How do I Know if I Have Thyroid Cancer?

Thyroid cancer is especially scary because it rarely causes significant symptoms and often happens in young people. Specifically for young women, thyroid cancer is one of the most common types of cancer. Because it strikes at a busy time of life, it can be easy to discount the mild symptoms that you might be feeling. So let's consider what symptoms you might have, and then how you will diagnose your nodule as a cancer in the end.

First, thyroid nodules are usually the first manifestation of a thyroid cancer. That is because a nodule is just a swelling within the thyroid gland that is separate/distinct from the normal thyroid tissue. The good news is that most nodules are benign. The bad news is that thyroid nodules are very common (more than 50% of the US population), and a significant portion of them (usually about 5%) are cancer. So if you notice a swelling in the base of your neck, think thyroid and get it checked out with your doctor.

Hoarseness is another symptom that can be associated with thyroid cancer, but it is usually a late-stage symptom. Because the nerve that moves the voice box (known as the recurrent laryngeal nerve, or RLN) is next to the thyroid, inflammation from cancer or even the cancer itself can cause voice changes. These should not be ignored, even though they are rarely directly caused by cancer. If you lose your voice completely when you have a thyroid nodule near the nerve, and if your voice doesn't recover fully, it can be especially concerning.

People often ask if thyroid labs will demonstrate that a person has thyroid cancer, and the answer is that they rarely show cancer. That is because the cancerous tissue usually doesn't produce much thyroid hormone, and the rest of the thyroid is usually able to compensate for this part of the thyroid that isn't working. While an overactive thyroid is less likely to be due to cancer than an underactive thyroid, people with overactive thyroid disease (especially Graves' disease) may be more likely to have thyroid cancer. And that cancer may be more aggressive.

Finally, swallowing problems can sometimes be associated with thyroid cancer. Usually, these swallowing problems are related to issues other than the thyroid, but we can't always tell. For that reason, we will often try other solutions (or non-surgical reasons) to address swallowing before immediately moving to thyroid surgery. However, if you notice that your swallowing has become very problematic in a relatively short period of time and you have a thyroid nodule that is suspicious, it can be a sign of a more aggressive cancer.

Other symptoms, such as fatigue, weight loss, brain fog and the other common thyroid symptoms are rarely directly correlated with thyroid cancer. But we do find them from time to time.

So how do you actually learn that you have thyroid cancer? It starts with an ultrasound which is then followed by a fine needle aspiration biopsy (FNA) if you nodule is suspicious. While there are other types of biopsy that can be done, the safest and most reproducible is the FNA. It is especially valuable when this is done with a cytologist (a type of pathologist who specializes in thyroid or needle biopsies) is on site to evaluate the specimen in real-time. As leaders in thyroid care, at the Russell Center we are proud to be able to offer rapid on site evaluation (ROSE) to our patients, a technique that improves accuracy and decreases the need for repeat biopsies in the future.

If you have learned that you have thyroid cancer, you will want to make sure that you learn about all of the treatment options, including non-surgical and minimally invasive thyroid surgery techniques. The Russell Center for Endocrine Health is a world leader in minimally invasive thyroid and parathyroid surgery, with Dr Jon Russell having completed more "scarless" thyroid surgeries than any other doctor in the United States. Because we specialize in all of these newer techniques, we are able to offer a customized treatment plan that can help you reach your goals. Call today if you are worried about thyroid cancer or have questions about your thyroid nodule.