type of surgery depends on the type and stage of thyroid cancer, the size of the nodule, and your age. The two common types of surgery are
Total Thyroidectomy : In this surgery your entire thyroid is removed. Your surgeon may also remove other tissues in the neck, that may have been affected by the cancer.
Lobectomy : In this surgery the lobe with the cancerous nodule is removed. Your surgeon also may remove a part of the remaining thyroid tissue or nearby lymph nodes.
Radioactive iodine therapy
This form of therapy uses radioactive iodine (I-I3I) to destroy thyroid cancer cells anywhere in your body. This therapy is usually given orally (liquid or capsules) in a small dose. The intestine absorbs the I-I3I, which flows through the bloodstream and collects in the thyroid cells. Thyroid cancer cells remaining in the neck and those that have spread to other parts of the body are killed when they absorb I-I3I.
Chemotherapy
Treatment of cancer using drugs is called chemotherapy.
Anticancer drugs used to treat thyroid cancerare usually given by an injection into a vein (IV). Chemotherapy may be combined with radiation therapy as primary treatment (instead or surgery) or to shrink the tumour before surgery. It may also be used after surgery and to treat cancer, That has spread to other organs.
Radiation therapy
This therapy uses high - energy rays to kill cancer cells. Radiation is directed at the neck or at parts of your body where the cancer has spread. Radiation therapy is used mainly to treat people with advanced thyroid cancerthat does not respond to radioactive iodine therapy. For external radiation therapy, you will be required to go to the hospital or clinic, usually a few days, for several weeks. External radiation may also be used to relieve pain or other problems.
Hormone treatment
This treatment is usually given after surgery for papillary and follicular cancer. When you take thyroid hormone pills, the growth of any remaining thyroid cancer cells slow down, which lower the chances of the disease recurring. After surgery of I-I3I therapy (which removes or destroys thyroid tissue), you may need to take thyroid hormone pills to replace the natural thyroid hormone.
WHAT ARE THE SIDE EFFECTS OF TREATMENT ?
Unwanted side effects may sometimes occur as cancer treatment can damage healthy cells and tissues. These side effects depend on many factors, including the type and extent of the treatment. The common side effects are loss of appetite, nausea, vomiting, mouth sores, hair loss, and reduction in number of blood cells. These side effects are temporary and go away with time.
PAIN MANAGEMENT
The management of pain is an integral part of cancer therapy. Medications are the cornerstone of cancer pain treatment, and their use is aimed at providing the greatest pain relief possible with the fewest number of side effects and the most ease of administration. Your doctor will prescribe a medication that ensures maximum pain relief. Sometimes your doctor might recommend some interventional procedures like surgery and injections.
FOLLOW UP CARE
In cancer treatment, follow up care is an essential element of the overall treatment plan. Regular checkups will be advised to detect any changes in your health as early as possible.
CANCER CARE AT ARTEMIS
At Artemis Health Institute state-of-the-art facilities are available for cancer diagnosis, treatment, follow up care and rehabilitation. These include advance imaging technologies such as a PET scan, DWIBS and 3TMRI for diagnosing cancer. The hospital is also equipped with state-of-the art radiation therapy such as Image Guided Radiation Therapy (IGRT) and Brachytherapy.
In temporary brachytherapy, the radioactive material is placed inside or near a tumour for a specific amount of time and then withdrawn. In temporary brachytherapy, a delivery device, such as a catheter, needle or applicator is placed into the tumour using fluoroscopy, ultrasound or CT to help position them. The physician may insert the radioactive material at the same time remotely through the delivery device, and later remove the material and delivery device. Temporary brachytherapy can be administered at a high-dose rate (HDR).
AHI has HDR Brachytherapy from Nucletron, Model Microselectron HDR.X.
Diseases:-
The oncologists at AHI are equipped to treat various kinds of cancers, including but not limited to:
- Larynx
- Colorectal Cancer
- Hodgkin's Disease
- Leukaemia
- Prostate Cancer
- Oesophagus Cancer
- Oral Cancer
- Thyroid Cancer
Special Care Units / Diagnostic Equipment / Facilities
- Diffusion Weighted Whole Body Imaging with Background Body Signal (DWIBS)
- 3 Tesla MRI (Magnetic Resonance Imaging)
- Mammography System
- PET Scan
- Advanced CT Scan (64-slice CT)
- PET-CT Fusion Technology
- Dual Head Gamma Camera
- Brachytherapy
- Image Guided Radiation Therapy (IGRT) - the first in North India
Team of Specialists:
- Dr Ranga Rao Consultant- Medical OncologyView Profile
- Dr. Deep Goel, Gastrointestinal Surgeon Consultant- Surgical OncologyView Profile
- Dr Subodh Pandey Consultant- Radiation OncologistView Profile