The thyroid gland

                                                                     
                                                                             

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The T3 and T4 hormones help regulate the body’s metabolic rate. Excess T3 and T4 will make you feel overactive and you may lose weight. If you do not have enough of these hormones you will feel sluggish and you may gain weight.
 

Calcitonin helps control blood calcium levels. Calcium is a mineral that performs a number of important functions, such as building strong bones.
 

Types of thyroid cancer
 

There are four main types of thyroid cancer. They are:
 

• papillary carcinoma – this is the most common type, accounting for four out of five cases; it usually affects people under 40 years of age, particularly women

• follicular carcinoma – accounts for around one in 10 cases of thyroid cancer and tends to affect older adults

• medullary thyroid carcinoma – accounts for around one in 20 cases; unlike the other types of thyroid cancer, medullary thyroid carcinoma can run in families

• anaplastic thyroid carcinoma – is the rarest and most aggressive type of thyroid cancer, accounting for one in 100 cases; most cases affect older people aged 60-80 years
   

Papillary and follicular carcinomas are sometimes known as differentiated thyroid cancers (DTCs), and they are often treated in the same way.
 

Causes of the thyroid cancer
 

In most cases, the cause of thyroid cancer is unknown. However, there are risk factors that can increase your chances of developing the condition.

The five main risk factors for developing thyroid cancer are:

• thyroid conditions

• radiation exposure

• inherited genetic mutations

• diet

• gender
   

Inherited genetic mutations
 

The two types of inherited condition where the mutation occurs are:

• familial medullary thyroid cancer (FMTC) – which affects many family members

• multiple endocrine neoplasia (MEN) syndrome, types 2A and 2B – where family members can develop a number of different endocrine tumors including medullary thyroid cancer.
   

If one of your parents has a history of medullary thyroid carcinoma or MEN syndrome, you should consider having a blood test to find whether you have the mutated genes. If your test results are positive, it will usually be recommended that your thyroid gland is surgically removed as a precaution.
 

Diet
 

If your diet contains low levels of the trace element, iodine, you are at increased risk of developing thyroid cancer.
 

Gender
 

Women are around two-and-a-half times more likely to develop thyroid cancer than men. It is thought this may be due to hormones released during a woman’s monthly period or during pregnancy. However, there is little scientific evidence to support this theory.
 

Symptoms of thyroid cancer
 

In its early stages, thyroid cancer tends to cause no or very few symptoms. The main symptom of cancer of the thyroid is a lump or swelling at the front of the neck just below your Adam’s apple, which is usually painless. Sometimes, the lymph nodes in your neck can also be affected and become swollen. Other symptoms of thyroid cancer only tend to occur after the condition has reached an advanced stage. These symptoms may include:

• unexplained hoarseness

• difficulty swallowing

• difficulty breathing

• pain in your neck
   

You should always visit National Oncology Center of Azerbaijan Head and Neck Department if you develop a swelling or lump at the front of your neck.
 

Goiters

A goiter is an enlarged thyroid gland. The thyroid gland can become enlarged due to one or more multiple swellings (nodules) within the gland.Non-cancerous goiters are usually caused by other, less serious problems with your thyroid gland, such as the thyroid gland:

• producing too much of the triiodothyronine (T3) and thyroxine (T4) hormones – this is known as having an overactive thyroid gland or hyperthyroidism

• not producing enough T3 and T4 hormones – this is known as having an underactive thyroid gland or hypothyroidism
   

Thyroid Blood test
 

The most common cause of swelling in the neck is either an overactive thyroid gland (hyperthyroidism) or an underactive thyroid gland (hypothyroidism). A thyroid blood test will help confirm or rule out these conditions. A thyroid blood test measures the amount of certain types of hormones in blood (Usually T3, T4, TSH, Anti-TPO, Anti-TG)
 

Ultrasound scan
 

Ultrasound scans is very useful way of detecting any changes or abnormalities inside your neck like nodules and recurrent cancer. Also ultrasound is used to control if the nodule is growing.
 

Recurrence
 

Cancerous cells will return in an estimated 5-20% of people with a history of thyroid cancer. Approximately 10-15% of people will experience a return of cancerous cells in other parts of their body, such as their bones. Also, it is very important to diagnose the thyroid cancer at early stage.
 

Outlook
 

Papillary and follicular carcinomas tend to be slow-growing and relatively straightforward to treat and have a good prognosis.

Medullary thyroid carcinoma is harder to treat. This type of thyroid cancer does not respond to iodine treatment.

Due to its aggressive nature, the outlook for anaplastic thyroid carcinoma is very poor. Fewer than one in 10 people will live at least five years after being diagnosed, with the average survival time being eight months.
 

Treating thyroid cancer
 

• surgery to remove your thyroid gland (thyroidectomy)

• a type of radiotherapy called radioactive iodine treatment, designed to destroy any remaining cancer cells and prevent the thyroid cancer returning
   

Replacement hormone therapy
 

After radioactive iodine treatment is completed, you will be prescribed an alternative hormone tablet called thyroxin, which most people only need to take once a day.You will need to have regular blood tests to check you are receiving the right amount of hormones, and to determine whether your dose needs to be adjusted.
 

Calcium levels
 

Occasionally, the parathyroid glands can be affected during surgery. The parathyroid glands are located close to the thyroid gland and help regulate the levels of calcium in your blood. If your parathyroid glands are affected during surgery, your calcium levels may decrease, which can cause a tingling sensation in your hands, fingers, lips and around your nose.These symptoms should be reported to your Doctor as you may need to take calcium supplements.
 

Radioactive iodine treatment
 

After having thyroid surgery and confirmation of cancer, a course of radioactive iodine treatment is recommended. This will help destroy any remaining cancer cells in your body and prevent the cancer returning. You should not take Thyroxin for at least 4 weeks and the TSH level should be minimumabove 30 for the treatment to be successful.
 

Dietary recommendations
 

While having radioactive iodine treatment, you will need to eat a diet low in iodine. It is recommended that you:
 

• avoid all seafood

• limit the amount of dairy products you eat

• do not take cough medicines or use sea salt because they both contain iodine
   

Eat plenty of fresh meat, fresh fruit and vegetables, and pasta and rice. They are all low in iodine.