This overview on Thyroid cancer looks at the known causes, symptoms and up-to-date alternative treatment options like Nanoknife IRE and Radiofrequency Ablation; it also covers the risks of levothyroxine and radioactive iodine treatment.
An explosion in Thyroid cancer diagnosis
New cases of thyroid cancer diagnosed in the Western world have significantly increased over the past 15 years. In 2019 there will be about 60,000 cases in the USA, with two thirds in women. In the UK in the year 2000 there were only about 1,300 people diagnosed with thyroid cancer. Now it is about 3,500 a year. Similarly, two thirds are women.
Thyroid cancer diagnosis levels have tripled in 20 years
But the explosion in diagnosis, may not reflect the real incidence according to experts.The UN’s Cancer Agency and IARC believe that the epidemic of thyroid cancer is due to over-diagnosis. They believe much of the explosion in the Western world is because of CAT scans picking up more problems which do not need treating. Yet those diagnosed usually have surgery, which can leave them in pain, and requiring hormone treatment for the rest of their lives.
The four main types of Thyroid Cancer:
Firstly, be clear. About 90% of thyroid nodules are not cancer - they are benign. Next, there are four types of thyroid cancer, of which the first two - Papilliary and Follicular - are 95% ot all cases. These tend to be slow growing so you do not need to rush into surgery - you have time to explore all your options. Here are the four main types of Thyroid cancer:
* Papillary thyroid cancer is the most common, affecting six out of ten of those diagnosed with thyroid cancer. This type is more common in women, and usually affects younger people. It is usually slow growing, but can sometimes spread to lymph nodes in the neck or near by.
* Follicular thyroid cancer is most found in young or middle aged people - making up three out of every 20 diagnosed. It can slowly spread to other parts of the body, most often to the lungs or bones.
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* Medullary thyroid cancer is a rare type, affecting between one in 10 and one in 20 of all those diagnosed. About a quarter of these run in families. They are caused by an inherited faulty gene. Medullary Thyroid cancer can spread to the lungs or bones.
* Anaplastic thyroid cancer is usually diagnosed in older people, and most commonly in women. About three quarters of those affected are over 60. Some three out of every 20 thyroid cancers diagnosed are this type, which tends to grow more quickly than the others.
Survival Rates for Thyroid cancer
5 year survival for Papilliary Thyroid cancer and Follicular is 100% for those diagnosed at stage 1 or 2. It declines to just over 50% for those diagnosed at stage 4. Medullary survival is nearly 100% for stages 1 and 2. All Anapaestic Thyroid cancer is deemed stage 4.
Causes of Thyroid cancer
Who is most at risk?
- Those who have had radiotherapy to the neck area at some earlier point in their lives. The cancer may develop between 10 to 30 years after treatment.
- People who have been exposed to radiation - It is more common in survivors of atomic explosions or accidents. For example, there was an increase in cases in the Ukraine, particularly in children, after the Chernobyl nuclear reactor accident in 1986. A massive cloud of pollution extended across Western Europe breaking into a number of separate fingers - for example, one cloud of caesium-137 moved up into Sweden, another though Switzerland and Southern German, another down through France and another down through scotland and into Wales. The worst of the cloud by-passed England and went down the North Sea.
- It is possible to inherit abnormal genes that increase your risk. These genes cause syndromes called MEN2a and MEN2b. Both of these cause medullary thyroid cancer. If MEN2 runs in your family, you and your relatives may be referred for screening for thyroid cancer. Medullary thyroid cancer can run in families where there is no sign of MEN2 gene changes.
- People with Gardner's syndrome and Cowden disease - two other conditions that can run in families, Gardener's syndrome is linked to adenomatous polyposis and a higher risk of thyroid cancer; Cowden disease or Cowden Syndrome is linked to an increased risk of several cancers including thyroid cancer.
- Treatment of hyperthyroidism with radioactive iodine - although this may cause other cancers like breast cancer, not just thyroid cancer.
- Mobile phones. The antennae of mobile phones are now contained in the base. and Professor Hardell has pointed to the dangers and risk of thyroid radiation. As always with mobile phones there is mixed research. The problem is that the smarter the phone the greater the dangers and risks, which can only get worse with 5G.
The symptoms of Thyroid cancer
These can include:
- A lump at the base of the neck
- A hoarse voice that does not get better
- Soreness or difficulty swallowing that does not get any better
- A lump elsewhere in the neck
All these are more likely to be caused by other illnesses, but if the hoarse voice or sore throat stays for more than a few weeks you should ask your doctor about it.
Most thyroid lumps are not cancer. As many as nine out of 10 women over 70, will have small lumps (nodules) in their thyroid glands. Only about one in 20 thyroid lumps are cancer.
Some people have extreme fatigue - this can be due to low iodine levels, or Chronic Fatigue Syndrome instead. This is caused by a gut microbiome imbalance.
Go to: Chronic Fatigue Syndrome
Another Thyroid problem is often simply treated with drugs such as levothyroxine when in fact it is also caused by an intestinal microbiome imbalance.
Go to Hashimoto's disease
Alternative Treatments for Thyroid cancer
Surgery is often used. Either a total or near total thyroidectomy - your whole thyroid removed - or a lobectomy - partial thyroidectomy.
The type of surgery depends on the patient and their type of cancer.
Radiotherapy. A form of targeted radiotherapy is often used for thyroid cancer involving Radioactive iodine. Iodine will be taken up by any remaining thyroid cancer cells in the thyroid or elsewhere in the body, and the radioactivity will kill them. Radioactive iodine may also given to people with a hyperactive thyroid or hyperthyroidism. Unfortunately, it has been shown by the NCI to increase risk of cancers in other parts of the body, particularly breast cancer..
Medullary and Anaplastic thyroid cancers do not pick up iodine well, so they tend to be treated with traditional external beam radiotherapy.
Proton beam therapy is also increasingly used.
Chemotherapy is sometimes used to treat advanced thyroid cancers, or those that have come back after a first treatment. It is still experimental, but there have been reports that is has kept thyroid cancer under control for long periods in some cases. In America the FDA has approved sorafenib, lenvatinib, vandentanib and carbozantinib depending on the type of thyroid cancer. These may not be available at your UK hospital. All cause side-effects and you should check them out in detail.
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Hormone Therapy. Thyroid hormone replacement usually involves Levothyroxine, a pill you take daily. The size of pill should be determined by your weight and size. Calcium and iron supplements may interfere with this.
Levothyroxine has been shown to increase risk of breast cancer. At CANCERactive we pulled together all the available research more than 12 years ago, and the use of synthetic thyroxine even then have numerous research studies linking it to an increase breast cancer risk. This was confirmed in the largest study of its kind in 2018.
Go to - Can synthetic thyroxine cause breast cancer
The Nanoknife IRE - A new a growing treatment for previously difficult to treat cancers - this involves using needles placed either side of the tumour and an electric current passed across the tumour. This punches holes in the cancer cells and they lyse. IRE is Irreversible Electroporation.
Go to: Nanoknife IRE in cancer treatment
Radiofrequency Ablation - Thyroid cancer may start with benign nodules or may appear as nodules. In either case Radiofrequency Ablation, which is used widely to treat other cancers with the minimum of side-effects, can be an alternative thyroid cancer treatment to surgery. For example there are expert practitioners in Texas. Then there is High Intensity Focussed Ultrasound, or HIFU - Benign nodules, common in South East Asia, can be treated by experts using HIFU in Hong Kong.
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