In Spain, between 4,000 and 5,000 cases of thyroid cancer are diagnosed per year, although the forecast for 2022 according to the latest study presented by the Spanish Society of Medical Oncology (SEOM) is around 6,000 people.
It predominantly affects women between the ages of 30 and 50, although it is usually more severe in men with a worse prognosis.
Five-year overall survival is around 96.9%, always being able to vary depending on factors such as local stage, age, type of cancer and whether there is metastasis.
In most patients, the specific reason why cancer develops is not known, although the only supported factor is exposure to ionizing radiation due to environmental pollution or therapeutic irradiation.
What causes thyroid cancer?
Thyroid cancer is a malignant growth or tumor that is located within the thyroid gland . The thyroid is a butterfly-shaped gland that is located at the base of the neck.
Its main function is to produce, store, and release thyroid hormones into the blood. To do this, it needs iodine, which we must provide through the diet.
These hormones are vital because they are involved in the development of the nervous system , regulate metabolism and are necessary to control the functions of all the organs of our body (control heart rate, cholesterol concentration, use of glucose, maintenance of body temperature , muscle strength, etc.).
Thyroid cancer is caused when there is an alteration in the DNA of the cells, producing a change or mutation in them. This alteration may be due to uncontrolled cell growth or loss of cell ability.
This lack of control in the cells and in excess, can favor the formation of a mass or tissue that receives the name of tumos. There are benign and malignant tumors that we can classify:
-
Benign tumors that are not cancer and the cells do not invade other parts of the body and that can usually be removed and also do not usually appear again. We call them adenomas.
-
Malignant tumors that are cancers where cells can invade nearby tissues or spread to other parts of the body. We call them carcinomas.
How does thyroid cancer manifest?
The symptoms of thyroid cancer are mostly minor. The main one is a lump or nodule that in most cases is asymptomatic and is positioned on the throat.
Other symptoms that can alert you that you have a thyroid problem and that it is essential that you go to an endocrinologist would be:
-
A lump above the trachea or in an area of the neck.
-
Pain in the neck, jaw or ear.
-
Difficulty swallowing or pain when swallowing.
-
Difficulty breathing in a particular position.
-
Hoarseness.
-
Chronic cough that is not associated with a cold.
-
Sensation of pressure in the throat when you wear a tie, closed-neck garments.
-
Symptoms that indicate a dysfunction of the thyroid gland.
These symptoms may simply derive from the existence of the lump or nodule in the thyroid. However, this does not imply that the nodule is malignant. The important thing is to recognize these symptoms to go to your endocrine .
Thyroid cancer and surgery
Surgical intervention is one of the main options within a diagnosis of thyroid carcinoma. In addition, this will significantly condition the patient’s evolution and prognosis.
The objective of the intervention is to eliminate or stop the disease and prevent the spread of cancer to neighboring and/or distant organs. Being a potentially curative option.
There are up to 6 types of surgical interventions, but the most common is the total thyroidectomy, which consists of the total removal of the thyroid gland.
What is the risk of thyroid surgery?
The risks of thyroidectomy are the same as those of any surgical intervention under general anesthesia and wound infection, hematoma, prolonged pain in the area operated on, or alterations in the healing of the surgical wound could occur, but this is not frequent.
There are other more complex complications that can occur due to damage or removal of other tissues or structures of the neck, such as dysphonia and hypocalcaemia.
One of the most recurring questions is in relation to the use of our voice after an operation. There is the recurrent laryngeal nerve that is in contact with the thyroid. It is thin, often branched, and exhibits many anatomical variations.
In some cases this can cause a transient aphonia or a change in the voice that disappears between two and ten weeks. The probability of permanent nerve injury is low.
In these cases, it will be indicated to go to treatment with speech therapy and it is often recovered because the vocal cord that is in perfect condition ends up supplying the functions of the one that has been damaged, with which you will be able to recover your voice. Follow-up should be done by an Otorhinolaryngologist.
The president of the Spanish Association of Thyroid Cancer, Aranzazu Sáez Sánchez comments that “ all patients undergoing a thyroidectomy can have temporary or permanent sequelae, the two most frequent being dysphonia, there may even be an injury to the nerve responsible for modulating the vocal cords and need rehabilitation therapy, luckily it is an infrequent sequel, the vast majority of operated patients can speak the same day of surgery.
The surgery lasts an average of 2 to 6 hours depending on the extent of the thyroid cancer. On the other hand, and if all goes well, patients who have undergone an operation for thyroid cancer in 24-48 hours can be at home with a fairly bearable postoperative period.
According to the president of AECAT, she refers to the importance of “being treated with an expert multidisciplinary team in thyroid cancer, since the more specialization, the less risk of sequelae. And as patients, having information about our pathology helps control the fears and doubts that we all have at diagnosis”
Thyroid cancer patients have a continuous follow-up for what could be considered a chronic disease since they depend for life, on check-ups and imaging tests and analyzes because they depend on an oral hormone that they have to constantly monitor (levothyroxine)
Bibliographic references:
Spanish Thyroid Cancer Association. 2022. Thyroid Cancer. https://www.aecat.net/el-cancer-de-tiroides/
Ten John. 2019. Post-surgical hypoparathyroidism: A disorder of growing interest among endocrinologists. https://www.elsevier.es/es-revista-endocrinologia-diabetes-nutricion-13-articulo-hypoparatiroidismo-postquirurgico-un-disorder-of-interest-S2530016419301466
Spanish Society of Medical Oncology. 2022. Cancer figures in Spain https://seom.org/images/LAS_CIFRAS_DEL_CANCER_EN_ESPANA_2022.pdf
Vidaurri-Ojeda, AC, Gómez-Hernández, J., Chávez-Hernández, MM, González-Fondón, A., & Jiménez-Báez, MV (2022). Thyroid cancer: Clinical characterization and concordance of diagnostic tests. Health Quintana Roo, 9(33), 11-17.
