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The thyroid gland is at the base of the throat just above the collarbone. It is thumb-size and shaped like a butterfly, with a lobe on the right and left sides of the trachea. As part of the endocrine system, it produces hormones that help regulate blood pressure, metabolism, heart rate, weight, and body temperature.
Thyroid cancer is a type of cancer that begins in the thyroid gland and can spread to nearby tissues and other areas of the body.
In Colorado, there are an estimated 710 new cases diagnosed annually and fewer than 50 deaths.
Thyroid cancer five-year relative survival rates vary depending on the type of thyroid cancer, how far the cancer has spread, age and overall health, how well it responds to treatment, and other factors.
However, the two most common types of thyroid cancer, papillary and follicular, have encouraging five-year relative survival rates. For papillary thyroid cancer, the rate is near 100 percent, and is 98 percent for follicular.
The rates are lower in instances in which the cancer spreads to distant parts of the body, such as the bones, but still are 76 percent for papillary and 64 percent for follicular.
The CU Cancer Center is the only National Cancer Institute Designated Comprehensive Cancer Center in Colorado and one of only four in the Rocky Mountain region.
The Cancer Center is home to a variety of specialists with expertise in treated thyroid cancer. The CU Endocrinology Thyroid Program, with a nationally recognized team specializing in the evaluation and management of thyroid cancer, that provides innovative, personalized care – from diagnosis through treatment of advanced disease.
Experts in the Endocrine Thyroid Program use on-site advanced technology to offer cutting-edge evaluation, and are part of a multi-disciplinary approach to providing comprehensive, state-of-the-art treatment options. The CU Cancer Center hosts several multi-discipliinary clinics for patients with thyroid cancer, including joint surgical and endocrinology clinics for earlier stage disease, and combined medical oncology and endocrinology clinics for patients wth advanced cancers.
The program also features UCH Thrive, a clinical program for patients with thyroid cancer who are stable or in remission. It emphasizes overall health and well-being, shifting the focus from active cancer treatment to monitoring disease stability.
Our clinical partnership with UCHealth has helped lead to thyroid cancer survival rates higher than the Colorado average for all stages of thyroid cancer.
There are two main types of cells in the thyroid gland:
This distinction is important because different cancers can develop in each cell type. That impacts how serious the cancer is and how it’s treated.
The main types of thyroid cancer are papillary, follicular, medullary, and anaplastic.
As with most types of cancer, scientists have identified several risk factors that make a person more likely to develop thyroid cancer. Some of these factors can’t be changed and some can. Among the risk factors that can’t be changed are:
Among the risk factors for thyroid cancer that may be changed are:
A particular concern with thyroid cancer is that it often doesn’t cause early symptoms or signs. Sometimes it may be found during a routine physical exam, while other time signs and symptoms don’t occur until the tumor has grown. Consult your doctor if you experience:
If you have any of these symptoms, speak with your doctor right away. Many of these signs and symptoms also can indicate non-cancerous conditions, but it’s important to see your doctor so their cause can be diagnoses and treated, if necessary.
Generally, one of the first steps your physician will take is to get a complete medical history. This may include questions about your family history, risk factors, symptoms, and other health concerns or problems. If someone in your family has had thyroid cancer, you may be at increased risk.
Your physician also will complete a physical exam to get more information about the signs and symptoms of thyroid cancer you may be experiencing, as well as any other health problems. The exam may include special attention to the size and firmness of your thyroid and the lymph nodes in your neck.
This may be followed by different tests, including:
A biopsy is used to make the actual thyroid cancer diagnosis. It is one of the most common ways to determine whether a nodule or lump on the thyroid gland is cancerous, and usually is done via fine-needle aspiration (FNA).
Your doctor may inject local anesthesia into the skin over the nodule before performing the biopsy, but often this isn’t necessary. Then, your doctor will use a thin, hollow needle to take some cells and fluid from the nodule. These are then sent to a lab to determine whether they are cancerous or benign. Biopsies generally are performed on nodules that are big enough to feel through the skin.
Lab tests of biopsy samples
Sometimes doctors will order molecular tests on cell and fluid samples taken during the biopsy. These may be to look for changes in certain genes related to thyroid cancer, or to see if existing cancer cells have changes in certain genes.
Your doctor won’t use blood tests to find thyroid cancer, but may use them to determine whether your thyroid gland is working like it should be. The results of blood tests may help your doctor determine whether other tests are needed.
After you have received a thyroid cancer diagnosis, your doctor will next work to determine the type of thyroid cancer and whether or how far the cancer has spread, a process called staging. The different stages help describe not only how much the cancer has spread and how much of it there is in your body, but also help determine the best way to treat it.
Staging is generally determined by the size of the tumor, whether it has spread to nearby lymph nodes and whether it has spread to distant organs.
Staging for thyroid cancer is determined by the type of thyroid cancer and the age of the patient
For patients younger than 55 with papillary or follicular thyroid cancer:
For patients 55 and older with papillary or follicular thyroid cancer:
For patients of all ages with anaplastic thyroid cancer, which grows quickly and is considered a stage IV thyroid cancer:
For patients of all ages with medullary thyroid cancer:
Currently there are six standard treatments for thyroid cancer, and the course of treatment that will be most effective may be determined by type and stage of thyroid cancer, your general health, and other factors.
If it hasn’t spread to distant parts of the body, thyroid cancer generally responds very well to treatment. If the cancer can’t be completely eradicated, a goal of treatment may be to destroy or remove as much cancer as possible and keep it from growing, spreading, or returning.
Surgery is the most common treatment for thyroid cancer. This could include:
Radiation therapy is a cancer treatment in which high-energy x-rays or other radiation are used to kill cancer cells or keep them from growing. There are two different kinds of radiation that can be used to treat thyroid cancer. Radioactive iodine is given by mouth to treat intermediate or high risk papillary or follicular thyroid cancers after surgery. . External beam uses x-rays to treat cancers.
It may be given after surgery to kill any cancer cells that weren’t removed during surgery.
Chemotherapy is a cancer treatment that kills cancer cells, or stops them from dividing, with drugs that enter the body either through the bloodstream or by being placed directly into an organ, body cavity, or the cerebrospinal fluid. Chemotherapy is rare used to treat thyroid cancer.
Thyroid hormone therapy is a cancer treatment that either removes certain hormones or blocks their usual actions and stops cancer cells from growing. In this therapy, drugs are used to prevent the body from making thyroid-stimulating hormone, which helps lower the risk of the thyroid cancer returning or continuing to grow.
Targeted therapy is a treatment that uses drugs or other substances to identify and attack cancer cells. Targeted therapy is generally less harmful to normal cells than chemotherapy and radiation. There are two types of targeted therapy:
Watchful waiting means closely monitoring a patient’s signs and symptoms without treatment, and reassessing if those signs and symptoms change.
At any given time, the UCCC offers a wide variety of clinical trials for patients with thyroid cancer.
The University of Colorado (CU) Cancer Center partners with UCHealth, Children’s Hospital Colorado, and Rocky Mountain Regional VA to provide clinical care. Please make an appointment with one of our clinical partners to be seen by a CU Cancer Center doctor.