How to Diagnose Thyroid Cancer

Recognizing Symptoms of Thyroid Cancer

Check for a lump on the front of your neck. A lump in the neck is the most distinctive symptom of thyroid cancer. The lump is located low on the front part of the neck, near where the neck meets the collarbones. The lump may be visible, or you may be able to feel it when you touch your neck. See your doctor immediately if you develop a lump in your neck. In some cases, you may notice an overall swelling of the lower front part of your neck, instead of a well-defined lump. The lump may appear suddenly or grow rapidly. Most neck lumps are caused by non-cancerous conditions, such as an enlarged thyroid gland or goiter. The lump is more likely to be caused by cancer if it is hard or firm to the touch, does not move easily when touched, and grows over time. Thyroid cancer may also cause swollen lymph nodes in your neck.

Make note of pain in the front of your neck. Thyroid cancer may cause aches or pain in your neck and throat. In some cases, the pain may radiate up your neck and into your ears. See your doctor if you have neck or throat pain that: Lasts longer than a week. Is accompanied by a lump in your neck. Causes difficulty breathing or swallowing.

Watch for changes in your voice. Thyroid cancer may affect your voice, causing it to sound hoarse, weak, or different in pitch from usual. See your doctor if you experience voice changes that: Do not go away after 3 weeks, especially if you haven’t had a cold or other upper respiratory infection. Are accompanied by pain, difficulty breathing or swallowing, or a lump in your throat.

Look for difficulty swallowing. Thyroid cancer may make it difficult for you to swallow food or liquid. Swallowing may be painful, or you may experience a sensation of food being stuck in your throat. Make an appointment with your doctor if you have difficulty swallowing.

Pay attention to breathing problems. Thyroid cancer may cause your airways to feel constricted, making it difficult to breathe. See your doctor immediately if you have trouble breathing.

Get checked if you have a persistent cough. Thyroid cancer can also cause a cough that does not go away. If you have a cough that lasts more than a few weeks, especially if you have not had a cold or other upper respiratory infection recently, see your doctor.

Getting a Medical Diagnosis

Make an appointment with your doctor for an exam. If you suspect you may have thyroid cancer, schedule a visit with your primary care doctor. They will perform a physical exam and ask you questions about your symptoms and medical history. Let your doctor know if there is any history of thyroid cancers or other types of cancers in your family. Go the the doctor as soon as you notice symptoms. Do not delay treatment.

Get blood tests to check your thyroid function. If you have symptoms of thyroid cancer, your doctor will probably recommend bloodwork. These blood tests are not used to detect the cancer itself, but can rule out other thyroid disorders and check for unusual hormone or antigen levels that may be associated with thyroid cancer.

Have imaging tests done to check for thyroid tumors. Imaging tests, such as CT scans or ultrasounds, can help identify possible cancerous tissue in the thyroid. They can also help determine whether, and how far, the cancer may have spread. If your doctor suspects that you have thyroid cancer, they may order a variety of imaging tests, including: A thyroid ultrasound. An ultrasound can determine if nodules in the thyroid are fluid-filled or solid. Solid nodules are more likely to be cancerous. A radioiodine scan. For this type of scan, your doctor will inject you with a small amount of radioactive iodine, or ask you to swallow it in pill form. A special camera then detects concentrations of radioactivity in your thyroid. “Cold” areas (with low radiation) may be cancerous. A CT, MRI, or PET scan. These types of scans create detailed images of internal organs. They can be useful for detecting tumors in the thyroid, as well as cancer that may have spread beyond the thyroid.

Get a biopsy to detect cancer cells in your thyroid. If other tests show that thyroid cancer is likely, your doctor will order a biopsy to make the final diagnosis. This involves taking a small piece of tissue from the thyroid for laboratory testing. The most common type of thyroid biopsy is fine needle aspiration (FNA). FNA biopsies can typically be performed in the doctor’s office under local or no anesthesia. The doctor will insert a fine needle into 3-4 points on the suspected tumor and pull a small amount of tissue into a syringe. The FNA may need to be repeated if the samples do not contain enough cells for a clear diagnosis. If the diagnosis is still unclear after a second FNA test, your doctor may recommend a surgical biopsy or lobectomy, in which some of your thyroid tissue is surgically removed under general anesthesia.

Talk to your doctor about treatment options, if necessary. If you are diagnosed with thyroid cancer, you will need to talk to your doctor about what to do next. Your doctor will refer you to a team of specialists who deal with cancer and thyroid conditions. Appropriate treatment depends on the type of thyroid cancer you have and how far it may have spread. Common treatments include: Surgery to remove part or all of the thyroid. Sometimes it is necessary to remove affected lymph nodes, as well. Radioactive iodine treatment. This is usually used together with surgery to destroy any remaining cancerous cells. Radiation therapy. This treatment is typically used if surgery and radioactive iodine therapy are ineffective. Targeted therapies, in which the cancer is treated directly with medications that destroy or slow the growth of cancer cells. Thyroid hormone replacement medications. Since many thyroid cancer treatments destroy or damage the thyroid itself, you will need to take supplements to replace the hormones produced by the thyroid.

Assessing Your Risk of Thyroid Cancer

Note the connection between sex, age, and thyroid cancer. Thyroid cancer is 3 times more likely to occur in people who are biologically female than in people who are biologically male. The likelihood of being diagnosed with thyroid cancer also depends on your age. Women are usually diagnosed with thyroid cancer in their 40s-50s, while men are usually diagnosed in their 60s-70s. The risk of age can vary based on the type of thyroid cancer. Papillary thyroid cancer, which is the most common type, can occur at any age while the most aggressive form, anaplastic thyroid cancer, is more common in people over the age of 60.

Look at the history of thyroid cancer in your family. You may be at increased risk of developing thyroid cancer if someone else in your family has had it. The risk is especially high if one of your parents, a sibling, or your child has been diagnosed with thyroid cancer. Certain types of thyroid cancer, such as medullary thyroid cancer and familial non-medullary thyroid carcinoma, tend to run in families. About 25% of people with medullary thyroid cancer (MTC) inherit the disease. If your family has a history of this type of thyroid cancer, you can get a DNA test to see if you have the gene for it.

Find out if you have other genetic risk factors. Certain kinds of genetic mutations and syndromes can increase your chances of developing thyroid cancer. You may be at risk of developing thyroid cancer if you have been diagnosed with: Familial adenomatous polyposis (FAP). Cowden disease. Carney complex, type I.

Examine your history of thyroid conditions. People who have had other thyroid conditions, such as an inflamed thyroid or goiter, may have a higher risk of developing thyroid cancer. However, there is no increased risk associated with an overactive or underactive thyroid.

Determine if you have a history of radiation exposure. Past exposure to radiation can increase your risk of developing thyroid cancer. People who received medical radiation treatments to the head and neck when they were children may be particularly at risk. You may also be at risk if you were ever exposed to radioactive fallout, e.g., from a nuclear weapon or a nuclear powerplant accident.

Make sure you get enough iodine in your diet. Having an iodine deficiency may increase your risk of getting thyroid cancer. Most people in the US get plenty of iodine in their diets. However, if you live in a part of the world where iodine deficiency is common, or if you suspect you may have an iodine deficiency, talk to your doctor about adding more iodine to your diet.