Thyroid cancer patients are generally reviewed every six months to check for any residual disease or recurrence annually.
Thyroid diseases are common worldwide. Most of these diseases are benign and generally present as thyroid enlargement. There are various types of thyroid cancer, the most common of which is papillary carcinoma. These cases have specific genetic mutations that are passed on in the family. Thyroid cancers commonly present as neck swelling. Sometimes, prolonged-standing thyroid swelling may rapidly increase in size. In case of huge swellings or advanced cancer, the windpipe or food pipe may be compressed, leading to difficulty in breathing or swallowing.
A patient with thyroid cancer requires a thorough clinical examination. The size and extent of swelling are noted. Using an endoscope, the status of the vocal cords is also indicated, as they may be affected by disease involving the nerve supplying them. Thyroid function tests are done. These include T3, T4 and TSH. Many times, direct FNAC may need to give a proper result. In such cases, ultrasonography-guided FNAC is done. If the thyroid swelling is enormous and extends to the chest or compresses the food and windpipe, a CT scan of the neck and chest may also be requested.
Treatment of thyroid cancer depends on various factors. These include age, sex and size of the lesion. Treatment is tailored to suit individual patients. Surgical excision of the thyroid gland may entail a hemithyroidectomy or a total thyroidectomy. If lymph nodes in the chest are also involved, they are released.
Common Complications Associated With Thyroid Surgery
This includes vocal cord palsy and hypocalcemia. Suppose the nerve supplying the vocal cord is injured during surgery or requires excise due to the disease. In that case, the patient may develop hoarseness of voice, which may be temporary or permanent. During thyroid surgery, if the blood supply to the parathyroid glands (related to calcium balance) is affected, the patient may develop hypocalcemia, where the blood level of calcium decreases.
If the radio-iodine scan shows a distant spread or residual disease, further ablation with radio-iodine may be required. If complete excision of the lesion during surgery is impossible, postoperative radiotherapy may be required. If the infection has spread to distant bony sites, radiotherapy may be given to
Thyroid cancers have an excellent prognosis and survival rate. Anaplastic thyroid cancer, however, has a poor prognosis. Chemotherapy is used to treat these cancers. Thyroid cancer patients are generally reviewed every six months to check for any residual disease or recurrence annually. Periodic clinical examination, ultrasonography, and thyroglobulin monitor the disease status.