Is thyroid cancer curable? Symtoms and Treatment

Thyroid cancer is one of the most common cancers in Vietnam, accounting for 1-2% of all cancers. The prognosis of the disease depends on the stage of the tumour, the degree of malignancy of the tumour cells and the age of the patient.

The article is advised by Dr Phung Thi Phuong Chi

1. What is thyroid cancer?

Thyroid cancer is a disease that occurs when thyroid cells grow abnormally, out of control of the body. The thyroid is a butterfly-shaped endocrine gland located in the middle of the neck, composed of two lobes on either side connected by the isthmus of the thyroid gland. The thyroid gland secretes many hormones, mainly thyroxine (T4), responsible for regulating the body's metabolism, growth and development.

Types of thyroid cancer:

• Papillary thyroid cancer: Cancer originates from follicular cells, accounts for 70-80% of the total cases, has a slow progression.
• Follicular thyroid cancer: Accounts for 10-15% of people with the disease has a faster progression rate than papillary thyroid cancer.
• Medullary thyroid cancer: Sporadic, accounting for about 5-10% of genetics and endocrine problems cases.
• Undifferentiated thyroid cancer: Rare, accounting for less than 2% but is a dangerous type, challenging to treat because it is often diagnosed late when cancer has metastasized.
• Lymphoid thyroid cancer: This type is scarce.

2. Thyroid cancer symptoms

Thyroid cancer often has no typical clinical symptoms in the early stages. As cancer cells grow, several signs may appear:

• Appearance of thyroid nodules, which are complex, moving with a swallowing rhythm or large lump, fixed in front of the neck.
• Enlarged, mobile or adherent lymph nodes in the neck area
• Hoarseness of voice.
• Feeling of swallowing
• Shortness of breath if the tumour invades the trachea.
• Neck skin infiltrate, bleeding ulcers.

3. Causes of thyroid cancer

It is not clear what causes the changes in thyroid cells. However, some of the following factors can increase the risk of thyroid cancer, including:

(1) Immune system disorder

When the immune system disrupts, producing antibodies to help fight the invasion of viruses and bacteria decreases. It creates an opportunity for harmful bacteria and viruses to attack the body, causing many dangerous diseases, including thyroid cancer.

(2) Radiation contamination

It can radioactively contaminate the body in childhood when using radiation to treat diseases or through the digestive tract, respiratory tract due to radioactive iodine.

(3) Genetic factors

About 70% of people with thyroid cancer have a close family member: father, mother or sibling who has had the disease.

About 2 out of 10 cases of medullary thyroid cancer MTCs are related to genetic factors. These cases may be isolated or associated with another disease. When combined with other tumours of the endocrine glands called multiple endocrine neoplasia syndrome (MEN2) caused by mutations in the RET gene. This form of cancer usually appears in childhood and young people, spreading very early.

Other genetic factors also increase the risk of thyroid cancer, such as familial adenomatous polyposis syndrome (which link to colon cancer) and Cowden's disease (which also increases the risk of uterine and breast cancers). Carney syndrome (which increases the risk of papillary and follicular thyroid cancers). Papillary thyroid cancer is often associated with familial factors, especially first-generation involvement.

(4) Age

Patients with thyroid cancer are mainly between the ages of 30 and 50. In particular, women are 2-4 times more likely to get the disease than men. The cause is hormonal changes in women, such as during pregnancy, that stimulate the formation of goitre, thyroid nodules.

(5) Thyroid disease

Subjects with goitre, thyroiditis, Basedow's disease, or hypothyroidism have a higher risk of thyroid cancer than healthy individuals.

(6) Side effects of some drugs

Doctors often prescribe patients with thyroid disease to take radioactive iodine, which is one of the causes of an increased risk of thyroid cancer.

(7) Other risk factors

• The body lacks iodine due to diet
• Overweight and obesity.

4. Diagnosis of thyroid cancer

Thyroid cancer diagnoses through medical interventions:

• Disease symptoms, clinical examination and assessment of the nature of the tumour in the thyroid gland, and whether there are accompanying cervical lymph nodes.
• Thyroid colour ultrasound: Reconstructing the thyroid gland's image helps the doctor assess the spite of the disease.
• Blood test: Measure the level of TSH (thyroid-stimulating hormone) to see if the thyroid gland is working correctly, early diagnosis of thyroid disorders.
• Fine needle aspiration cytology (FNA): Precious method in diagnosing benign or malignant tumours.

5. Is thyroid cancer curable?

Compared with many other types of cancer, the prognosis for thyroid cancer is often better because of its low malignancy. The disease has a high cure rate; 98% of cases are cured if detected early and treated correctly.

In Vietnam, 80-90% of thyroid cancers are differentiated cancers. With this type of cancer, the doctor will perform surgery, treatment with radioactive iodine 131 to destroy cancer cells. After that, with regular follow-up and physical examination, the patient can live well for many decades.

Assoc. Prof. Dr Ngo Thanh Tung, Director of the National Radiation Therapy Center, in charge of the hospital's nuclear medicine department, said: "There are patients with lung metastatic thyroid cancer who still cure, after 5-6 years. just relapsed".

Prognosis of thyroid cancer by stage:

• Stage I: The 5-year survival rate is 100%.
• Stage II: The 5-year survival rate is from 98 – 100%.
• Stage III: The 5-year survival rate is 71-93%.
• Stage IV: The 5-year survival rate is 28 – 51%.

Regarding the treatment of the disease, depending on the type of thyroid cancer, the stage of the disease, the age and the health status of the patient, the doctor will prescribe the appropriate treatment method.

• Thyroidectomy: Removal of a lobe into the isthmus of the thyroid gland or the entire thyroid gland. If cancer cells have spread to the cervical lymph nodes, the doctor will recommend surgery to remove the whole lymph node around the thyroid gland.
• Radiotherapy with radioactive iodine: The doctor gives the patient a small dose of radioactive iodine to kill cancer cells, usually prescribed after the patient has removed the entire thyroid gland.
• Endocrine therapy: Supplementing deficient hormone levels secreted by the thyroid gland after total thyroidectomy or radioactive iodine treatment.
• External radiation therapy: Using high-energy ionizing radiation rays to kill cancer cells.
• Chemotherapy: Using drugs to kill cancer cells.
• Targeted treatment: Only affects cancer cells, does not destroy benign cells. It is a treatment method indicated when the disease is at an advanced stage.

After finishing treatment, patients should actively visit every 3 months for the first two years, every 6 months for the next 3 years and once a year in the following years to prevent thyroid cancer from returning. Besides, it is necessary to build a healthy lifestyle, eat scientifically, regularly practice sports and strictly follow the instructions of the doctor (if any).

🎯 Detecting thyroid cancer at an early stage is an essential ineffective treatment. Therefore, when abnormal signs suspecting thyroid cancer, it is necessary to visit an early examination for timely diagnosis. In particular, each person should actively screen for cancer periodically, especially the group of people after the age of 30, who are at high risk of disease to best prevent the disease.

✅ Currently, CarePlus Clinic is implementing a thyroid cancer screening package with in-depth examination items including Clinical consultation, fine needle aspiration (FNA), thyroid colour ultrasound with the Latest equipment, blood tests.

It helps to detect early risk factors and changes in cellular DNA that can lead to thyroid cancer. It is the basis to help patients have timely treatment, increase the chance of cure in the early stages, avoid severe progression, making treatment complicated and expensive.

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Register for Thyroid Cancer Screening Package HERE