Cancer screening exams can help find thyroid cancer at its earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. These tests are usually done when a patient is healthy and has no specific symptoms.

Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose thyroid cancer early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.

If you or anyone in your family have, or have previously been diagnosed with, familial medullary thyroid cancer, you should ask your doctor about getting a blood test to test for the gene that causes this cancer.

Thyroid Cancer Risk Factors

A risk factor is anything that increases your chances of developing thyroid cancer. The following factors may play a role in the development of thyroid cancer:

  • Being between 25 and 65 years old
  • Being female
  • Being exposed to radiation to the head and neck as a child or being exposed to radiation from an atomic bomb. The cancer may occur as soon as 5 years after exposure.
  • Having a history of goiter (enlarged thyroid)
  • Having a family history of thyroid disease or thyroid cancer
  • Having certain genetic conditions such as familial medullary thyroid cancer (FMTC), multiple endocrine neoplasia type 2A syndrome, and multiple endocrine neoplasia type 2B syndrome
  • Being Asian

(Source: National Cancer Institute)

Not everyone with risk factors will get thyroid cancer. But having certain risk factors appears to increase your risk of developing the disease. If you are at high risk for thyroid cancer, talk to your doctor about tests to find out if you have early signs of the disease.

Diagnosing Thyroid Cancer

If symptoms suggest you might have thyroid cancer, your doctor will give you a thorough physical examination and record your medical history, including information about symptoms and any risk factors you may have.

The following tests or procedures can help detect and diagnose thyroid cancer:

Physical Exam

The doctor examines the neck, thyroid, voice box and lymph nodes in the neck for unusual growths (nodules) or swelling.

Laryngoscopy

The doctor examines the voice box with a mirror or with a laryngoscope — a thin, tube-like instrument with a light and lens attached. A laryngoscopy can help the doctor see if the vocal cords, which can be affected by thyroid cancer, are functioning properly.

Blood Tests

There are a couple blood tests used to diagnose thyroid cancer:

Blood Hormone Studies

A test in which a blood sample is taken and checked to measure the amounts of certain hormones released into the blood by organs and tissues in the body. A higher or lower than normal amount of thyroid-stimulating hormone — a chemical produced by the pituitary gland in the brain — may indicate a problem. The blood may also be checked for high levels of the hormone calcitonin and antithyroid antibodies.

Blood Chemistry Tests

A sample of blood is checked for certain substances produced by the body’s organs and tissues. A higher or lower than normal amount of a substance can be a sign of disease in the organ or tissue producing it.

Imaging Tests

Imaging tests produce pictures of the inside of the body. There are several imaging tests that check for thyroid cancer. Imaging tests can also help determine the extent, or stage, of the disease.

Imaging tests may include one of the following:

Ultrasound

A test that uses sound waves and echoes to make a picture of internal organs or masses. Ultrasound can be used to estimate the size of a tumor on the thyroid and whether it is solid or fluid-filled. Ultrasound may also be used to aid in a fine-needle aspiration biopsy.

Computed Tomography Scan (CT Scan)

A type of X-ray test that produces detailed, cross-sectional images of your body.

Biopsy

A biopsy is a procedure that removes a small piece of tissue for analysis under a microscope. A pathologist will check the sample for the presence of cancer cells. A biopsy may be performed using one of the two ways below:

Fine-Needle Aspiration Biopsy of the Thyroid

A procedure in which thyroid tissue is removed using a thin needle. A pathologist will analyze the samples under a microscope and check for the presence of cancer cells.

Surgical Biopsy

A surgical procedure in which a thyroid nodule or one entire lobe of the thyroid is removed and checked by a trained pathologist for the presence of cancer.

Endocrine Biomarker
 

Staging Thyroid Cancer

If you are diagnosed with thyroid cancer, staging is a way of determining the amount and location of your cancer. Staging is a factor doctors use to help choose treatment options.

The staging classification remains the same through treatment.

Thyroid cancer is staged according to the type of disease present and the age of the patient at the time of diagnosis.

The following stages are used for papillary and follicular thyroid cancer in patients younger than 45 years:

Stage I

In stage I papillary and follicular thyroid cancer, the tumor is any size, may be in the thyroid, or may have spread to nearby tissues and lymph nodes. Cancer has not spread to other parts of the body.

Stage II

In stage II papillary and follicular thyroid cancer, the tumor is any size and cancer has spread from the thyroid to other parts of the body, such as the lungs or bone, and may have spread to lymph nodes.

The following stages are used for papillary and follicular thyroid cancer in patients 45 years and older:

Stage I

In stage I papillary and follicular thyroid cancer, cancer is found only in the thyroid and the tumor is 2 centimeters or smaller.

Stage II

In stage II papillary and follicular thyroid cancer, cancer is only in the thyroid and the tumor is larger than 2 centimeters but not larger than 4 centimeters.

Stage III

In stage III papillary and follicular thyroid cancer, either of the following is found:

    • The tumor is larger than 4 centimeters and only in the thyroid or the tumor is any size and cancer has spread to tissues just outside the thyroid, but not to lymph nodes; or
    • The tumor is any size and cancer may have spread to tissues just outside the thyroid and has spread to lymph nodes near the trachea or the larynx (voice box).

Stage IV

Stage IV papillary and follicular thyroid cancer is divided into stages IVA, IVB, and IVC.

  • In stage IVA, either of the following is found:
    • The tumor is any size and cancer has spread outside the thyroid to tissues under the skin, the trachea, the esophagus, the larynx (voice box), and/or the recurrent laryngeal nerve (a nerve with two branches that go to the larynx); cancer may have spread to nearby lymph nodes; or
    • The tumor is any size and cancer may have spread to tissues just outside the thyroid. Cancer has spread to lymph nodes on one or both sides of the neck or between the lungs.
  • In stage IVB, cancer has spread to tissue in front of the spinal column or has surrounded the carotid artery or the blood vessels in the area between the lungs; cancer may have spread to lymph nodes.
  • In stage IVC, the tumor is any size and cancer has spread to other parts of the body, such as the lungs and bones, and may have spread to lymph nodes.

The following stages are used for medullary thyroid cancer:

Stage 0

Stage 0 medullary thyroid cancer is found only with a special screening test. No tumor can be found in the thyroid.

Stage I

Stage I medullary thyroid cancer is found only in the thyroid and is 2 centimeters or smaller.

Stage II

In stage II medullary thyroid cancer, either of the following is found:

  • The tumor is larger than 2 centimeters and only in the thyroid; or
  • The tumor is any size and has spread to tissues just outside the thyroid, but not to lymph nodes.

Stage III

  • In stage III medullary thyroid cancer, the tumor is any size, has spread to lymph nodes near the trachea and the larynx (voice box), and may have spread to tissues just outside the thyroid.

Stage IV 

Stage IV medullary thyroid cancer is divided into stages IVA, IVB, and IVC.

  • In stage IVA, either of the following is found:
    • The tumor is any size and cancer has spread outside the thyroid to tissues under the skin, the trachea, the esophagus, the larynx (voice box), and/or the recurrent laryngeal nerve (a nerve with 2 branches that go to the larynx); cancer may have spread to lymph nodes near the trachea or the larynx; or
    • The tumor is any size and cancer may have spread to tissues just outside the thyroid. Cancer has spread to lymph nodes on one or both sides of the neck or between the lungs.
  • In stage IVB, cancer has spread to tissue in front of the spinal column or has surrounded the carotid artery or the blood vessels in the area between the lungs. Cancer may have spread to lymph nodes.
  • In stage IVC, the tumor is any size and cancer has spread to other parts of the body, such as the lungs and bones, and may have spread to lymph nodes.

Anaplastic thyroid cancer is considered stage IV thyroid cancer.

Anaplastic thyroid cancer grows quickly and has usually spread within the neck when it is found. Stage IV anaplastic thyroid cancer is divided into stages IVA, IVB, and IVC.

  • In stage IVA, cancer is found in the thyroid and may have spread to lymph nodes.
  • In stage IVB, cancer has spread to tissue just outside the thyroid and may have spread to lymph nodes.
  • In stage IVC, cancer has spread to other parts of the body, such as the lungs and bones, and may have spread to lymph nodes.

(Source: National Cancer Institute)

 

If you have received a thyroid cancer diagnosis, or if you want a second opinion or just want to speak to a thyroid cancer specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment. 

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