What are the early symptoms of thyroid cancer?

Written by Yan Chun
Oncology
Updated on November 02, 2024
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Thyroid cancer is a common malignant tumor in the head and neck area. The early symptoms of thyroid cancer are highly atypical, and many patients do not present clear early symptoms. Often, patients discover painless nodules in the thyroid incidentally during physical examinations; these nodules can move up and down with swallowing motions. In a minority of cases, when the nodules of early-stage thyroid cancer are large, they can cause hoarseness or coughing and choking when drinking water. Some patients might experience intermittent, hidden pain in the thyroid area during the early stages, which often resolves on its own without treatment. Besides these, in its early stages, thyroid cancer may not present other obvious symptoms. As the condition progresses, significant clinical symptoms appear only when the tumor invades surrounding structures or metastasizes to distant sites.

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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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Written by Gong Chun
Oncology
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Thyroid cancer ultrasound manifestations

The characteristics of ultrasonography for thyroid cancer include the tumor being a solid hypoechoic mass with unclear boundaries, uneven internal echoes, abundant internal blood flow, and the presence of sandy calcifications and longitudinal growth, among others. Currently, ultrasonography is the preferred method for examining thyroid nodules. It can clearly identify the number, nature, and location of thyroid nodules, as well as whether there are any abnormally enlarged lymph nodes in the neck. Ultrasonography is highly accurate in differentiating the nature of thyroid nodules, with experienced ultrasonographers reaching an accuracy rate of over 80%. However, the highest accuracy in differentiating the nature of thyroid nodules is still achieved with fine-needle aspiration cytology.

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Written by Gong Chun
Oncology
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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.

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Written by Gan Jun
Endocrinology
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Is thyroid swelling malignancy the same as thyroid cancer?

Thyroid malignancy refers to thyroid cancer, but even malignant thyroid cancer generally has a good prognosis. However, it is crucial to achieve early detection, diagnosis, and treatment. It is advised to promptly visit a thyroid specialty department for comprehensive examinations, including thyroid ultrasound, evaluation of thyroid function, and related thyroid antibodies. A fine needle aspiration biopsy should be conducted for a clear pathological diagnosis, followed by immediate active treatment, primarily surgical. Thyroid cancer includes papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, and undifferentiated cancer. The surgery mainly involves minimally invasive and traditional methods. Post-surgery, it is recommended to perform lymph node dissection, assess the extent of metastasis, and decide whether to proceed with Iodine-131 radiotherapy. Due to the loss of thyroid function, proactive thyroid hormone replacement therapy is advised, along with dynamic monitoring of thyroid health through ultrasound and related examinations.

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Written by Cui Fang Bo
Oncology
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Is thyroid cancer without lymph node metastasis considered early stage?

Thyroid cancer, if it has not metastasized to lymph nodes, generally falls under early-stage. Once thyroid cancer is diagnosed, surgical removal is the primary treatment choice. Postoperative treatments vary depending on the different pathological types of thyroid cancer. For the most common type, papillary carcinoma, if the surgery is radically curative, further treatment may not be necessary, and merely supplementing thyroid hormones suffices. In cases such as follicular carcinoma, undifferentiated carcinoma, or medullary carcinoma, even after surgically radical removal, postoperative treatment often requires further radiotherapy or treatment with Iodine-131, depending on the surgical pathology results. (The use of medications should be carried out under the guidance of a professional doctor.)