Is Thyroid Isthmus Cancer Different?

When you learn that you have thyroid cancer, there are a few pieces of information that are important. One of the most important is the location of your thyroid cancer. Just like in real estate, location of a thyroid cancer can be one of the most important things. And isthmus thyroid cancer is a specific location that can impact your treatment options and even how aggressive your specific thyroid cancer is. In this article, we will review 5 things that you should know about thyroid isthmus cancer.

1- The isthmus is the narrow part in the middle of your thyroid that connects the two lobes. In the analogy of the butterfly, the isthmus is the body. Because it is small and lies directly over the trachea, or windpipe, nodules or isthmic thyroid cancers can be more visible. This can be a good thing, because it can be easy to diagnose a thyroid cancer at an earlier stage.

2- Thyroid cancer in the isthmus can be more likely to spread. This is likely because the drainage of the thyroid isthmus to the surrounding lymph nodes is different than it is in the sides of your thyroid, and also because there is not as much thyroid tissue in the isthmus. This can be one reason that thyroid isthmus cancers can be considered to be more aggressive in some cases.

3- Treatment of thyroid isthmus cancer can be harder or it can be easier, and it can require more surgery or less surgery than a similar thyroid cancer that is not in the thyroid isthmus. While this can seem counterintuitive, it makes more sense when you consider the anatomy: smaller thyroid isthmus cancers can sometimes be treated by only removing the central part of the thyroid, leaving both thyroid lobes (both wings of the butterfly). In this situation, thyroid hormone levels and thyroid function are less likely to be affected. On the other hand, larger isthmus cancers are more likely to involve both thyroid lobes, and require a total thyroidectomy.

4- Innovative options are often available for thyroid isthmus cancers. While radiofrequency ablation (RFA) isn't perfect for all isthmus thyroid cancers, some thyroid cancers that are identified early might be eligible for RFA. At the same time, some of these small isthmus thyroid cancers may be eligible for a very focused surgery which can be completed without a scar (or even with a simultaneous thyroid rejuvenationTM).

5- You need to find a doctor who can offer you all of the treatment options. One thing that we commonly see at the Russell Center is that patients were recommended a total thyroidectomy by another doctor for their thyroid isthmus cancer. We are pleased that we can often provide alternative options and choices.

If you have questions about a thyroid isthmus cancer or a thyroid isthmus nodule, reach out and let us know how we can help!