Thyroid Cancer Risks & Symptoms

Thyroid cancer diagnoses have spiked for U.S. women this past decade.

That's why it's essential to pay attention to this small gland at the base of your neck. The thyroid is an important part of your endocrine system, producing a hormone that helps control metabolism.

In the realm of cancer diagnosis and cancer care, thyroid cancer stands out as being unique from diagnosis to treatment. Michael Hancock, MD, an Indianapolis endocrinologist with Franciscan Physician Network Diabetes & Endocrinology Specialists, discusses risk factors and thyroid cancer symptoms in females.

What Is Thyroid Cancer?

Thyroid cancer is a cancer that starts in the thyroid gland, a butterfly-shaped gland found at the base of the throat near the windpipe. About the size of a walnut, a healthy thyroid typically cannot be found through the skin.

How Common Is Thyroid Cancer?

Thyroid cancer is the most common cancer of the endocrine system. About 43,000 Americans are expected to be diagnosed with thyroid cancer in 2022, according to the National Cancer Institute. Thyroid cancer accounts for less than 1 percent of all cancer deaths,

Women are about three times more likely than men to develop cancer in their thyroid gland. While thyroid cancer is most often diagnosed in men and women aged 45 to 64 years, thyroid cancer is the most commonly diagnosed cancer in women aged 20 to 34 years.

What Are The Four Types Of Thyroid Cancer?

There are four major types of thyroid cancer:

• Papillary, the most common form of thyroid cancer
• Follicular
• Medullary thyroid cancer
• Anaplastic thyroid cancer, the least common form of thyroid cancer.

“About nine out of 10 thyroid cancers are considered what we call differentiated, which means it looks very similar to thyroid tissue under the microscope, and those would be the papillary and the follicular thyroid cancer.”

How Is Thyroid Cancer Different From Other Cancers?

“One of the things that separates thyroid cancer from a lot of other cancers is it's often diagnosed at a younger age than most other adult cancers,” Dr. Hancock said. “About two thirds of people diagnosed with thyroid cancer are between the ages of 20 and 55, seven and 10 cases of thyroid cancer are in women. And why that is the case is not exactly clear to us.”

But for those diagnosed with cancer in the thyroid gland, recovery is optimistic.

“Overall the big differentiating factor from thyroid cancer compared to other cancers is that the long-term survival rate is quite good, over 90% for most patients,” Dr. Hancock said.

What Are Risk Factors For Thyroid Cancer?

“The most common risk factor is the history of radiation therapy, especially at a young age,” Dr. Hancock said. “So folks who have had radiation therapy, maybe for a childhood cancer, like a Hodgkin's lymphoma or something like that will have a higher risk of thyroid cancer.

“Or folks who were exposed to a dose of radiation maybe as part of an environmental disaster or something as a child will have a higher lifetime risk of thyroid cancer, but most patients with thyroid cancer have no identifiable risk factors.”

Risk factors for thyroid cancer can include:

• Being between 25 and 65 years old.
• Being female.
• Having a history of goiter (enlarged thyroid).
• Having a family history of thyroid disease or thyroid cancer.
• Being of Asian descent.

What Are Thyroid Cancer Symptoms?

Thyroid cancer may not always cause early signs or symptoms.

Check with your doctor if you have any of these possible symptoms of thyroid cancer:

• A lump or nodule in the thyroid gland in your neck
• Trouble breathing
• Trouble swallowing
• Pain when swallowing
• Hoarseness

How Is Thyroid Cancer Diagnosed?

Many cases of thyroid cancer are discovered during other exams or testing, Dr. Hancock said.

“Maybe they have an ultrasound of the arteries in their neck to look for a blockage or they have a cat scan of their head, neck or chest for, headaches or a cough or something,” he explained. “And they'll report, whatever it is they're looking for, originally for the scan. But then incidentally, there is a thyroid nodule and then they'll take the work up from there.”

After a thyroid nodule is found in a physical exam, your physician may recommend an ultrasound to look at the thyroid gland and a blood test called TSH.

“If you discover a nodule that is suspicious enough for thyroid cancer, that you want to evaluate it further, then the next step is what's called a fine needle aspiration biopsy,” Dr. Hancock said. “The fine needle aspiration biopsy is essentially a small needle that's poked through the skin, into the nodule itself. When the needle penetrates the nodule, a very small amount of the tissue comes out into the needle. They can then take that tissue, put it on a microscope slide and have the laboratory doctors examine it to tell if there's signs of any thyroid cancer there or not.

“The most common answer we get is benign, which means this is not cancerous. And that's always what we hope for. Sometimes you get an answer that says, this is thyroid cancer. And then you know what you're dealing with.”

Is A Thyroid Nodule A Sign Of Cancer?

For most adults, a thyroid nodule is not a sign of cancer.

“Most of those nodules are not cancerous,” Dr. Hancock said. “In adults, about 10% of thyroid nodules are cancerous. The risk of a nodule being cancerous is a little bit higher in children. It's about 20 to 30%. Although thyroid nodules overall are less common in children than in adults.”

Is Thyroid Cancer Preventable?

“Thyroid cancer isn't necessarily preventable,” Dr. Hancock said. “We haven't identified a lot of preventable actions you can take. We recommend engaging in just general healthy lifestyle, like we all should do. And then if you are doing home thyroid exams, anything you would find that you would be concerned about or felt abnormal to you or felt different definitely let your doctor know about that.”

What Is Treatment For Thyroid Cancer Like?

Treatment for thyroid cancer typically relies on surgery and doesn't usually require chemotherapy or external radiation treatment. However, most patients experiencing thyroid cancer will be on thyroid hormone after their surgery for thyroid cancer to replace the thyroid hormone that the gland was making prior to the surgery. 

Listen Now: Learn About Thyroid Cancer

Franciscan Health endocrinologist Dr. Michael Hancock discusses thyroid cancer signs, diagnosis and treatment in the Franciscan Health Doc Pod podcast.