Thyroid cancer

Thyroid cancer is cancer that's found in the thyroid gland. It's quite rare in the UK.

What is thyroid cancer?

• Thyroid cancer is cancer that's found in the thyroid gland.
• The thyroid gland is a small gland in the front, lower part of your neck. It makes and releases hormones that help with things like your digestion, muscles and heart.
• Thyroid cancer is quite rare in the UK. Women are more likely to get it than men.
• How serious thyroid cancer is depends on the type of thyroid cancer, how big it is, if it has spread and your general health.

Symptoms of thyroid cancer

Main symptoms of thyroid cancer

Symptoms of thyroid cancer include:

• a lump in the front, lower part of your neck – the lump usually feels hard, slowly gets bigger and is not painful
• a hoarse voice
• a sore throat
• difficulty swallowing or breathing
• pain in the front of your neck, or a feeling like something is pressing against your neck

Other symptoms can include:

• a red face (flushing) – this may be harder to see on brown or black skin
• softer poos or diarrhoea
• weight loss
• a cough

If you have a thyroid condition, such as a goitre (swollen thyroid), you may get symptoms like these regularly.

You might find you get used to them. But it's important to be checked by a GP if your symptoms change, get worse, or do not feel normal for you.

See a GP if:

• you have a lump in your neck – either a new lump or an existing lump that's getting bigger
• you've had a hoarse voice, sore throat or cough for more than 3 weeks
• you have pain in the front of your neck, or a feeling like something is pressing against your neck

Important

These symptoms are very common and can be caused by many different conditions.

Having them does not definitely mean you have thyroid cancer. But it's important to get them checked by a GP.

This is because if they're caused by cancer, finding it early may mean it's easier to treat.

What happens at the GP appointment

The GP may feel your neck and might arrange for you to have a blood test.

Referral to a specialist

You may get an urgent referral for more tests or to see a specialist in hospital if the GP thinks you have symptoms that could be cancer. This does not definitely mean you have cancer.

Causes of thyroid cancer

Who is more likely to get thyroid cancer

Anyone can get thyroid cancer. It's not always clear what causes it.

You might be more likely to get it if:

• you're a woman and have not been through the menopause
• you have a condition that affects the thyroid such as a swollen thyroid (goitre), Hashimoto's disease or nodules (non-cancerous lumps) in or on your thyroid
• you have a brother, sister, parent or child who has had thyroid cancer
• you were exposed to a lot of radiation or had radiotherapy treatment in the past, especially if it was when you were a child
• you've had certain cancers before such as breast cancer, oesophageal cancer, testicular cancer or non-Hodgkin lymphoma

Many thyroid cancers are also linked to your lifestyle.

How to lower your chance of getting thyroid cancer

You cannot always prevent thyroid cancer. But making healthy changes can lower your chances of getting it and other types of cancer.

Do

• try to lose weight if you are overweight

• try to cut down on alcohol – avoid drinking more than 14 units a week

• try to quit smoking

It's important to get any symptoms of thyroid cancer checked by a GP.

Tests and next steps for thyroid cancer

Main tests for thyroid cancer

If the GP refers you to a specialist, you may need more tests and scans to check for thyroid cancer.

Tests you may have include:

• blood tests
• an ultrasound scan of your neck
• taking a small sample from your thyroid gland using a needle (biopsy), to be checked for cancer

You may not have all these tests.

Getting your results

It can take up to 2 weeks to get the results of your tests.

Try not to worry if your results are taking a long time to get to you. It does not definitely mean anything is wrong.

You can call the hospital or GP if you are worried. They should be able to update you.

A specialist will explain what the results mean and what will happen next. You may want to bring someone with you for support.

If you're told you have thyroid cancer

Being told you have thyroid cancer can feel overwhelming. You may be feeling anxious about what will happen next.

It can help to bring someone with you to any appointments you have.

A group of specialists will look after you throughout your diagnosis, treatment and beyond.

Your team will include a clinical nurse specialist who will be your main point of contact during and after treatment.

You can ask them any questions you have.

Macmillan Cancer Support has a free helpline that's open every day from 8am to 8pm.

They're there to listen if you have anything you want to talk about.

Call 0808 808 00 00.

Treatment for thyroid cancer

Main treatments for thyroid cancer

Thyroid cancer is often treatable.

The treatment you have will depend on:

• the size and type of thyroid cancer you have
• if it has spread
• your general health

It will usually include surgery. It may also include hormone therapy, radioactive iodine treatment, targeted medicines, radiotherapy or chemotherapy.

The specialist care team looking after you will:

• explain the treatments, benefits and side effects
• work with you to create a treatment plan that's best for you
• help you manage any side effects

You'll have regular check-ups during and after any treatments. You may also have tests and scans.

If you have any symptoms or side effects that you're worried about, talk to your specialists. You do not need to wait for your next check-up.

Surgery

Surgery is the most common treatment for thyroid cancer.

Depending on the type and stage of the cancer, you may have:

• all of your thyroid removed (total thyroidectomy)
• part of your thyroid removed (partial thyroidectomy or lobectomy)

During surgery you may also have some lymph nodes (glands) in your neck removed if your cancer has or might have spread to them.

Hormone therapy

If you've had surgery to remove your thyroid, you usually need to take hormone tablets to replace the hormones your thyroid made.

It can also help stop the cancer coming back.

You may also need to take hormone tablets if you've had part of your thyroid removed.

Radioactive iodine treatment

Radioactive iodine treatment uses radiation to kill cancer cells.

The treatment contains a small amount of radiation that you take as a tablet or drink.

You may have radioactive iodine treatment for thyroid cancer:

• after surgery to kill any cancer cells that may have been left behind or to help stop the cancer coming back
• if the cancer has come back or spread to another part of the body

Targeted medicines

Targeted medicines aim to stop cancer growing.

You may have treatment with targeted medicines for thyroid cancer if:

• other treatments are not an option or are no longer working
• the cancer has spread to another part of the body

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells.

You may have radiotherapy for thyroid cancer if:

• the cancer cannot be removed by surgery
• the cancer has spread to another part of the body

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

It's not usually used to treat thyroid cancer, but you may have it if the cancer has come back or has spread to another part of your body.

What happens if you've been told your cancer cannot be cured

If you have advanced thyroid cancer it might be very hard to treat. It may not be possible to cure the cancer.

If this is the case, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.

Finding out the cancer cannot be cured can be very hard news to take in.

You will be referred to a special team of doctors and nurses called the palliative care team or symptom control team.

They will work with you to help manage your symptoms and make you feel more comfortable.

The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.