Thyroid gland is situated in the front of the neck, most of it on the two sides of the larynx. Its secretion pours directly into the bloodstream and regulates among many other things, the metabolism of the body.
The swelling of the thyroid, is more often due to other causes than the cancer, iodine deficiency and goitre being the commonest. Cancer of the thyroid occurs mostly in older people. Its association with chronic thyroiditis particularly Hashimoto’s disease is well confirmed.
Cause(s)
It is not known. Its association with chronic thyroid inflammation particularly Hashimoto’s disease is well known.
Symptoms
A nodular swelling or a generalized swelling of the thyroid producing prominence of the veins in the neck.
Diagnosis
Routine: Blood: Hb, TLC, DLC, ESR, may be normal.
Special: X-ray of the neck.
Ultra-sound examination of the thyroid to see whether the swelling is solid or contains liquid and so may be a cyst. Thyroid scan to see whether any area is inactive and so suspicious of cancer. Needle biopsy of the swelling and its histological examination. This reveals the type of cancer as well.
Additional: X-ray of the chest and suspected bone, to see whether there is spread of the cancer over there.
Treatment
Surgery: The involved part of the thyroid is removed and also the surrounding normal area.
Some part of the normal gland is left intact in order to make available the thyroid secretions needed by the body. Danger to laryngeal nerves is there during surgery, which can make a person hoarse.
Radiation: In cancers, which are very fast growing, radiation keeps in check the growth, and may be the spread of the cancer to other parrs of the body.
If the cancer has spread to some part and can be localised, radiation over the area helps to keep in check its growth.
Chemotherapy: The results of chemotherapy are not very satisfactory. Adriamycin helps in only in 20 per cent of the cases.
Prognosis
It is usually a slow-growing cancer, and chances of cure through surgery at an early stage are good. Fast-growing, fast-spreading cancers carry a bad prognosis. An analysis of the post-operative follow-up shows that, on the whole, the prognosis of cancer of the thyroid is good, if treated early and properly.
Early Detection
Signs & Symptoms
· Gradual increase in swelling of the thyroid gland in the neck.
Investigations
· Thyroid scan to see whether any area is inactive and so suspicious.
· Needle biopsy of the swelling and its histological examination.