Thyroid Cancer - LPNI

Thyroid Cancer

The thyroid gland is located below the larynx in the throat.  It is butterfly-shaped and can be felt when swallowing.  The thyroid produces hormones: triiodothyronine (T3) and thyroxine (T4).  Thyroid cells are the only ones in the body to absorb iodine.  Iodine combines with tyrosine to make T4.  The thyroid hormones aid in the metabolism of all cells in the body.  They help regulate heart rate, blood pressure, body temperature, and weight, among other important body functions.   According to the American Cancer Society, about 62,000 adults in the USA are diagnosed with thyroid cancer each year.  It is the fifth most common cancer in women, often those aged between 40 and 50.  It is also the most rapidly increasing cancer in the USA, and can occur in women who are 20 years old.  

Thyroid cancer doesn’t really show any early symptoms.  As it begins to grow, it may cause:

• a lump that can be felt in the throat with or without pain;
• hoarseness, difficulty in swallowing;
• swollen glands in the neck;
• difficulty breathing, and a constant cough which is not due to a cold.

There are several factors that increase the risk of thyroid cancer.  These are:

• Being female: it is three times more often seen in women.  In men, it more often occurs between the ages of 60 and 70.
• Exposure to high levels of radiation, such as radiation treatments to the head or neck for other cancers, or fallout from a nuclear power plant or nuclear weapons testing.  According to Mayo Clinic, “if you live within 10 miles of a nuclear power plant, you may be eligible to receive a medication that blocks the effects of radiation on the thyroid.  If an emergency should occur, taking the tablets could help prevent thyroid cancer.  Contact the state or local emergency management department for more information.”
• Some genetic syndromes such as certain types multiple endocrine-related cancers.
• Lack of iodine in the diet, common in countries where iodine is not added to salt or other foods.

There are four main types of thyroid cancer:

• Papillary: the most common type which grows slowly and is usually found in only one of the two lobes. It is very curable if found early and in those under 45 years old. The tumor looks very like normal thyroid tissue under a microscope. This is called differentiated thyroid cancer.
• Follicular: grows slowly, and is more differentiated and less common than papillary.  It is also very curable when found early and in people younger than age 45.   Papillary and follicular types make up about 90 per cent of all thyroid cancers.
• Medullary: genetic origin and does not look like normal thyroid tissue under a microscope.  It makes up about five per cent of all thyroid cancers.
• Anaplastic: rare, fast growing, and more difficult to treat since it grows so quickly.  It makes up about two per cent of thyroid cancer.

Thyroid cancer is often found during routine checks or testing for other problems.  A thorough medical and family history will be obtained.  A biopsy will be done using ultrasound, and if the lab results are malignant, surgery will be performed to remove all or part of the thyroid and, sometimes, enlarged lymph nodes from the neck.  After the thyroid is removed, medication (thyroid hormone) will be given for the rest of the individual’s life.  This replaces the hormones that the thyroid normally produces, and it prevents the pituitary gland from producing thyroid-stimulating hormone (THS), that could cause any remaining thyroid cancer cells to grow.  Other treatment options include radioactive iodine, radiation therapy, chemotherapy, injecting alcohol into small cancers that are difficult to get to during surgery, and the use of certain medications, especially in advanced thyroid cancer.

Pat Crouch, RN, BSN

Faith Community Nurse, St. John Lutheran church, Country Club Hills, Illinois, USA