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Thyroid cancer

Carcinoma glandulae thyroideae · Rakovina štítné žlázy

What it is

Mostly papillary cancer, one of the most curable cancers, with follicular, medullary and the rare, rapidly fatal anaplastic forms; South Korea's ultrasound screening multiplied diagnoses fifteen-fold with no fall in deaths — mostly overdiagnosis.

Symptoms & signs

  • Painless, firm neck lump
  • swollen nodes in the neck
  • hoarseness
  • swallowing difficulty
  • rapidly growing mass (anaplastic)
  • usually found incidentally

🚩 Get help if…

  • call 112 / 911 now Noisy breathing or struggling to breathe
  • see a doctor soon Neck lump growing fast over weeks
  • see a doctor soon Hoarse voice or trouble swallowing
  • see a doctor soon Tingling lips or cramps after thyroid surgery

Where it strikes

Medical treatment

  • Ultrasound and fine-needle aspiration trials support
  • Active surveillance for low-risk papillary microcarcinoma — in Japanese cohorts few grew and none died of it trials support
  • Lobectomy for low-risk cancer; total thyroidectomy for larger or spread disease — risks voice-nerve damage and low calcium trials support
  • lifelong levothyroxine after total thyroidectomy
  • Radioactive iodine after surgery — can be omitted in low-risk cancer (ESTIMABL2) mixed evidence
  • lenvatinib or sorafenib for iodine-resistant cancer
  • selpercatinib for RET-altered thyroid cancer — approved (FDA 2020, EMA 2021)
  • dabrafenib + trametinib for BRAF-mutant anaplastic cancer — FDA-approved 2018

Natural & lifestyle

  • No thyroid screening of people without symptoms
  • avoid unnecessary neck radiation, above all in children
  • iodine sufficiency

Emerging & experimental

  • Radiofrequency ablation of small papillary cancers
  • redifferentiation drugs to restore iodine uptake

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Kelp and iodine supplements — do not treat cancer; excess disturbs thyroid function and can delay radioiodine anecdotal / traditional
  • Selenium — observational links with thyroid disease; no trial in cancer early / small studies

ICD codes