How is thyroid cancer caused?

Written by Gong Chun
Oncology
Updated on September 27, 2024
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The causes of thyroid cancer are similar to those of most other malignancies. The etiology of thyroid cancer is not yet clear, but some factors are found to be associated with its occurrence: The first is neck radiation. The thyroid is an endocrine organ, sensitive to radiation. Radiation exposure can potentially cause thyroid cells to become cancerous, especially in those who received high doses of neck radiation in childhood and are more susceptible to thyroid cancer. The second factor is genetics; some thyroid cancers have a clear genetic predisposition, the most typical being medullary thyroid cancer. The third point is that the rapid increase in the incidence rate of thyroid cancer is partly due to the advancement in early diagnostic techniques, allowing for the detection of many early-stage lesions. Of course, iodine intake has already been shown to be related to some benign thyroid conditions. However, its relationship with thyroid cancer requires further study.

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The Differences between Thyroiditis, Hyperthyroidism, and Thyroid Cancer

Thyroiditis, hyperthyroidism, and thyroid cancer are clinically distinct conditions. Thyroiditis refers to inflammatory changes in the thyroid, either autoimmunity-related, suppurative or due to inflammation. Hyperthyroidism broadly refers to a functional change, which can result from various thyroid changes caused by diseases, including external damage and inflammation, leading to symptoms of hyperthyroidism. However, these manifestations should not be confused with each other, with the latter more closely related to autoimmune thyroiditis. Thyroid cancer, on the other hand, is a malignant alteration that also occurs in the thyroid gland but is not closely related to thyroiditis or hyperthyroidism. Generally, thyroid cancer is malignant, while thyroiditis and hyperthyroidism are benign, chronic conditions.

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What are the early symptoms of thyroid cancer?

The most common clinical symptom of thyroid cancer in its early stages is an abnormal lump in the neck. Additionally, some patients may experience symptoms related to abnormal thyroid function. Thyroid cancer is currently a malignant tumor with a relatively high incidence rate globally and in China. There are four pathological types of thyroid cancer: papillary carcinoma, follicular carcinoma, undifferentiated carcinoma, and medullary carcinoma. Among these, papillary carcinoma is the most common and has the best prognosis. For patients presenting with an abnormal neck lump and thyroid function abnormalities, the diagnosis of thyroid cancer should be considered. Diagnosis can be confirmed through tissue obtained by biopsy or surgical excision for pathological examination. For patients with confirmed diagnoses of thyroid cancer, surgery is the preferred treatment method.

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Written by Gan Jun
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Is a hypoechoic area definitely thyroid cancer?

A thyroid nodule underwent an ultrasound B-examination and showed hypoechoic features, but this does not necessarily indicate thyroid cancer. It is essential to conduct relevant tests to determine the cause. For such thyroid nodules, it is first important to check their specific size. If there is concern about the presence of a malignant tumor, it is advisable to perform a fine needle aspiration for pathological examination to confirm the diagnosis. If the thyroid nodule exceeds one centimeter and causes local pain or affects surrounding blood vessels, leading to symptoms of compression, it is recommended that patients should promptly undergo surgical removal for treatment.

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Written by Gong Chun
Oncology
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How is thyroid cancer diagnosed?

The first point is the diagnostic process for differentiated thyroid cancer. Initially, most patients may not have symptoms, while a minority might show symptoms due to invasion of surrounding organs. Ultrasound examination is the preferred method for diagnosing thyroid nodules. Ultrasound can clarify the number, nature, and location of thyroid nodules, as well as provide information on whether there are abnormally enlarged lymph nodes in the neck. It has a relatively high accuracy in identifying the nature of thyroid nodules. Currently, the most accurate test for determining the nature of thyroid nodules remains the fine needle aspiration cytology, which has a diagnostic sensitivity of 83-92% and specificity of 80-92%, but it is not 100% conclusive. The second point is about the diagnosis of medullary thyroid cancer. Besides the tests common for thyroid cancers, additional tests for medullary thyroid cancer can include fine needle aspiration, ultrasound, and some serological tests, such as calcitonin and carcinoembryonic antigen tests.

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Symptoms of thyroid cancer

The symptoms of thyroid cancer, the first point is the clinical manifestations of differentiated thyroid cancer. Most differentiated thyroid cancers are asymptomatic, with only occasional palpable nodules of varying sizes and textures, which can sometimes be detected in routine physical and imaging examinations. A few advanced thyroid cancers may produce noticeable symptoms due to large nodules or invasion of surrounding organs, such as compression of the trachea causing breathing difficulties, difficulty swallowing due to pressure on the esophagus, and hoarseness due to compression of the recurrent laryngeal nerve. The second point concerns the specific clinical manifestations of medullary thyroid carcinoma. The specific symptoms of medullary thyroid cancer include persistent watery diarrhea, not accompanied by severe malabsorption in the large intestine, often with facial flushing, some endocrine syndromes, and some associated conditions such as pheochromocytoma, multiple mucosal neuromas, and parathyroid adenomas.