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 Gan Jun
Endocrinology
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Does hypothyroidism lead to thyroid cancer?

Hypothyroidism and thyroid cancer are two different types of thyroid diseases; hypothyroidism does not cause thyroid cancer, and there is no necessary connection between the two. Hypothyroidism refers to a decrease in thyroid function levels, caused by abnormalities in the secretion and synthesis functions of the thyroid, closely related to disorders of the endocrine system. In contrast, thyroid cancer is a change in tissue nature due to malignant transformation in thyroid tissue cells, it is not related to the thyroid's endocrine functions, and currently, there is no research indicating that hypothyroidism increases the likelihood of developing thyroid cancer. Patients with thyroid diseases should undergo dynamic thyroid ultrasonography and monitoring of thyroid function to further clarify their condition.

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Written by Gong Chun
Oncology
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Early symptoms of thyroid cancer

Differentiated thyroid cancer often has no symptoms in the early stages, with only incidental palpation of nodules of various sizes and textures on the front of the neck. Some patients may find abnormalities during routine physical examinations through imaging studies, and symptoms may appear only in the later stages. The second point concerns the characteristics of medullary thyroid cancer, which exhibits specific symptoms early on, such as persistent, watery diarrhea. Additionally, this cancer involves an endocrine syndrome, where tumor cells secrete calcitonin and adrenocorticotropic hormone, potentially leading to facial flushing, elevated blood pressure, and reduced blood calcium. This may be associated with other conditions such as pheochromocytoma, multiple mucosal neuromas, and parathyroid adenomas, which can also cause corresponding symptoms.

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Written by Gan Jun
Endocrinology
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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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Written by Chen Xie
Endocrinology
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What are the clinical manifestations of thyroid cancer?

For patients with thyroid cancer, the most common clinical manifestation is thyroid nodules, and most patients do not have obvious clinical symptoms, only being incidentally discovered during physical examinations. In rare cases, patients may seek medical attention due to enlarged cervical lymph nodes. As the condition progresses, the neck mass gradually enlarges, becomes firmer, and its mobility decreases during swallowing. In some rapid developments, it may invade surrounding tissues, leading to late-stage symptoms such as hoarseness, difficulty breathing, and difficulty swallowing. When the cervical sympathetic nerve is compressed, it can cause pain in the ears, occipital region, and shoulders. In the case of medullary carcinoma, which can produce serotonin and calcitonin, patients may sometimes experience symptoms such as diarrhea, palpitations, facial flushing, or decreased blood calcium levels.