2. INTRODUCTION
• THYROID GLAND IS A SMALL, BUTTERFLY-SHAPED GLAND
• LOCATED AT THE FRONT OF THE NECK UNDER SKIN .
• IT'S A PART OF ENDOCRINE SYSTEM AND CONTROLS MANY OF BODY'S
IMPORTANT FUNCTIONS BY PRODUCING AND RELEASING (SECRETING)
CERTAINTHE .
• THYROID GLAND CONSISTS 2 LOBES LOCATED ON EITHER SIDE OF THE
WINDPIPEIT.
• IS PRODUCES HORMONES THAT REGULATE THE BODY'S METABOLIC
RATE, GROWTH AND DEVELOPMENT.
• IT PLAYS A ROLE IN CONTROLLING HEART, MUSCLE AND DIGESTIVE
FUNCTION, BRAIN DEVELOPMENT AND BONE MAINTENANC.
3. CANCER OF THE THYROID GLAND –EPIDEMIOLOGY
• THYROID CANCER IS A RARE FORM OF CANCER ACCOUNTING FOR LESS THAN 1%
OF ALL CANCER CASES IN THE UK.
• IT'S MOST COMMON IN PEOPLE AGED 35 TO 39 YEARS AND IN THOSE AGED 70
YEARS OR OVER.
• WOMEN ARE 2 TO 3 TIMES MORE LIKELY TO DEVELOP THYROID CANCER THAN
MEN.
IT'S UNCLEAR WHY THIS IS, BUT IT MAY BE A RESULT OF THE HORMONAL CHANGES
ASSOCIATED WITH THE FEMALE REPRODUCTIVE SYSTEM
4. TYPES OF THYROID CANCER
• THERE ARE 5 MAIN TYPES OF THYROID CANCER:
• 1)PAPILLARY THYROID CANCER DEVELOPS FROM FOLLICULAR CELLS
AND USUALLY GROW SLOWLY. IT IS THE MOST COMMON TYPE OF
THYROID CANCER. IT IS USUALLY FOUND IN 1 LOBE. ABOUT 10% TO 20%
OF PAPILLARY THYROID CANCER APPEARS IN BOTH LOBES. IT IS A
DIFFERENTIATED THYROID CANCER, MEANING THAT THE TUMOR LOOKS
SIMILAR TO NORMAL THYROID TISSUE UNDER A MICROSCOPE. PAPILLARY
THYROID CANCER CAN OFTEN SPREAD TO LYMPH NODES
5. • 2)FOLLICULAR THYROID CANCER
• ALSO DEVELOPS FROM FOLLICULAR CELLS AND USUALLY GROWS
SLOWLY. FOLLICULAR THYROID CANCER IS ALSO A DIFFERENTIATED
THYROID CANCER, BUT IT IS FAR LESS COMMON THAN PAPILLARY
THYROID CANCER.
• FOLLICULAR THYROID CANCER AND PAPILLARY THYROID CANCER ARE
THE MOST COMMON DIFFERENTIATED THYROID CANCERS.
• THEY ARE VERY OFTEN CURABLE, ESPECIALLY WHEN FOUND EARLY AND
IN PEOPLE YOUNGER THAN 50. TOGETHER, FOLLICULAR AND PAPILLARY
THYROID CANCERS MAKE UP ABOUT 95% OF ALL THYROID CANCER.
6. • 3) HURTHLE CELL CANCER ALSO CALLED HURTHLE CELL CARCINOMA,
IS CANCER THAT IS ARISES FROM A CERTAIN TYPE OF FOLLICULAR CELL.
• HURTHLE CELL CANCERS ARE MUCH MORE LIKELY TO SPREAD TO LYMPH
NODES THAN OTHER FOLLICULAR THYROID CANCERS.
• 4)MEDULLARY THYROID CANCER DEVELOPS IN THE C CELLS AND IS
SOMETIMES THE RESULT OF A GENETIC SYNDROME CALLED : MULTIPLE
ENDOCRINE NEOPLASIA TYPE 2 (MEN2) .
7. • 5)ANAPLASTIC THYROID CANCER
• THIS TYPE IS RARE, ACCOUNTING FOR ABOUT 1% OF THYROID CANCER.
• IT IS A FAST-GROWING, POORLY DIFFERENTIATED THYROID CANCER
THAT MAY START FROM DIFFERENTIATED THYROID CANCER OR A
BENIGN THYROID TUMOR.
• ANAPLASTIC THYROID CANCER CAN BE SUBTYPED INTO GIANT CELL
CLASSIFICATIONS. BECAUSE THIS TYPE OF THYROID CANCER GROWS SO
QUICKLY, IT IS MORE DIFFICULT TO TREAT SUCCESSFULLY.
8.
9. RISK FACTORS
• THE MAIN RISK FACTORS FOR DEVELOPING THYROID CANCER ARE :
• 1)GENDER:WOMEN ARE DIAGNOSED WITH 2 OF EVERY 3 THYROID
CANCER.
• 2)AGE:THYROID CANCER CAN OCCUR AT ANY AGE, BUT ABOUT TWO-
THIRDS OF ALL CASES ARE FOUND IN PEOPLE BETWEEN THE AGES OF 20
AND 55. ANAPLASTIC THYROID CANCER IS USUALLY DIAGNOSED AFTER
AGE 60.
• 3)GENETICS: SOME TYPES OF THYROID CANCER ARE ASSOCIATED WITH
GENETICS. BELOW ARE SOME KEY FACTS ABOUT THIS DISEASE, GENES,AND
FAMILY HISTORY.
• 4)RADIATION EXPOSURE: EXPOSURE TO MODERATE LEVELS OF RADIATION
TO THE HEAD AND NECK MAY INCREASE THE RISK OF PAPILLARY AND
10. SYMPTOMS AND SIGNS
• THYROID CANCER CAN CAUSE ANY OF THE FOLLOWING SIGNS OR
SYMPTOMS
• 1)A LUMP IN THE NECK, SOMETIMES GROWING QUICKLY.
• 2)SWELLING IN THE NECK.
• 3)PAIN IN THE FRONT OF THE NECK, SOMETIMES GOING UP TO THE EAR
• 4)HOARSENESS OR OTHER VOICE CHANGES THAT DO NOT GO AWAY
• 5)TROUBLE SWALLOWING
• 6)TROUBLE BREATHING
• 7)A CONSTANT COUGH THAT IS NOT DUE TO A COLD
11. STAGES OF THYROID CANCER
• THE THYROID CANCER STAGING CLASSIFICATION SYSTEM IS VERY SIMILAR FOR
OLDER PATIENTS WITH DIFFERENTIATED TUMORS AND FOR THOSE WITH
MEDULLARY THYROID CANCER. AGE IS NOT A CONSIDERATION WHEN
CLASSIFYING MEDULLARY CANCERS.
• STAGE 1 :THE TUMOR IS 2 CM OR SMALLER (LESS THAN AN INCH WIDE), AND
HAS NOT GROWN OUTSIDE THE THYROID. IT HAS NOT SPREAD TO NEARBY
LYMPH NODES OR DISTANT SITES.
• STAGE 2:BETWEEN 2 AND 4 CM WITHOUT EVIDENCE OF EXTRA THYROIDAL
DISEASE
• STAGE 3:THE TUMOR IS LARGER THAN 4 CM, BUT THE TUMOR DOES NOT
EXTEND BEYOND THE THYROID GLAND.
• STAGE 4:THE TUMOR IS ANY SIZE AND HAS EXTENDED BEYOND THE THYROID
12. DIAGNOSIS
• 1)PHYSICAL EXAMINATION:THE DOCTOR WILL FEEL THE NECK, THYROID GLAND,
THROAT, AND LYMPH NODES IN THE NECK FOR UNUSUAL GROWTHS OR
SWELLING. IF SURGERY IS RECOMMENDED, THE LARYNX MAY BE EXAMINED AT
THE SAME TIME WITH A LARYNGOSCOPE, WHICH IS A THIN, FLEXIBLE TUBE WITH A
LIGHT.
• 2)BLOOD TESTS:
• THYROID HORMONE THIS TEST TO FIND OUT THE LEVELS OF (T3) AND (T4) IN THE
BODY.
• THYROID-STIMULATING HORMONE (TSH).
• 3)ULTRASOUND: AN ULTRASOUND USES SOUND WAVES TO CREATE A PICTURE OF
THE INTERNAL ORGANS
13. • 4)BIOPSY:A BIOPSY IS THE REMOVAL OF A SMALL AMOUNT OF TISSUE FOR
EXAMINATION UNDER A MICROSCOPE , ONLY A BIOPSY CAN MAKE A
DEFINITE DIAGNOSIS.
A BIOPSY FOR THYROID NODULES WILL BE DONE IN 1 OF 2 WAYS:
• FINE NEEDLE ASPIRATION
• SURGICAL BIOPSY
• 5)MOLECULAR TESTING OF THE NODULE SAMPLE.
• 6)X-RAY
• 7)CT SCAN: USED TO EXAMINE PARTS OF THE NECK THAT CANNOT BE
SEEN WITH ULTRASOUND
14. • TREATMENT
• :1) SURGERY:IT IS THE MAIN TREATMENT ,SURGICAL OPTIONS INCLUDE:
• LOBECTOMY: REMOVES THE LOBE OF THE THYROID GLAND WITH THE
CANCEROUS NODULE
• NEAR-TOTAL THYROIDECTOMY:ALSO CALLED SUBTOTAL THYROIDECTOMY,
THIS IS SURGERY TO REMOVES MOST OF THE THYROID GLAND. A SMALL
AMOUNT OF THYROID TISSUE REMAINS.
• TOTAL THYROIDECTOMY :REMOVES THE ENTIRE THYROID GLAND.
• 2)HORMONE TREATMENT : THYROID HORMONE REPLACEMENT IS
LEVOTHYROXINE 3)RADIOACTIVE IODINE THERAPY
• 4)THERAPIES USING MEDICATION: CHEMOTHERAPY AND TARGETED THERAPY
15. • TREATMENT OPTIONS BY STAGE
• STAGE 1AND 2 SURGERY, HORMONE THERAPY, POSSIBLE RADIOACTIVE IODINE
THERAPY AFTER SURGERY
• STAGE 3: SURGERY, HORMONE THERAPY, POSSIBLE RADIOACTIVE IODINE
THERAPY OR EXTERNAL- BEAM RADIATION THERAPY AFTER SURGERY
• STAGE 4: SURGERY, HORMONE THERAPY, RADIOACTIVE IODINE THERAPY,
EXTERNAL-BEAM RADIATION THERAPY, TARGETED THERAPY, AND
CHEMOTHERAPY.
• RADIATION THERAPY MAY ALSO BE USED TO REDUCE PAIN AND OTHER
PROBLEMS.
16. • FOLLOW-UP CARE
• 1)PHYSICAL EXAMS AND MEDICAL TESTS YOUR FOLLOW-UP CARE MAY INCLUDE
REGULAR PHYSICAL EXAMINATIONS, MEDICAL TESTS, OR BOTH.
• 2)OTHER FOLLOW-UP TESTS MAY INCLUDE A CHEST X-RAY, AN ULTRASOUND OF
THE NECK, A FULL- BODY SCAN, OR OTHER IMAGING TESTS.
• 3)TESTS FOR LONG-TERM SIDE EFFECTS BASED ON THE TYPE OF TREATMENT
RECEIVED
• 4)BREAST CANCER SCREENING YOUNG WOMEN WHO ARE TREATED FOR
PAPILLARY OR FOLLICULAR THYROID CANCER HAVE A HIGHER RISK OF
DEVELOPING BREAST CANCER IN THE FUTURE.
