Thyroid cancer

Overview

Thyroid cancer occurs when cancer cells form in the tissues of the thyroid. People don’t usually undergo routine screenings for thyroid cancer as they may for other cancers. 

Our approach

Highlights of the advanced treatments and services offered at Northwell Health include:

  • Minimally invasive surgery, which in some cases is a same-day procedure.
  • Highly precise radiation therapy techniques such as radioactive iodine therapy.
  • Novel approaches to chemotherapy.
  • Thyroid hormone therapy to balance thyroid levels and reduce the chance of thyroid tumor growth.
  • Supportive therapies to boost the immune system, reduce pain and improve quality of life.

Multidisciplinary Thyroid Cancer Treatment

Within the first several days of a visit, the multidisciplinary team will conduct comprehensive tests and develop a personalized thyroid cancer treatment program. Each thyroid cancer diagnosis is unique, so the team meets regularly to discuss patient treatment during weekly multidisciplinary conferences where thyroid cancer experts share ideas and best practices for delivering the best possible collaborative patient care. The specialists review each treatment phase to constantly improve care and ensure treatment milestones are reached.

From diagnosis through treatment, each patient is in the capable hands of experts every step of the way. 

Symptoms

Thyroid cancer is normally discovered in patients experiencing specific symptoms such as:

  • A lump that can be felt through the skin on the neck
  • Trouble swallowing
  • Increasing hoarseness and other changes in the voice
  • Pain in the neck and throat
  • Swollen lymph nodes in the neck

Be aware that these symptoms could be due to conditions other than thyroid cancer, so it’s best to see a doctor right away.

Diagnosis

The first step in making a diagnosis of thyroid cancer is usually a physical, during which a doctor will review personal and family medical history. If thyroid cancer is suspected, the patient will be sent for additional tests.

Specialists use a variety of tests, typically outpatient procedures, to deliver an accurate thyroid cancer diagnosis:

  • Thyroid function tests — these tests determine how well the thyroid is functioning. Tests can include:
    • A blood test to measure the level of thyroid-stimulating hormone (TSH) in the blood, which helps determine thyroid function.
    • An ultrasound exam of the thyroid gland, using sound waves, to detect signs of irregularities such as growth.
    • Thyroid scans, using radioactive materials such as iodine or technetium, to find similar abnormalities.
    • Functional stimulation tests to narrow down the location of problems to the pituitary gland, the hypothalamus or the thyroid gland.
  • Chest X-ray — X-rays of the heart, lungs and surrounding tissues are taken to see if the cancer has spread.
  • Ultrasound — also known as sonography, this procedure for thyroid cancer diagnosis uses the reflected echoes of high-frequency sound waves to create images of nodules in the thyroid. This enables the doctor to identify the number and size of the nodules.
  • Ultrasound-guided biopsy — a needle, accurately guided by ultrasound, removes a small tissue sample that can be examined by a pathologist for signs of cancer.
  • CT or CAT scan (computerized axial tomography) — more detailed than an X-ray, this procedure uses a combination of X-rays and computer technology to produce detailed three-dimensional images. This test is normally used to see if the cancer has spread (metastasized) to other areas of the body and sometimes helps guide a biopsy needle.
  • MRI scan (magnetic resonance imaging) — a powerful magnet, radio waves and computer imaging combine to create highly detailed pictures of areas inside the body and shows if and where the cancer has spread.
  • PET scan (positron emission tomography) — small amounts of radioactive sugar are injected to highlight cancers and areas of infection and inflammation. For thyroid cancer diagnosis, this imaging test looks at metabolic activity within different organs of the body. Cancer cells are distinguished by higher metabolic activity.

Staging

Once a thyroid cancer diagnosis has been confirmed, the doctor will conduct one or more of the diagnostic imaging tests listed above to determine the location of the cancer and how far it has spread. This process is called staging.

The stage is based on nodule size and whether the cancer has spread to nearby tissues or other parts of the body, usually to nearby tissues in the neck or to the lymph nodes, lungs and bones.

Staging is necessary in order to design the most effective treatment plan.

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