Thyroid Cancer

Thyroid cancer is cancer of the thyroid gland in the front of the neck. Most thyroid cancers — particularly papillary and follicular types — are slow-growing and very treatable, often with excellent long-term survival. Medullary and especially anaplastic thyroid cancers are less common and more aggressive.

How it usually shows up

• A lump (nodule) in the front of the neck that you can see or feel — often picked up on a routine scan or self-examination.
• Hoarse voice, especially if persistent.
• Difficulty swallowing or breathing — with larger lumps.
• Swollen lymph node in the neck.
• Cough without infection.
• Most thyroid nodules are not cancer — but a new neck lump deserves evaluation.

Risk factors

• Previous radiation to the neck (childhood).
• Family history of thyroid cancer or MEN syndromes.
• Iodine status — both severe deficiency and very high intake affect thyroid cancer patterns.
• Female sex — but male thyroid lumps are more often cancer when they occur, so take them seriously.
• Chronic autoimmune thyroid disease — a small rise in lymphoma risk (not papillary cancer).

Evaluation

• Thyroid function tests (TSH).
• Ultrasound of the neck — the key imaging test.
• FNAC (fine-needle aspiration) of suspicious nodules — the diagnostic test.
• In selected cases: molecular markers, staging scans, calcitonin (medullary).

Treatment

• Surgery — thyroidectomy (sometimes partial, sometimes total); neck node clearance as needed.
• Radioactive iodine after surgery for many papillary/follicular cases — given as a drink; targets any remaining thyroid tissue.
• Thyroid hormone replacement — lifelong after total thyroidectomy; keeps metabolism normal.
• Targeted therapy — for advanced or RAI-resistant cases.
• Watchful monitoring for certain small, low-risk papillary cancers — increasingly considered.
• Surveillance for life — ultrasound, thyroglobulin blood test.

Outcomes for common types are among the best in oncology. Careful follow-up matters — treatment choices made at the start affect surveillance for decades, so discuss at a thyroid-experienced centre.