RGCIRC, Niti Bagh
THYROID AND PARATHYRIOD GLAND CANCER
Signs and Symptoms of Thyroid Cancer
The thyroid is a small gland located in the front of the neck. It has two lobes and is shaped like a butterfly. As part of the endocrine system, this gland makes hormones that affect us from head to toe including our heart rate, temperature, mental function, and metabolism.
Most common symptoms:
- Painless lumps or swellings in the front or sides of the neck
- Hoarseness
- Dry cough not responding to conservative management
- Difficulty in swallowing
- Difficulty in breathing
- Pain in the throat or neck not responding to conservative management
Types of Thyroid Cancer
Broadly Thyroid Cancers can be classified as
- Well Differentiated Cancers—Pappillary Thyroid Cancer, Follicular Cancer.
- Lymphoma
- Medullary Carcinoma-Hereditary/Sporadic
- Anaplastic—Worst Type
- Metastatic
Causes and Risk Factors of Thyroid Cancer
Preexisting Thyroid Enlargement( Goitre).Family History Of Thyroid Diseases,Thyroiditis
Genetic Mutations(Men's Syndromes)
Low Iodine Intake
Obesity
Previous Radiation Exposure
Previous Radioactive Fallouts From Nuclear Reactors Or Power Plants
Screening and Diagnosis of Thyroid Cancer
There Is No Standard Screening Test For Thyroid Cancer. Routine Physical Examination During General Ent Examination May Reveal Thyroid Nodule. If There Is History Of Men Syndrome Or Medullary Cancer Thyroid Or Pheochromocytoma In Family, Doctor Must Ask For Genetic Tests. Prophylactic Surgery Even Before The Age Of 5 Years For Thyroid Cancer (MTC Only) May Be Curative.
How do we Diagnose?
To find the cause of symptoms, a surgical oncologist evaluates a person’s medical history, performs a physical examination, and orders diagnostic tests. The examination and tests conducted may vary depending on the symptoms. Examination of a sample of tissue under the microscope is always necessary to confirm a diagnosis of cancer.
- We insist on clinical examination.
- Physical examination includes thorough examination of neck -thyroid, nodes, position of trachea, any signs of hyper or hypothyroidism, eye signs etc.
- An Ultrasound-guided Fine Needle aspiration Cytology test is usually used to diagnose diseases of thyroid and parathyroid.
- IDL/DL to see vocal cords
- Laboratory tests examine samples of blood(Especially Thyroid function tests, serum calcium, PTH etc), urine, or cells from the nodes.
- CT scan /Magnetic resonance imaging (or MRI) of neck and chest in locally advanced cases.
Treatment of Thyroid Cancer
Surgeries (Open or Robotic) offered
- Total Thyroidectomy
- Hemithyroidectomy
- Various types of neck dissections
DO’s after Surgery
- Normal diet.
- All medicines as prescribed in the discharge note along with medicines for chronic diseases like diabetes, hypertension, and asthma should be continued as earlier.
- Walking and moving around is a must.
- Shoulder exercises as and when advised.
- Care of the drain and output charting as advised.
- Care of the wound as advised. Avoid Betadine for cleaning the wound. You can use alcohol hand rubs.
- Watch for symptoms of hypocalcemia as explained by doctor or nurse at the time of discharge.
DON'Ts after Surgery
- Avoid addictions.
- Avoid thyroxine tablets and iodized salt, sea food till your surgeon gives you clear instructions
- Avoid Betadine for cleaning the wound
- Avoid bakery products, seafood.
Tumor Board/ Multispecialty Clinic Evaluation
Each and every Head & Neck cancer patient is evaluated by a special team of Surgical Oncologists (Head & Neck unit), Onco-pathologists, and Imaging Specialists. Depending on the age, general condition, type of pathology, and stage of the disease, a custom-made treatment plan is charted out for each and every patient as per International Treatment Guidelines. (NCCN – National Comprehensive Cancer Network)
When to contact the treating team?
- As per appointment.
- If the swelling around the neck wound increases suddenly or within few hours
- If there’s difficulty in breathing or swallowing, fever, hoarseness.
- If symptoms of hypocalcemia appear (tingling, numbness, or twitching sensation around lips, finger tips, and toe tips. Spasm of hands and feet). Immediately have 4 tablets of calcium. The required injection of Calcium Gluconate(To be given in 10 minutes intravenously) is written in your discharge summary. You can receive the same at any nearest health care institution.