Thyroid Cancer
Thyroid nodules are being identified with increasing frequency in clinical practice, due in large part to the increasing use of diagnostic imaging. Studies using new high-resolution imaging techniques are identifying thyroid nodules that would never have been diagnosed in the past. Although more than 90% are small, non-palpable, benign lesions that will never develop into clinically significant tumors, some patients have non-palpable or palpable lesions that are malignant.
Identification of malignant thyroid nodules is important, especially those that will cause problems if not diagnosed early. To distinguish between low-risk and high-risk subgroups of patients, a complete history and physical examination, laboratory investigations, and neck ultrasound are needed.
Signs and Symptoms
Thyroid cancer can cause any of the following signs or symptoms:
- A lump or mass in the neck that sometimes grows rapidly.
- Neck swelling.
- Pain in the front of the neck, sometimes reaching to the ears.
- Hoarseness or other voice changes that persist.
- Swallowing problems (swallowing food).
- Difficulty breathing.
- Constant cough that is not due to a cold.
If you have any of these signs or symptoms, see your doctor immediately. Many of these symptoms can also be caused by non-cancerous conditions or even other cancers of the neck area. Thyroid nodules are common and usually benign (not cancer). However, if you experience any of these symptoms, it is important to see your doctor so that the cause can be determined and treatment if necessary.
Treatments
Surgery is the standard treatment for patients with primary thyroid cancer, followed by radioactive iodine therapy and/or thyroid hormone therapy. However, the risk of complications is increased in patients with high surgical risk.
Targeted Cancer Treatment
In these patients, ultrasound-guided ablation techniques, including radiofrequency ablation (RFA) and microwave ablation (MWA), have been suggested as alternatives. These ablation techniques are safe and effective for local tumor control in patients with papillary thyroid carcinoma, but may have limited efficacy in controlling regional microscopic metastases or diminutive multifocal carcinoma. Some studies of radiofrequency have shown efficacy (ie, pain control and cosmetic improvement) in the treatment of large inoperable primary thyroid cancer.
Thermal ablation is primarily used for the treatment of small, unresectable tumors, for patients who have been resistant to chemo/radiotherapy treatment or who are NOT surgical candidates, such as:
- Obese patients
- Patients with chronic diseases (diabetes, hypertension, cirrhosis, etc.)
- Patients who cannot have general anesthesia
- Patients with severe heart disease
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