Thyroid Cancer FAQ

How does the thyroid gland work?

Thyroid hormone regulation is controlled by the pituitary gland (an endocrine gland in the skull that produces and releases hormones), specifically through thyroid-stimulating hormone (TSH):

• When thyroid hormone levels are too low, TSH stimulates the thyroid to release more;
• Conversely, when there is too much thyroid hormone in circulation, the pituitary gland inhibits thyroid activity;

Proper thyroid function depends on adequate iodine intake (a component of T3 and T4 hormones), estimated at 150 µg/day, obtained, for example, from drinking water.

Is thyroid cancer widespread?

Thyroid cancer accounts for 4% of all human cancers. Incidence has increased over the past 20 years, likely due to improved diagnostic methods. Ultrasound allows detection of small nodules previously missed.

Women are affected far more than men (a 4:1 ratio), with the most affected age group being 45-50 years old.

What are the screening tests for thyroid cancer?

There's no blood test to screen for thyroid cancer. Ultrasound is an option, but not feasible for large-scale screening.

Up to 70% of people over 50 in Western countries have thyroid nodules, but only 5% are malignant. Therefore, widespread ultrasound screening isn't recommended due to unnecessary alarm. Testing is usually only done if risk factors exist, such as family history or an enlarged gland.

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Can diet help prevent thyroid cancer?

Since nodule formation is linked to iodine deficiency, common in Europe and Westernized countries, consuming iodized salt is a primary preventative measure. Iodized salt is recommended for everyone to ensure adequate iodine intake. While excessive salt intake should be avoided, using iodized salt in moderation is advised. Other iodine-containing foods, like fish, don't provide significant amounts, so dietary changes for iodine aren't necessary.

How is thyroid cancer diagnosed and treated?

After nodule detection, a needle aspiration with cytological examination is needed to determine its nature. A sample is taken and analyzed. An experienced endocrinologist should perform the aspiration, and an experienced cytopathologist should analyze the sample.

For malignant nodules, thyroidectomy (surgical removal of the thyroid gland) is usually performed. Surgical removal of the thyroid gland. However, lobectomy (removal of a lobe) or watchful waiting (monitoring every six months for two years, then annually) might be appropriate for smaller carcinomas (<1 cm) with patient consent.

Is there a risk of metastasis with thyroid cancer?

Distant metastasis is rare (5%), but regular follow-up is essential. Thyroglobulin testing and neck ultrasound can detect if the tumor has spread beyond the thyroid to lymph nodes.

How to choose a healthcare facility for thyroid cancer treatment?

Consider the center's experience (number of thyroidectomies performed annually) and post-operative follow-up, ideally by an endocrinologist specializing in thyroid cancer or a nuclear medicine physician (if radiotherapy is needed).

When should a thyroid assessment be considered?

Thyroid assessment is advised for risk factors like family history, polygamy, or fertility issues. Thyroid dysfunction can affect pregnancy, increasing miscarriage risk and potentially leading to premature birth or low birth weight. Women with thyroid disease should receive ongoing endocrinological and gynecological care during pregnancy.

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