Thyroid Cancer Archives

What You Need to Know Before Choosing a Cancer Treatment

What You Need to Know Before Choosing a Cancer Treatment from Patient Empowerment Network on Vimeo.

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What steps could help you and your doctor decide on the best treatment path for your specific cancer? This animated video explains how identification of unique features of a specific cancer through biomarker testing could impact prognosis, treatment decisions and enable patients to get the best, most personalized cancer care.


If you are viewing this from outside of the US, please be aware that availability of personalized care and therapy may differ in each country. Please consult with your local healthcare provider for more information.


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TRANSCRIPT:

Dr. Jones:

Hi! I’m Dr. Jones and I’m an oncologist and researcher. I specialize in the care and treatment of patients with cancer. 

Today we’re going to talk about the steps to accessing personalized care and the best therapy for YOUR specific cancer. And that begins with something called biomarker testing.

Before we start, I want to remind you that this video is intended to help educate cancer patients and their loved ones and shouldn’t be a replacement for advice from your doctor.

Let’s start with the basics–just like no two fingerprints are exactly alike, no two patients’ cancers are exactly the same. For instance, let’s meet Louis and another patient of mine, Ben. They both have the same type of cancer and were diagnosed around the same time–but when looked at up close, their cancers look very different.  And, therefore, should be treated differently.

We can look more closely at the cancer type using biomarker testing, which checks for specific gene mutations, proteins, chromosomal abnormalities and/or other molecular changes that are unique to an individual’s disease.

Sometimes called molecular testing or genomic testing, biomarker testing can be administered in a number of ways, such as via a blood test or biopsy. The way testing is administered will depend on YOUR specific situation.

The results could help your healthcare team understand how your cancer may behave and to help plan treatment. And, it may indicate whether targeted therapy might be right for you. When deciding whether biomarker testing is necessary, your doctor will also take into consideration the stage of your cancer at diagnosis.

Louis:

Right! My biomarker testing results showed that I had a specific gene mutation and that my cancer may respond well to targeted therapy.

Dr. Jones, Can you explain how targeted therapy is different than chemo?

Dr. Jones:

Great question! Over the past several years, research has advanced quickly in developing targeted therapies, which has led to more effective options and better outcomes for patients.

Chemotherapy is still an important tool for cancer treatment, and it works by affecting a cancer cell’s ability to divide and grow. And, since cancer cells typically grow faster than normal cells, chemotherapy is more likely to kill cancer cells.

Targeted therapy, on the other hand, works by blocking specific mutations and preventing cancer cells from growing and dividing.

These newer therapies are currently being used to treat many blood cancers as well as solid tumor cancers.  As you consider treatments, it’s important to have all of the information about your diagnosis, including biomarker testing results, so that you can discuss your treatment options and goals WITH your healthcare team.

Louis:

Exactly–Dr. Jones made me feel that I had a voice in my treatment decision. We discussed things like potential side effects, what the course of treatment looks like and how it may affect my lifestyle.

When meeting with your healthcare team, insist that all of your questions are answered. Remember, this is YOUR life and it’s important that you feel comfortable and included when making care decisions. 

Dr. Jones:

And, if you don’t feel your voice is being heard, it may be time to consider a second—or third—opinion from a doctor who specializes in the type of cancer you have. 

So how can you use this information to access personalized treatment?

First, remember, no two cancers are the same. What might be right for someone else’s cancer may not work for you.

Next! Be sure to ask if biomarker testing is appropriate for your diagnosis. Then, discuss all test results with your provider before making a treatment decision. And ask whether testing will need to be repeated over time to identify additional biomarkers.

Your treatment choice should be a shared decision with your healthcare team. Discuss what your options and treatment goals are with your doctor.

And, last, but not least, it’s important to inquire about whether a targeted therapy, or a clinical trial, might be appropriate for you. Clinical trials may provide access to promising new treatments.

Louis:

All great points, Dr. Jones! We hope you can put this information to work for you. Visit powerfulpatients.org to learn more tips for advocating for yourself.

Dr. Jones:

Thanks for joining us today. 


This program is supported by Blueprint Medicines, and through generous donations from people like you.

Patient Profile: Vanessa Steil

“PEN builds community and empowers you to be your own advocate.” – Vanessa Steil, thyroid cancer survivor and patient advocate.

When Vanessa Steil recounts how she was first diagnosed with thyroid cancer, you can tell it is a story she has told many times. The dates, the terminology, and which doctor told her what and when are all precisely chronicled in her memory. Yet it took her reflecting on her story as a survivor to process just how crucial all of the details were. Now, she’s passionate and committed to helping others, and she has dedicated much of her time—and career— over the past eight years to doing just that.

It all started in March 2013 during a routine visit to the gynecologist. The doctor, who performed a neck check as part of the exam, felt a lump on the right side of Vanessa’s thyroid. “I was taken off guard by the whole thing,” she says. She tried to convince herself that the lump was nothing serious, but she followed the doctor’s advice for further testing, and a month later was diagnosed with papillary thyroid carcinoma: thyroid cancer. She was 26 years old. “My whole world changed with just three words. In an instant, I went from feeling like a normal person to having to absorb all this new medical jargon,” she says.

It was a difficult time for Vanessa. She was young, she didn’t know anyone else her age who had cancer, and she didn’t know anyone with thyroid cancer. While she had support from friends and family, at the end of the day she felt very much alone. As the weeks passed by and her mind raced on, she began to second-guess her diagnosis, question whether she should have surgery, and considered having another biopsy. “I had to work through the emotional aspects of my diagnosis, including coming to grips with the fact that I had thyroid cancer and the fear I felt about the outcome,” she explains. “You have to be in a positive place when you are going to have surgery.” Fortunately, her cancer was not overly aggressive, and she was able to delay the surgery until she felt more prepared.

By June 2013, she was ready for surgery and had a total thyroidectomy that included the removal of six lymph nodes, one of which was positive for cancer. The surgery was successful, and so far, she hasn’t required any radiation therapy, a common follow-up treatment post thyroid cancer. While in 2017 her antithyroglobulin levels, a marker that can be used to monitor a possible cancer recurrence in those with an autoimmune condition, went up and remained that way, she continues to be monitored. Her bloodwork and scans are done twice a year, and once a year she has a neck ultrasound; each time she experiences what survivors call “scanxiety” until she gets an all clear from the results.

When Vanessa was diagnosed, her endocrinologist gave her a key piece of advice that she didn’t completely understand at the time, but it stuck with her, and the meaning soon became clear. He told her, “Don’t turn this diagnosis into a research project.” As someone who is naturally curious and was eager to learn all she could about her disease, as soon as she was diagnosed, Vanessa took to “Dr. Google” looking for information and answers, but she wasn’t always finding helpful information. “While online, I was landing on horror stories,” she says, adding that while it is important to be knowledgeable about your disease, it is imperative to get accurate information and to be careful about choosing which sites or social media outlets to use as resources. “The Internet can be a scary rabbit hole, and it can cause unnecessary worry,” she says. “Finding a reputable site, like Patient Empowerment Network (PEN), that’s done a lot of the legwork for you and has comprehensive resources available is invaluable,” she says. Vanessa especially appreciates that PEN helps prepare patients for doctor visits by providing a list of questions to ask and offers relevant insight to caregivers, and survivors. “I was impressed with the PEN content, because it helps the patient from diagnosis to recovery,” she says. She also recommends sites that offer a sense of community where you can interact with other patients who have had similar experiences. “PEN builds community and empowers you to be your own advocate,” she says. “You have to know your body and speak up for yourself. That’s where the community aspect comes in. As a survivor, I try to provide that sense of community for others.”

After her surgery, Vanessa found a creative outlet that allows her to provide support for others and helped her through her own recovery. She created a lifestyle and wellness blog, Living in Steil (pronounced style), where she shares her personal journey and favorite resources as well as beauty, food, fitness, and health and wellness information. She says she was inspired to start the blog in February 2014, while recovering from surgery and trying to put the pieces of her life back together. “You don’t often process the emotional aspects of cancer until later,” she says. “It’s been cathartic to blog about my experience and have the site resonate with so many other patients and survivors.”

Her work as a blogger has led to many more opportunities to share her story including being asked to participate in a book, Tough: Women who Survived Cancer by Marquina Iliev-Piselli and collaborations with other advocacy groups in the healthcare space. In addition to her blog, Vanessa is a health coach and Board Certified Patient Advocate who also works for a pancreatic cancer foundation where she manages public relations and social media. She credits her diagnosis with helping her find her career niche and a meaningful role that allows her to make a difference in the lives of patients every day.

As far as her cancer is concerned, technically she is in remission, but says she is vigilant about staying on top of her health. “I have never taken my survivor status for granted,” she says. She continues to be her own advocate and has found that sometimes means she needs to find new doctors. If they are not listening to her or are not open to communication, she knows it’s time to move on. “It’s important to find a doctor who takes your concerns to heart,” she says.

Through Vanessa’s own experience with cancer, she’s learned a lot about advocating for herself and others. Vanessa has experienced firsthand what works and what doesn’t, and she is grateful to be able to share her knowledge. “If I can bridge the gap for people with a cancer diagnosis and make it easier for them to get the resources they need, then that is rewarding for me,” she says. “I had a difficult diagnosis, but I learned from my challenges and now I can share that knowledge with others. I can’t think of a better way to pay it forward than that.”

Read more about Vanessa and follow along with her journey at www.livinginsteil.com or on social media at @livinginsteil.


Read more patient stories here.

Thyroid Awareness: January and Beyond

This post was originally published by Sharon O’Day on MedicareGuide on January 21, 2021 here.


Most people with thyroid disease don’t even know they have it. More than one in eight Americans will develop a thyroid condition during their lifetime, but up to 60% are unaware of it.1

That’s because the symptoms — fatigue, depression, sleep disturbances and weight loss or gain, among others — could just as well be signs of other medical conditions and life stages.

That’s what makes Thyroid Awareness Month, which falls in January each year, so important. If both people and doctors think of thyroid problems more often, cases can be diagnosed earlier and the disease can be managed sooner.

What Is Thyroid Disease?

Thyroid disease is a medical condition that keeps your thyroid from producing the right amount of the hormones needed by your body’s systems to function. This small, butterfly-shaped gland at the lower front of your neck affects how well every cell, tissue and organ in your body works.

a close up of a christmas tree

Photo by Torten Dettlaff

The cause of thyroid disease is unknown, but it can often be managed with medical attention. But first it has to be diagnosed through blood tests, imaging (scans or ultrasounds) and physical exams.

With hypothyroidism, the gland doesn’t make enough thyroid hormone and you can feel tired, gain weight and feel the cold more intensely. 
On the flip side, when the gland produces too much hormone you can develop hyperthyroidism, leaving you feeling tired and nervous. You may also lose weight and find your heartbeat is rapid.

Graves’ disease is a specific form of hyperthyroidism, an autoimmune genetic disorder that affects about 1% of the U.S. population.2

Women are five to eight times more likely than men to be among the estimated 20 million Americans with a thyroid condition.3

Different types of benign (non-cancerous) growths and malignant (cancerous) tumors can develop in the thyroid gland. Thyroid nodules, for example, are common and usually benign; these lumps can be solid or filled with fluid. You should still seek immediate medical attention because, while most growths don’t turn out to be cancer, some do.4

What About Thyroid Cancer?

When the cells in the thyroid grow out of control, the disease can become thyroid cancer. In 2017, the latest year for Centers for Disease Control statistics, more than 33,000 women and nearly 12,000 men were diagnosed with thyroid cancer.5

Thyroid cancer has more specific symptoms than other forms of thyroid disease: a lump or swelling on the side of the neck, trouble or pain breathing or swallowing and a hoarse voice.6

What Are the Trends in Thyroid Cancer?

The yearly number of new thyroid cancer cases in the U.S. has grown steadily, from 18,000 in 1999 to a peak of 49,500 in 2015, with a small drop-off after that.7

In 2017, for every 100,000 Americans, 14 new thyroid cancer cases were reported and one person died.8

Scientists aren’t sure what causes thyroid cancer. But the risk factors include:9

Gender and Race

The chances of a thyroid cancer diagnosis are nearly three times higher for women than for men.10

But if you’re Black or American Indian/Alaska Native, you have about a 45% lower chance of being diagnosed with thyroid cancer than if you’re white, Asian/Pacific Islander or Hispanic.11

Survival Studies

Three factors influence the five-year survival rate for thyroid cancer patients: gender, age and race.12 

  • Survival rates are higher for women than for men: 98% versus 93.6%.
  • Survival drops as people age, from 99.4% for those under 45 to 86.1% for those over 75.
  • Survival is slightly lower for Blacks compared with whites and people of other races/ethnicities.

For women, thyroid cancer has the highest five-year survival rate of all cancers. For men, only prostate cancer and testicular cancer have higher survival rates.

Regional Glances

Across all ages, genders, races and ethnicities, the rate of new cancers is higher in the extended New England area and some western and midwest states, including Utah, Wyoming, North Dakota and Kansas.13

How You Can Raise Awareness About Thyroid Disease

Thyroid Awareness Month highlights the crucial role the thyroid plays in the ability of major organs to function. It aims for more people to get tested if they have unexplained symptoms like those mentioned above. And it promotes early treatment.

As with any type of cancer, greater awareness leads to earlier detection, which can save lives. A cancer stage is defined by whether cancer cells have been contained within the thyroid or traveled to other parts of the body, which influences your treatment options as well as the odds of recovery.14 

If you want to participate in Thyroid Awareness Month, here are six simple ways to get involved:

  • Do a thyroid neck check. You’ll need a hand-held mirror and a glass of water. Tip your head back, take a sip of water and swallow. Using the mirror as you swallow, watch the lower front of your neck for any bulges or protrusions. If you see any, talk to your physician right away.
  • Encourage friends and family to get tested. Although symptoms are pretty general, if a loved one complains of feeling cold, not sleeping well or having trouble swallowing, ask them to do the at-home neck check and suggest they see their doctor.
  • If you can, donate. Even if thyroid disease hasn’t affected you directly, consider donating to:
  • Share information online and off. ThyCa offers free materials to increase awareness of thyroid issues. Order some today and help spread the word.
  • Share Your Thyroid Story.  Paloma Health developed a video campaign that invites people to share their thyroid story to help raise awareness for thyroid disease symptoms, risk factors and treatment options. According to the organization, when someone submits a story, they’re automatically entered for a chance to win a thyroid support bundle giveaway.
  • Use hashtags to raise awareness on social media. By using these designated hashtags from the ATA and ThyCA, your efforts to raise awareness will be multiplied:
    • #thyroid #hypothyroidism #thyroidhealing #thyroidproblems #thyroiddisease #thyroidhealth #autoimmunedisease #hormones #hyperthyroidism #hypothyroidism #hashimotos #cancer #thyroidcancer #autoimmune #thyroidweightloss #covid #hashimotosdisease #thyroidwarrior #thyroidawareness #thyroidectomy #hypothyroid

Next Steps

January is Thyroid Awareness Month and September is Thyroid Cancer Awareness Month. But your efforts to raise awareness are needed year-round because most thyroid disease cases go undetected in their early stages.

Check yourself regularly with the swallow test. It only takes a minute or two. And stay vigilant when friends and family mention unexplained symptoms. If the signs fall in general categories such as fatigue, depression, sleep disturbances and weight loss or gain, encourage them to visit their doctor to have their thyroid checked.

Your efforts to promote Thyroid Awareness Month can help reduce the number of Americans who have a thyroid problem but don’t know and don’t get checked before a very treatable issue becomes much more serious.


  1. American Thyroid Association. “General Information/Press Room.” thyroid.org (accessed December 18, 2020).
  2. General Information/Press Room.”
  3. General Information/Press Room.”
  4. American Cancer Society. “What Is Thyroid Cancer?” cancer.org (accessed December 18, 2020).
  5. Centers for Disease Control and Prevention. “United States Cancer Statistics: Data Visualizations.” gis.cdc.gov (accessed December 18, 2020).
  6. Centers for Disease Control and Prevention. “Thyroid Cancer.” cdc.gov (accessed December 18, 2020).
  7. United States Cancer Statistics: Data Visualizations.”
  8. United States Cancer Statistics: Data Visualizations.”
  9. National Cancer Institute. “Thyroid Cancer Treatment (Adult) (PDQ®)–Patient Version.” cancer.gov (accessed December 18, 2020).
  10. United States Cancer Statistics: Data Visualizations.”
  11. United States Cancer Statistics: Data Visualizations.”
  12. United States Cancer Statistics: Data Visualizations.”
  13. United States Cancer Statistics: Data Visualizations.”
  14. Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974-2013.”

“Wait, There’s a Good Cancer?”

When the Luck of the Draw Leads to the Short End of the Stick

Cancer is one of the most feared diseases. Everyone is affected by it in some way, but no one really imagines getting it themselves. So imagine hearing that you got the “good” cancer, a commonly used term for thyroid cancer. That can’t be right. Cancer is cancer…isn’t it? But who are we, as patients, to question what our doctors tell us? They’re the ones who went to medical school and have years of training. But maybe thyroid cancer isn’t that bad?

That’s what I thought when I was told that my cancer was the “good” one by more than one doctor. In fact, one doctor told me that thyroid cancer was “the cancer to have if you had to get it.” I didn’t have any symptoms at the time, so I took these words, spoken to me by medical professionals, as truth. Unfortunately, I learned that there was no such thing as a “good” cancer once I began treatment.

While thyroid cancer is slow-growing, does have a very good prognosis, and can be easily treatable, no cancer is the same. For example, I had the papillary variant of thyroid cancer, a common diagnosis amongst most thyroid cancer patients. I underwent surgery to remove half of the thyroid with the tumor, but my treatment didn’t end there. It was discovered in the pathology report that I had metastasis that was not shown on the original ultrasound that showed the tumor in my thyroid. As a result, I had to undergo a second surgery for the removal of the remaining half of my thyroid. Additionally, I was told by my surgeon that, because of the metastasis, he didn’t know if cancer could be elsewhere in my body, and I would need to undergo oral radiation therapy. “Wasn’t this the ‘good’ cancer?” I thought over and over.

Furthermore, what doctors don’t explain, at least very well in my case, is what not having a thyroid is going to be like. I wasn’t aware of what a thyroid was nor its functions when I was told that it was harboring a tumor. Nor did I know until I had to be placed on a supplement, or rather a replacement, for my lack of thyroid. I learned quickly that the thyroid essentially interacts with every other system in the body through controlling metabolism, heart rate, temperature, energy level, etc. My body slowly adjusted to this new medication with a prescribed dose that was initially “simply a guess” based on my age, weight, and overall health. From there, my healthcare team and I adjust the dose based on how my body responds. If I think about this, especially as a woman, my body goes through many changes as I age, and I’m sure many of them are affected by a properly-functioning thyroid, which I no longer have. I’m not saying that I’m not eternally grateful for their actually being a supplement I can take to, quite literally, live, on a daily basis. What I am saying is that the stigma and the choice of words and phrases surrounding this cancer, perpetuated by medical professionals needs to stop. At the very least, they need to recognize thyroid cancer as a cancer, a diagnosis that inevitably impacts the life, good or bad, of every patient who has this terrible disease well into survivorship.

If you’re a thyroid cancer patient, whether newly-diagnosed, in treatment, no evidence of disease (NED), or anywhere in between, educate and advocate for yourselves. Find doctors who take the time to understand your wants and needs as an individual human being. Never think that your cancer is “less than,” because it matters.

Extended Quick Guide to Medicare

This guide was originally published by our partner, Triage Cancer, here.

2021-Health-Insurance-Medicare-Quick-Guide

Quick Guide to Health Insurance Options

This guide was originally published by our partner, Triage Cancer, here.

2021-Health-Insurance-Options-Quick-Guide

Barriers to Clinical Trial Participation

 

What are some of the barriers to clinical trial participation? What is a virtual clinical trial? Should my doctor be speaking to me about my clinical trial options? Dana Dornsife, founder of Lazarex Cancer Foundation, speaks to the key barriers in trials and how COVID-19 has really opened the door for a lot of opportunity to engage with patients around clinical trials.

Barriers to Clinical Trial Participation

Barriers to Clinical Trial Participation from Patient Empowerment Network on Vimeo.

What is a Virtual Clinical Trial?

What is a Virtual Clinical Trial? from Patient Empowerment Network on Vimeo.

COVID and Clinical Trials

COVID and Clinical Trials: Has There Been a Shift? from Patient Empowerment Network on Vimeo.

Tomorrow’s Medicine Today

 

From PEN-Powered Activity Guide V, beloved medical oncologist Dr. Bora Lim of The University of Texas MD Anderson Cancer Center walks us through what a clinical trial is, the phase of how drugs get approved, and how the pandemic crisis has amplified the criticality of clinical trials.

What is a Clinical Trial?

What is a Clinical Trial? from Patient Empowerment Network on Vimeo.

How Do Drugs Get Approved?

How Do Drugs Get Approved? from Patient Empowerment Network on Vimeo.

Will Pandemic Transform Future of Clinical Trials?

Will Pandemic Transform Future of Clinical Trials? from Patient Empowerment Network on Vimeo.

Clinical Trials as an Empowerment Tool

Clinical Trials as an Empowerment Tool from Patient Empowerment Network on Vimeo.

The Power of Journaling During Cancer Treatment

There are two ways to fight cancer, both of which are equally as important. The first is physical and the second mental. Journaling might not be able to help with the physical symptoms, but easing the mind can truly help in such situations.

By providing a safe place to store your thoughts and experiences, you will be able to find a great source of power. If you have never thought about journaling before, this might be the perfect time for you to give it a try. Here are some important reasons why this might be a very great decision.

1. Keeping track of all important moments

Some people believe that battling cancer is only filled with negative moments and experiences. While that is true to a big extent, there can be plenty of memorable moments that you might want to keep track of. The beginning of your treatments is a moment that you can write about and think about when this situation is over.

Other important moments might include family gatherings, important presents you might receive, very bad and very good days that stand out in your treatment course. Just because a day way difficult doesn’t mean it should be considered bad. At the end of this difficult journey, you will be able to look back at everything you wrote and remember the good and bad times.

2. Helping ease certain symptoms

Another great reason why journaling can truly help cancer patients during their treatments is because of symptom management. Research has actually shown that journaling can help with combating symptoms and dealing with the physical size of things.

Writing about how you feel and what you are going through can help you sleep better and feel more energetic. Getting plenty of rest will allow you to feel less nauseous, be in a better mood and battle everything with a stronger will. The more you face your symptoms, the stronger you will feel through your treatment.

3. Fighting against the stress

The stress that can be caused by such a difficult diagnosis is great and can truly affect your mood and outlook on life. Being under stress can make you feel tired, mess up your sleeping schedule and make you feel more negative about everything. This is not ideal for any situation you are in in your life and there are ways to overcome it.

Journaling can provide you with a safe space to write everything you have in your mind. During your treatments, you will possibly want to appear strong in front of your family and you might not want to share everything you feel. You can write all your thoughts in your journal and let everything out. This way you will be able to handle everything you face and feel a lot less stressed.

4. Reminding yourself of things you love

When dealing with any hardship in life, it is important to keep thinking of things that bring you joy. Journaling has helped me create a notebook full of memories, which I can go through any time I need some positivity in my life. You don’t only have to put words into it but anything and everything that makes you think of memories and people you hold dear.

In your journal you can keep stickers, receipts, drawings and cards from loved ones. Then you can write how receiving these things made you felt. When the days get difficult and you are struggling, open your journal again. Read through everything nice you have collected and it can help you remember all the reasons why this difficult process is worth it.

5. Seeing all the progress you have made

Last but not least, another important reason why journaling is so helpful during cancer treatment is that it can help keep track of your progress. There are going to be many days that will be hard and many that will be good and filled with hope. In order to be able to go through both, it is important that you keep track of everything new that happens in your journey.

The good days will help you remember that things will get better. The difficult days will allow you to live in the moment and work on staying positive. Journaling this experience can also help your family better understand what goes on in your head and how they can help. After you have successfully put this difficult period of your life behind, you can even share your story with other patients through your journal.

Battling cancer every way possible

Journaling is a creative and fun activity that can help you deal with certain symptoms and negative thoughts during your treatment. Even if you have little experience with writing, journaling gives you the chance to get creative. You don’t need any special skills in order to journal. You just need a notebook, some fun colors and a few thoughts in your head.

Through writing about your experiences, you will be able to express how you feel and let everything run its course. This treatment course might be tough, but writing everything down will help you see just how much progress you are making. This can truly help you feel stronger mentally and physically and overcome this situation like a true warrior!

Do You Need to See an Endocrinologist for Your Thyroid Disease?

This resources was originally published by the Verywell Health here.


In most cases, the diagnosis of a thyroid condition is made by a person’s primary care doctor, who may then refer you to an endocrinologist, a physician who treats hormone problems like thyroid disease and others. But that’s not always the case—or necessary. Sometimes, your general practitioner is comfortable managing your thyroid condition on his own, and this is perfectly sensible for certain thyroid diagnoses.

There are other healthcare practitioners, such as naturopaths and chiropractors, who also treat thyroid patients. While their expertise may be helpful as a complement to your thyroid care, it should not be a substitute for that of a primary care doctor or endocrinologist.

How to Work With Your Thyroid Medical Team

As managing thyroid disease can be challenging and is, in most cases, a lifelong commitment, it’s important to have the right team of professionals helping you along the way.

Thyroid Disease Doctor Discussion Guide

Get our printable guide for your next doctor’s appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Primary Care Doctors

Your primary care doctor may be able to manage your thyroid disease, especially if you are diagnosed with hypothyroidism. This is because most primary care doctors are comfortable and trained to monitor thyroid stimulating hormone (TSH) levels and adjust thyroid hormone replacement medication accordingly

That said, there are some specific situations that warrant a referral to an endocrinologist.

  • If you are pregnant or planning pregnancy
  • A newborn or child with a thyroid condition
  • Presence of thyroid nodules or an enlarged thyroid gland (goiter)
  • Any type of hyperthyroidism, including Graves’ disease
  • Secondary hypothyroidism (if a pituitary problem is causing hypothyroidism)
  • Thyroid eye disease
  • Suspected thyroid cancer

Endocrinologists

An endocrinologist is a doctor who completes training in internal medicine (like a primary care physician) and then undergoes more training (usually two to three years) in the field of endocrinology.

Endocrinologists diagnose and treat hormonal imbalances, usually due to various gland conditions, such as:

  • Thyroid disorders
  • Diabetes
  • Osteoporosis and bone health
  • Adrenal disorders
  • Pituitary disorders
  • Menopause issues in women
  • Testosterone problems in men2

While primary care doctors can manage some endocrine conditions, like “textbook” hypothyroidism and diabetes, other conditions warrant the care of an endocrinologist, like pituitary or adrenal gland problems or hyperthyroidism.

Even if you have “textbook” hypothyroidism, do not be surprised if your primary care doctor refers you to an endocrinologist. This can be for a number of reasons—perhaps you have multiple other medical problems (making your case a complex one), or perhaps your doctor does not have a lot of experience treating patients with such a disorder.

Sometimes, primary care doctors simply want an “extra set of eyes” from an endocrinologist, whether that’s taking a second look at your diagnostic test results and/or modifying your treatment plan—all of this is OK, if not, a sign of good care.

Depending on your diagnosis and treatment plan, your endocrinologist may opt to manage your condition on his own, as in the case of Graves’ disease or monitoring thyroid nodules.

Alternatively, your endocrinologist may work alongside your primary care doctor to manage your condition. For example, your primary care doctor may refer you to an endocrinologist for an initial diagnosis of Hashimoto’s disease. Once your endocrinologist stabilizes your thyroid hormone replacement dose, your primary care doctor may then follow your TSH levels. You may then only see your endocrinologist if a problem arises, or once a year for a check-in.

Other Practitioners

Many thyroid patients look to seek out 360-treatment plan—that is, one that includes the expertise of practitioners of different disciplines and takes a “whole body” approach. Naturopaths and chiropractors are two professionals who are sometimes consulted.

If you consult with these or other practitioners, be sure that you only do so as an adjunct to your care by a primary care doctor or endocrinologist. He or she should also be aware of any treatments recommended by other clinicians.

Naturopathic Doctors

A licensed naturopathic doctor (ND) graduates from a four-year graduate level holistic medical school. Their approach to healthcare tends to be more integrative perhaps than traditional doctors in that NDs believe no part of your body operates in complete isolation from the rest of the system.3

So, for example, an ND may discuss the aspects of how nutrition affects thyroid disorders and make sure that you have a diet plan that works to support your thyroid health. In addition, by ordering labs and imaging tests, an ND may evaluate other hormones such as the sex hormone estrogen and cortisol (the “stress hormone” produced by your adrenals glands).

Complement to Your Thyroid Care

While an integrative approach to your thyroid health is appealing, NDs do not necessarily follow the guidelines recommended by professional societies like the American Thyroid Association (ATA) or the American Association of Clinical Endocrinologists (AACE).

For instance, for the treatment of hypothyroidism, many NDs prescribe desiccated thyroid hormone, which is derived from the dried thyroid glands of pigs or cows and provides both T4 (thyroxine) and triiodothyronine (T3). Alternative names include natural thyroid, thyroid extract, porcine thyroid, pig thyroid; brand names include Nature-throid and Armour Thyroid.

This type of thyroid hormone replacement medication provides a ratio of T4:T3 that is not natural to humans (4:1 instead of 16:1), which tends to produce some degree of hyperthyroidism. That is why most expert bodies (the AACE and ATA, for instance) do not recommend its usage, except for perhaps select patients. Instead, for the vast majority of patients, experts recommend sticking with levothyroxine alone (brand names: Synthroid, Levoxyl, and Tirosint).4

Lastly, some NDs practice botanical medicine, recommending herbs for the care of various medical problems. Taking herbs and supplements can be especially harmful to a person with thyroid disease as they may interfere with your medication and/or the functioning of your thyroid gland.

Chiropractors

According to the American Chiropractic Association, chiropractors are designated as “physician-level providers,” in the vast majority of states. While the doctor of chiropractic (DC) program is similar to the doctor of medicine (MD) program in the first two years, the programs diverge in the second half. During this time, the DC program focuses on diet, nutrition, and spinal manipulation, while the MD program emphasizes the study of pharmacology.5

Complement to Your Thyroid Care

While your chiropractor may have been the one to diagnose your thyroid disease (they can order laboratory tests and imaging studies, like a naturopath), once diagnosed, your chiropractor must refer you to a medical doctor for proper treatment—for instance, thyroid hormone replacement for hypothyroidism and either an anti-thyroid drug, surgery, or radioactive iodine ablation for hyperthyroidism.

Chiropractors can, however, provide supportive thyroid care, such as nutritional guidance or ways to ease musculoskeletal pain associated with the underlying thyroid disease (like carpal tunnel syndrome or joint aches).

Chiropractors are legally prohibited from prescribing thyroid medication, which means that they cannot treat or cure thyroid conditions.

A Word From Verywell

The decision to find a doctor for your thyroid care can be a challenging one, as the relationship is an intensely personal one, and it’s not easy to find the right match, particularly when you may be limited by geography and insurance.

Remain proactive in seeking out the right doctor-patient relationship. And keep a positive mindset, too. When you find that trusting, compassionate partnership, you will just know it.

Tests for Thyroid Cancer

This resources was originally published by the American Cancer Society here.


Thyroid cancer may be diagnosed after a person goes to a doctor because of symptoms, or it might be found during a routine physical exam or other tests. If there is a reason to suspect you might have thyroid cancer, your doctor will use one or more tests to confirm the diagnosis. If cancer is found, other tests might be done to find out more about the cancer.

Medical history and physical exam

If you have any signs or symptoms that suggest you might have thyroid cancer, your health care professional will want to know your complete medical history. You will be asked questions about your possible risk factorssymptoms, and any other health problems or concerns. If someone in your family has had thyroid cancer (especially medullary thyroid cancer) or tumors called pheochromocytomas, it is important to tell your doctor, as you might be at high risk for this disease.

Your doctor will examine you to get more information about possible signs of thyroid cancer and other health problems. During the exam, the doctor will pay special attention to the size and firmness of your thyroid and any enlarged lymph nodes in your neck.

Imaging tests

Imaging tests may be done for a number of reasons:

  • To help find suspicious areas that might be cancer
  • To learn how far cancer may have spread
  • To help determine if treatment is working

People who have or may have thyroid cancer will get one or more of these tests.

Ultrasound

Ultrasound uses sound waves to create images of parts of your body. You are not exposed to radiation during this test.

This test can help determine if a thyroid nodule is solid or filled with fluid. (Solid nodules are more likely to be cancerous.) It can also be used to check the number and size of thyroid nodules as well as help determine if any nearby lymph nodes are enlarged because the thyroid cancer has spread.

For thyroid nodules that are too small to feel, this test can be used to guide a biopsy needle into the nodule to get a sample. Even when a nodule is large enough to feel, most doctors prefer to use ultrasound to guide the needle.

Radioiodine scan

Radioiodine scans can be used to help determine if someone with a lump in the neck might have thyroid cancer. They are also often used in people who have already been diagnosed with differentiated (papillary, follicular, or Hürthle cell) thyroid cancer to help show if it has spread. Because medullary thyroid cancer cells do not absorb iodine, radioiodine scans are not used for this cancer.

For this test, a small amount of radioactive iodine (called I-131) is swallowed (usually as a pill) or injected into a vein. Over time, the iodine is absorbed by the thyroid gland (or thyroid cells anywhere in the body). A special camera is used several hours later to see where the radioactivity is.

For a thyroid scan, the camera is placed in front of your neck to measure the amount of radiation in the gland. Abnormal areas of the thyroid that have less radioactivity than the surrounding tissue are called cold nodules, and areas that take up more radiation are called hot nodules. Hot nodules usually are not cancerous, but cold nodules can be benign or cancerous. Because both benign and cancerous nodules can appear cold, this test by itself can’t diagnose thyroid cancer.

After surgery for thyroid cancer, whole-body radioiodine scans are useful to look for possible spread throughout the body. These scans become even more sensitive if the entire thyroid gland has been removed by surgery because more of the radioactive iodine is picked up by any remaining thyroid cancer cells.

Radioiodine scans work best if patients have high blood levels of thyroid-stimulating hormone (TSH, or thyrotropin). For people whose thyroid has been removed, TSH levels can be increased by stopping thyroid hormone pills for a few weeks before the test. This leads to low thyroid hormone levels (hypothyroidism) and causes the pituitary gland to release more TSH, which in turn stimulates any thyroid cancer cells to take up the radioactive iodine. A downside of this is that it can cause the symptoms of hypothyroidism, including tiredness, depression, weight gain, sleepiness, constipation, muscle aches, and reduced concentration. One way to raise TSH levels without withholding thyroid hormone is to give an injectable form of thyrotropin (Thyrogen) before the scan.

Because any iodine already in the body can affect this test, people are usually told to avoid foods or medicines that contain iodine for a few days before the scan.

Radioactive iodine can also be used to treat differentiated thyroid cancer, but it is given in much higher doses. This type of treatment is described in Radioactive iodine (radioiodine) therapy.

Chest x-ray

If you have been diagnosed with thyroid cancer (especially follicular thyroid cancer), a plain x-ray of your chest may be done to see if cancer has spread to your lungs.

Computed tomography (CT) scan

The CT scan is an x-ray test that makes detailed cross-sectional images of your body. It can help determine the location and size of thyroid cancers and whether they have spread to nearby areas, although ultrasound is usually the test of choice. A CT scan can also be used to look for spread into distant organs such as the lungs.

One problem using CT scans is that the CT contrast dye contains iodine, which interferes with radioiodine scans. For this reason, many doctors prefer MRI scans for differentiated thyroid cancer.

Magnetic resonance imaging (MRI) scan

MRI scans use magnets instead of radiation to create detailed cross-sectional images of your body. MRI can be used to look for cancer in the thyroid, or cancer that has spread to nearby or distant parts of the body. But ultrasound is usually the first choice for looking at the thyroid. MRI can provide very detailed images of soft tissues such as the thyroid gland. MRI scans are also very helpful in looking at the brain and spinal cord.

Positron emission tomography (PET) scan

PET scan can be very useful if your thyroid cancer is one that doesn’t take up radioactive iodine. In this situation, the PET scan may be able to tell whether the cancer has spread.

Biopsy

The actual diagnosis of thyroid cancer is made with a biopsy, in which cells from the suspicious area are removed and looked at in the lab.

If your doctor thinks a biopsy is needed, the simplest way to find out if a thyroid lump or nodule is cancerous is with a fine needle aspiration (FNA) of the thyroid nodule. This type of biopsy can sometimes be done in your doctor’s office or clinic.

Before the biopsy, local anesthesia (numbing medicine) may be injected into the skin over the nodule, but in most cases an anesthetic is not needed. Your doctor will place a thin, hollow needle directly into the nodule to aspirate (take out) some cells and a few drops of fluid into a syringe. The doctor usually repeats this 2 or 3 more times, taking samples from several areas of the nodule. The biopsy samples are then sent to a lab, where they are looked at to see if the cells look cancerous or benign.

Bleeding at the biopsy site is very rare except in people with bleeding disorders. Be sure to tell your doctor if you have problems with bleeding or are taking medicines that could affect bleeding, such as aspirin or blood thinners.

This test is generally done on all thyroid nodules that are big enough to be felt. This means that they are larger than about 1 centimeter (about 1/2 inch) across. Doctors often use ultrasound to see the thyroid during the biopsy, which helps make sure they are getting samples from the right areas. This is especially helpful for smaller nodules. FNA biopsies can also be used to get samples of swollen lymph nodes in the neck to see if they contain cancer.

Sometimes an FNA biopsy will need to be repeated because the samples didn’t contain enough cells. Most FNA biopsies will show that the thyroid nodule is benign. Rarely, the biopsy may come back as benign even though cancer is present. Cancer is clearly diagnosed in only about 1 of every 20 FNA biopsies.

Sometimes the test results first come back as “suspicious” or “of undetermined significance” if FNA findings don’t show for sure if the nodule is either benign or malignant. If this happens, the doctor may order lab tests on the sample (see below).

If the diagnosis is not clear after an FNA biopsy, you might need a more involved biopsy to get a better sample, particularly if the doctor has reason to think the nodule may be cancer. This might include a core biopsy using a larger needle, a surgical “open” biopsy to remove the nodule, or a lobectomy (removal of half of the thyroid gland). Surgical biopsies and lobectomies are done in an operating room while you are under general anesthesia (in a deep sleep). A lobectomy can also be the main treatment for some early cancers, although for many cancers the rest of the thyroid will need to be removed as well (during an operation called a completion thyroidectomy).

Lab tests of biopsy (or other) samples

In some cases, doctors might use molecular tests to look for specific gene changes in the cancer cells. This might be done for different reasons:

  • If FNA biopsy results aren’t clear, the doctor might order lab tests on the samples to see if there are changes in the BRAF or RET/PTC genes. Finding one of these changes makes thyroid cancer much more likely.
  • For some types of thyroid cancer, molecular tests might be done to see if the cancer cells have changes in certain genes (such as the BRAFRET/PTC, or NTRK genes), which could mean that certain targeted drugs might be helpful in treating the cancer.

These tests can be done on tissue taken during a biopsy or surgery for thyroid cancer. If the biopsy sample is too small and all the molecular tests can’t be done, the testing may also be done on blood that is taken from a vein, just like a regular blood draw.

Blood tests

Blood tests are not used to find thyroid cancer. But they can help show if your thyroid is working normally, which may help the doctor decide what other tests may be needed. They can also be used to monitor certain cancers.

Thyroid-stimulating hormone (TSH)

Tests of blood levels of thyroid-stimulating hormone (TSH or thyrotropin) may be used to check the overall activity of your thyroid gland. Levels of TSH, which is made by the pituitary gland, may be high if the thyroid is not making enough hormones. This information can be used to help choose which imaging tests (such as ultrasound or radioiodine scans) to use to look at a thyroid nodule. The TSH level is usually normal in thyroid cancer.

T3 and T4 (thyroid hormones)

These are the main hormones made by the thyroid gland. Levels of these hormones may also be measured to get a sense of thyroid gland function. The T3 and T4 levels are usually normal in thyroid cancer.

Thyroglobulin

Thyroglobulin is a protein made by the thyroid gland. Measuring the thyroglobulin level in the blood can’t be used to diagnose thyroid cancer, but it can be helpful after treatment. A common way to treat thyroid cancer is to remove most of the thyroid by surgery and then use radioactive iodine to destroy any remaining thyroid cells. These treatments should lead to a very low level of thyroglobulin in the blood within several weeks. If it is not low, this might mean that there are still thyroid cancer cells in the body. If the level rises again after being low, it is a sign that the cancer could be coming back.

Calcitonin

Calcitonin is a hormone that helps control how the body uses calcium. It is made by C cells in the thyroid, the cells that can develop into medullary thyroid cancer (MTC). If MTC is suspected or if you have a family history of the disease, blood tests of calcitonin levels can help look for MTC. This test is also used to look for the possible recurrence of MTC after treatment. Because calcitonin can affect blood calcium levels, these may be checked as well.

Carcinoembryonic antigen (CEA)

People with MTC often have high blood levels of a protein called carcinoembryonic antigen (CEA). Tests for CEA can help monitor this cancer.

Other blood tests

You might have other blood tests as well. For example, if you are scheduled for surgery, tests will be done to check your blood cell counts, to look for bleeding disorders, and to check your liver and kidney function.

Medullary thyroid carcinoma (MTC) can be caused by a genetic syndrome that also causes a tumor called pheochromocytoma. Pheochromocytomas can cause problems during surgery if the patient is under anesthesia (in a deep sleep). This is why patients with MTC who will have surgery are often tested to see if they have a pheochromocytoma as well. This can mean blood tests for epinephrine (adrenaline) and a related hormone called norepinephrine, and/or urine tests for their breakdown products (called metanephrines).

Vocal cord exam (laryngoscopy)

Thyroid tumors can sometimes affect the vocal cords. If you are going to have surgery to treat thyroid cancer, a procedure called a laryngoscopy will probably be done first to see if the vocal cords are moving normally. For this exam, the doctor looks down the throat at the larynx (voice box) with special mirrors or with a laryngoscope, a thin tube with a light and a lens on the end for viewing.

What’s the Difference Between Hypothyroidism and Hyperthyroidism?

This article was originally published by the US News on April 19, 2019 here.


The two conditions have similar-sounding names but are actually quite different.

IN THE WORLD OF medicine, many conditions have names that may seem unfamiliar to English speakers. Some of these diseases have names borrowed from other languages, and Greek is a usual suspect when it comes to terms that may not be immediately recognizable to many of us.

This is true for two common medical conditions that have to do with the thyroid gland. The terms hypothyroidism and hyperthyroidism describe two problems that can arise in the thyroid gland – a small, butterfly-shaped structure in the neck that produces hormones that regulate a wide range of bodily functions. At first glance, these words may seem identical. But a tiny change in a couple letters alters the meaning of the two terms substantially, referring to two different conditions.

What Is Hypothyroidism?

In Greek, “‘hypo’ means low or below normal,” says Dr. Joseph Wanski, an endocrinologist with L.A. Care Health Plan in Los Angeles. “Hypothyroidism defines the clinical condition of low or underactive laboratory levels of the thyroid hormone because the thyroid gland does not make enough” of the hormones that the body requires.

These hormones are important because they’re involved with all sorts of bodily functions from how the heart works to how fast your metabolism runs. “The thyroid gland in the neck manufactures a protein called thyroid hormone, which is crucial to the day-to-day function of every cell in the body,” says Dr. John Duncan, pediatric endocrinologist with Health First Medical Group in Melbourne, Florida. “Without it, all chemical functions within the cell slow down.”

Therefore, the term hypothyroidism is used to describe a state of inadequate levels of thyroid hormone, and it “accounts for the majority of issues people experience with their thyroid gland,” says Dr. Brian Jameson, an endocrinologist with Geisinger in Danville, Pennsylvania. “Hypothyroidism is also known as underactive thyroid. In other words, everything in the body slows down. When levels of two key thyroid hormones, thyroxine (T4) and triiodothyronine (T3) are too low in the blood, people experience symptoms.”

Symptoms associated with hypothyroidism include:

  • Fatigue.
  • Dry skin and hair.
  • Brittle nails.
  • Slowing of bowels or development of constipation.
  • Weight gain.
  • Puffy face.
  • Muscle cramps.
  • Irregular, infrequent or heavier than normal menstrual periods.
  • Forgetfulness.
  • Depression.
  • A hoarse voice.
  • Pain, stiffness or swelling of the joints.
  • Muscle weakness, aches or stiffness.

If hypothyroidism occurs in a child, it can result in short stature. In teenagers, it may cause an “alteration of pubertal characteristics,” Wanski says. Duncan points out that although being overweight is sometimes blamed on so-called glandular issues, AKA hypothyroidism, “not all individuals with excessive weight will be hypothyroid.”

What Is Hyperthyroidism?

At the other end of the thyroid spectrum is hyperthyroidism, in which the thyroid becomes overactive and generates too much thyroid hormone. “Hyperthyroidism is also known as overactive thyroid,” Jameson says. “In other words, everything in the body speeds up. When levels of two key thyroid hormones, thyroxine (T4) and triiodothyronine (T3) are too high in the blood, people experience symptoms.”

This overstimulation of the thyroid gland results in “a massive surplus of thyroid hormone. This accelerates all the chemical functions and all the cells,” Duncan says. This condition can cause a range of symptoms including:

  • Sleeplessness.
  • Rapid heart rate.
  • Heart failure.
  • Weight loss.
  • Tremor.
  • Bulging eyes or a fullness in the front of the neck.
  • More frequent bowel movements.
  • Seizures.
  • Heart disease.

Hyperthyroidism may also cause “an assortment of other undesirable clinical consequences,” Duncan says.

What Causes Hypothyroidism and Hyperthyroidism?

Duncan says that in most cases, these diseases are caused by “aberrant immunity cell function where white blood cells ‘attack’ the thyroid, which triggers under-function or over-function of the gland. However, there are infants who can be born without a thyroid gland (congenital hypothyroidism)” or the thyroid can be underdeveloped or “located in the wrong place,” Jameson adds. With hyperthyroidism, “there are infants who can inherit the immunity proteins and be born with hyperthyroidism,” Duncan says.

With hypothyroidism, “the most common cause is an autoimmune disease called Hashimoto’s thyroiditis,” Jameson says. “This disease causes the immune system to mistakenly attack a healthy thyroid gland. As a result, the thyroid becomes inflamed and is no longer able to make enough thyroid hormones. It may also become enlarged and develop lumps and bumps known as nodules.” Wanski adds that other causes of hypothyroidism include:

  • Radiation to the thyroid.
  • Thyroid surgery.
  • Damage to the pituitary gland, a pea-sized structure behind the nose at the base of the brain that regulates hormones throughout the body.
  • Certain medications.

The National Institute of Diabetes and Digestive and Kidney Disease reports that an autoimmune disorder called “Graves’ disease is the most common cause of hyperthyroidism in the United States. Wanski says other causes of hyperthyroidism include:

  • The development of a nodule or lump (or multiple nodules) in the thyroid gland that begins to produce excess hormone.
  • Certain medications.
  • Viral infections.

Jameson adds that in some cases, thyroid nodules can begin producing hormones when they shouldn’t, a condition called toxic nodular goiter. “Thyroid inflammation, also known as thyroiditis,” may also lead to the development of hyperthyroidism

Who’s Likely to Develop Thyroid Problems?

The American Thyroid Association reports that “more than 12 percent of the U.S. population will develop a thyroid condition during their lifetimes.” And because an “estimated 20 million Americans have some form of thyroid disease,” it may be something you’ll have to deal with at some point.

Although anyone can develop a problem with the thyroid at any age, there are a few risk factors that may make a thyroid issue more likely, including:

  • Being female.
  • Having recently been pregnant.
  • Being 60 or older.
  • Having a family history of thyroid or autoimmune disease.
  • Having a personal history of thyroid problems or surgery.
  • Having an autoimmune disease.

Duncan says problems with the function of the thyroid gland are “far more common in women than men,” ranging from 5 to 8 times more likely to develop in females. “Approximately 5 percent of women will eventually develop a thyroid problem.”

How Are These Conditions Diagnosed?

If hypo- or hyperthyroidism is suspected, your doctor will perform a physical examination and take a thorough medical history. A blood test can determine whether your body’s level of thyroid hormones is in the normal range or too high or too low.

Sometimes, your doctor may find a goiter upon examination. This is the term used to describe an enlarged thyroid, which may be obvious as a lump on the side of your throat. A goiter can be a sign of any issue with the thyroid, including hypo- or hyperthyroidism, cancer or simply a lack of dietary iodine. (Iodine is routinely added to table salt in the U.S. to help ward off this issue.)

If signs of hyperthyroidism are found, your doctor may want to conduct additional tests, including:

  • Radioiodine uptake test, in which a small dose of a radioactive iodine is administered and the amount that’s absorbed by the thyroid is measured.
  • Thyroid scan, in which a radioactive iodine isotope is injected and a camera creates an image of the thyroid once the isotope has been absorbed.
  • Thyroid ultrasound, in which sound waves are used to create an image of the thyroid.

Although your primary care physician may be able to diagnose and manage many thyroid issues, some patients may need to see an endocrinologist – a specialist doctor who focuses on diseases affecting the endocrine system and hormones.

How Are These Conditions Managed?

Both hypo- and hyperthyroidism can be dangerous, and “if left untreated, hypothyroidism can lead to unconsciousness and death,” Wanski says. On the other hand, hyperthyroidism “can cause significant weight loss, infertility, a heart irregularity called atrial fibrillation and double-vision.”

Therefore, it’s important to get appropriate medical care if you have either condition. “If you’re feeling unwell and experience any of the common symptoms of a thyroid problem, talk to your doctor,” Jameson says. “Treatment is relatively simple and can help you get back to feeling like yourself again.”

Depending on which condition you’re dealing with and what’s causing it, you may have a few options for treating it.

“In hypothyroidism, tablets of thyroxine – synthetic thyroid hormone identical to negative thyroid hormone – are administered daily and monitored through blood testing,” Duncan says. These medications restore normal levels of hormones and alleviate many of the symptoms of hypothyroidism.

With hyperthyroidism, the treatment may be somewhat more complicated. “Being multifactorial, hyperthyroidism may require one or more therapies,” Duncan says, but “the goal is to diminish or eliminate the overproduction of thyroid hormone.” Treatment options may include:

  • Anti-thyroid medications. These drugs slow the production of excess amounts of hormones.
  • Beta-blockers. Although usually used to treat high blood pressure, these medications can treat some of the symptoms of hyperthyroidism including tremor, palpitation and rapid heart rate.
  • Radioactive iodine. This approach destroys some or all of the thyroid to stop the overproduction of thyroid hormones.
  • Surgery. A thyroidectomy may be undertaken in certain instances to remove most of the thyroid gland and possibly the parathyroid glands, and Jameson says this approach may be a better option for pregnant women or “people who are unable to tolerate other medical treatments.” This approach will necessitate the use of medications for the rest of your life to replace the hormones that can no longer be manufactured within the body.

The most common treatment for hyperthyroidism tends to be radioactive iodine, which is typically administered as an oral pill, and may only require a single dose to be effective. Iodine is an element that is “essential for proper function of the thyroid gland, which uses it to make the thyroid hormone,” the American Thyroid Association reports. The thyroid absorbs iodine, and if it is radioactive, this can shrink or destroy the gland. This therapy is also sometimes used to treat thyroid cancer.

If the treatment destroys the gland or suppresses the thyroid too much, you may develop hypothyroidism as a side effect, but this can be addressed by medications that replace the loss of needed hormones. Hypothyroidism is generally considered easier to treat than hyperthyroidism.

Regardless of which condition you’re being treated for, it’s important to seek appropriate care, especially if you have other medical conditions, as “those may also be adversely affected by the problem until therapy has been introduced,” Wanski says.

The same is true for hyperthyroidism, which can have significant health consequences if it’s not addressed properly. If it’s “left untreated long enough, it can even cause seizures or severe heart disease,” Duncan says.

Jameson adds that “thyroid cancer is also a concern” in people with thyroid problems, particularly those with hypothyroidism. “Thyroid cancer is relatively common, and about three times as many women get thyroid cancer as men. It generally occurs in the nodular goiter of hypothyroidism but can be seen in people whose glands function properly. It’s rare to see thyroid cancer associated with hyperthyroidism.”

Even though it can happen, Jameson says you shouldn’t panic about developing cancer if you’re diagnosed with a thyroid problem. “Thyroid cancer is a very treatable cancer in most instances, usually with surgical removal of all or part of the thyroid and subsequent radioactive iodine tablets to treat the remaining cancer afterward.”

Signs and Symptoms of Thyroid Cancer

This resources was originally published by the American Cancer Society here.


Thyroid cancer can cause any of the following signs or symptoms:
  • A lump in the neck, sometimes growing quickly
  • Swelling in the neck
  • Pain in the front of the neck, sometimes going up to the ears
  • Hoarseness or other voice changes that do not go away
  • Trouble swallowing
  • Trouble breathing
  • A constant cough that is not due to a cold

If you have any of these signs or symptoms, talk to your doctor right away. Many of these symptoms can also be caused by non-cancerous conditions or even other cancers of the neck area. Lumps in the thyroid are common and are usually benign. Still, if you have any of these symptoms, it’s important to see your doctor so the cause can be found and treated, if needed.

What Is Thyroid Cancer?

This resources was originally published by the American Cancer Society here.


Thyroid cancer is a type of cancer that starts in the thyroid gland. Cancer starts when cells begin to grow out of control. (To learn more about how cancers start and spread, see What Is Cancer?)

The thyroid gland makes hormones that help regulate your metabolism, heart rate, blood pressure, and body temperature.

Where thyroid cancer starts

The thyroid gland is in the front part of the neck, below the thyroid cartilage (Adam’s apple). In most people, the thyroid cannot be seen or felt. It is shaped like a butterfly, with 2 lobes — the right lobe and the left lobe — joined by a narrow piece of gland called the isthmus (see picture below).

 

Illustration showing the parts of the thyroid gland (right lobe, isthmus, left lobe) in relation to the thyroid cartilage and trachea

 

The thyroid gland has 2 main types of cells:

  • Follicular cells use iodine from the blood to make thyroid hormones, which help regulate a person’s metabolism. Having too much thyroid hormone (hyperthyroidism) can cause a fast or irregular heartbeat, trouble sleeping, nervousness, hunger, weight loss, and a feeling of being too warm. Having too little hormone (hypothyroidism) causes a person to slow down, feel tired, and gain weight. The amount of thyroid hormone released by the thyroid is regulated by the pituitary gland at the base of the brain, which makes a substance called thyroid-stimulating hormone (TSH).
  • C cells (also called parafollicular cells) make calcitonin, a hormone that helps control how the body uses calcium.

Other, less common cells in the thyroid gland include immune system cells (lymphocytes) and supportive (stromal) cells.

Different cancers develop from each kind of cell. The differences are important because they affect how serious the cancer is and what type of treatment is needed.

Many types of growths and tumors can develop in the thyroid gland. Most of these are benign (non-cancerous) but others are malignant (cancerous), which means they can spread into nearby tissues and to other parts of the body.

Benign thyroid conditions

Thyroid enlargement

Changes in the thyroid gland’s size and shape can often be felt or even seen by patients or by their doctor.

An abnormally large thyroid gland is sometimes called a goiter. Some goiters are diffuse, meaning that the whole gland is large. Other goiters are nodular, meaning that the gland is large and has one or more nodules (bumps) in it. There are many reasons the thyroid gland might be larger than usual, and most of the time it is not cancer. Both diffuse and nodular goiters are usually caused by an imbalance in certain hormones. For example, not getting enough iodine in the diet can cause changes in hormone levels and lead to a goiter.

Thyroid nodules

Lumps or bumps in the thyroid gland are called thyroid nodules. Most thyroid nodules are benign, but about 2 or 3 in 20 are cancerous. Sometimes these nodules make too much thyroid hormone and cause hyperthyroidism. Nodules that produce too much thyroid hormone are almost always benign.

People can develop thyroid nodules at any age, but they occur most commonly in older adults. Fewer than 1 in 10 adults have thyroid nodules that can be felt by a doctor. But when the thyroid is looked at with an ultrasound, many more people are found to have nodules that are too small to feel and most of them are benign.

Most nodules are cysts filled with fluid or with a stored form of thyroid hormone called colloid. Solid nodules have little fluid or colloid and are more likely to be cancerous. Still, most solid nodules are not cancer. Some types of solid nodules, such as hyperplastic nodules and adenomas, have too many cells, but the cells are not cancer cells.

Benign thyroid nodules sometimes can be left alone (not treated) and watched closely as long as they’re not growing or causing symptoms. Others may require some form of treatment.

Types of Thyroid Cancers

The main types of thyroid cancer are:

  • Differentiated (including papillary, follicular and Hürthle cell)
  • Medullary
  • Anaplastic (an aggressive cancer)

Differentiated thyroid cancers

Most thyroid cancers are differentiated cancers. The cells in these cancers look a lot like normal thyroid tissue when seen in the lab. These cancers develop from thyroid follicular cells.

Papillary cancer (also called papillary carcinomas or papillary adenocarcinomas): About 8 out of 10 thyroid cancers are papillary cancers. These cancers tend to grow very slowly and usually develop in only one lobe of the thyroid gland. Even though they grow slowly, papillary cancers often spread to the lymph nodes in the neck. Even when these cancers have spread to the lymph nodes, they can often be treated successfully and are rarely fatal.

There are several subtypes of papillary cancers. Of these, the follicular subtype (also called mixed papillary-follicular variant) is most common. It has the same good outlook (prognosis) as the standard type of papillary cancer when found early, and they are treated the same way. Other subtypes of papillary carcinoma (columnar, tall cell, insular, and diffuse sclerosing) are not as common and tend to grow and spread more quickly.

Follicular cancer (also called follicular carcinoma or follicular adenocarcinoma): Follicular cancer is the next most common type, making up about 1 out of 10 thyroid cancers. It is more common in countries where people don’t get enough iodine in their diet. These cancers usually do not spread to lymph nodes, but they can spread to other parts of the body, such as the lungs or bones. The outlook (prognosis) for follicular cancer is not quite as good as that of papillary cancer, although it is still very good in most cases.

Hürthle (Hurthle) cell cancer (also called oxyphil cell carcinoma): About 3% of thyroid cancers are this type. It is harder to find and to treat.

Medullary thyroid carcinoma

Medullary thyroid cancer (MTC) accounts for about 4% of thyroid cancers. It develops from the C cells of the thyroid gland, which normally make calcitonin, a hormone that helps control the amount of calcium in blood. Sometimes this cancer can spread to lymph nodes, the lungs, or liver even before a thyroid nodule is discovered.

This type of thyroid cancer is more difficult to find and treat, There are 2 types of MTC:

  • Sporadic MTC, which accounts for about 8 out of 10 cases of MTC, is not inherited (meaning it does not run in families). It occurs mostly in older adults and often affects only one thyroid lobe.
  • Familial MTC is inherited and 20% to 25% can occur in each generation of a family. These cancers often develop during childhood or early adulthood and can spread early. Patients usually have cancer in several areas of both lobes. Familial MTC is often linked with an increased risk of other types of tumors. This is described in more detail in Thyroid Cancer Risk Factors.

Anaplastic (undifferentiated) thyroid cancer

Anaplastic carcinoma (also called undifferentiated carcinoma) is a rare form of thyroid cancer, making up about 2% of all thyroid cancers. It is thought to sometimes develop from an existing papillary or follicular cancer. This cancer is called undifferentiated because the cancer cells do not look very much like normal thyroid cells. This cancer often spreads quickly into the neck and to other parts of the body, and is very hard to treat.

Less Common Thyroid Cancers

Less than 4% of cancers found in the thyroid are thyroid lymphomas, thyroid sarcomas, or other rare tumors.

Parathyroid cancer

Behind, but attached to, the thyroid gland are 4 tiny glands called the parathyroids. The parathyroid glands help regulate the body’s calcium levels. Cancers of the parathyroid glands are very rare — there are probably fewer than 100 cases each year in the United States.

Parathyroid cancers are often found because they cause high blood calcium levels. This makes a person tired, weak, and drowsy. It can also make you urinate (pee) a lot, causing dehydration, which can make the weakness and drowsiness worse. Other symptoms include bone pain and fractures, pain from kidney stones, depression, and constipation.

Larger parathyroid cancers may also be found as a nodule near the thyroid. No matter how large the nodule is, the only treatment is to remove it surgically. Parathyroid cancer is much harder to cure than thyroid cancer.

Communicating About Cancer: A Brief Guide to Telling People Who Care

Getting a cancer diagnosis can easily be the most terrifying, heart-wrenching experiences one has in their lifetime. Everything from different treatment options (if you’re lucky), to financing, and maintaining quality of life suddenly are in full force front and center. It can be hard to know who to turn to if you’re not directed to a support group (of which there are many), and especially how to tell loved ones and co-workers. The choice is yours, of course, in whom you wish to tell and when – there is no right or wrong answer. (However, I and many others have found that having a caregiver to help manage appointments, billing, etc. can help).

Should you choose to tell others, here are some tips that I have read and/or heard from other cancer patients/survivors as well as some I have found personally helpful:

Kids:

  • It depends on the age – using simpler terms with younger kids (8 and under) may be more helpful, while older kids and teens can understand more detail. For example, saying that you’re sick and you’re getting the best care from a team of doctors who really want to help you get better
  • According to the American Cancer Society, children need to know the basics, including:
    • The name of the cancer
    • The specific body part(s) of where it is
    • How it’ll be treated
    • How their own lives will be affected
  • Think of a list of questions ahead of time that you think they may ask and jot down answers, such as how the cancer happened (that it’s not anyone’s fault), if it’s contagious, and/or if it’ll be fatal
  • Make sure that they know you are open to talking about it at any time. You can also perform check-ins with each other to monitor feelings

Family and friends:

  • Select a group of people, including immediate family and close friends
  • Divulge information only you feel comfortable sharing. Maybe it’s the basics, as mentioned above, or more detailed information
  • Prepare for different reactions, including sadness, anger, frustration, depression, anxiety, compassion, and support
  • Also prepare for people to not feel comfortable and feel as if they’re helpless. A cancer diagnosis is a heavy weight to bear, and not everyone will feel like the have the capacity to help as much as they want to
  • As the patient, tell them how you’re looking for support (ex. what are your needs during this time, including physical, emotional, mental). Guiding members of your support system to get your needs met may help them feel more at ease and able to help

Work:

  • Telling a supervisor/manager may be one of the hardest tasks for fear of discrimination
    • However, the Americans with Disabilities Act (ADA), which covers employers with 15 ore more employees, prohibits discrimination based on:
      • Actual disability
      • A perceived history of disability
      • A misperception of current disability
      • History of disability
    • The ADA also:
      • Protects eligible cancer survivors from discrimination in the workplace
      • Requires eligible employers to make “reasonable accommodations” to allow employees to function properly on the job
      • Ensure that employers must treat all employees equally
    • The Family and Medical Leave Act (FMLA) also gives you the right to take time off due to illness without losing your job
      • However, an employee must have worked for his or her employer for at least 12 months, including at least 1,250 hours during the most recent 12 months in order to qualify. The law applies to workers at all government agencies and schools nationwide as well as those at private companies with 50 or more employees within a 75-mile radius
    • The Federal Rehabilitation Act prohibits employers from discriminating against employees because they have cancer
      • However, this act applies only to employees of the federal government, as well as private and public employers who receive public funds

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