Thyroid Cancer Awareness Month: Gland becomes real pain in my neck

Thyroid cancer is sometimes detected by a lump on the neck big enough to feel or see, as AJC content producer Nancy Clanton found out.After an ultrasound and biopsy, she had her thyroid removed on September 13.You should expect swelling, with Clanton's worst occurring three days after surgery.Papillary thyroid cancer — her diagnosis — is the most common type, making up about 80% of all cases of thyroid cancer.People can live without a thyroid, so removal is the usual course of treatment

I know Thyroid Cancer Awareness Month is nearly over, but I have a good excuse for being tardy. I was preoccupied with finding a lump on my thyroid, getting an ultrasound, getting a biopsy and then having the “butterfly gland” removed.

I haven’t finished my treatment for breast cancer — for which I had a lumpectomy last September — but that didn’t stop thyroid cancer from setting up house in the gland at the base of my neck.

What does the thyroid do?

Your thyroid makes two main hormones — thyroxine (T-4) and triiodothyronine (T-3) — that support the rate at which the body uses fats and carbohydrates, help control body temperature, have an effect on heart rate, and help to control how much protein your body makes.

On the back side of the thyroid are four parathyroid glands, which control the amount of calcium in your blood. I now have only two.

Despite all this, I found out the hard way, you can live without it. Mine was removed September 13. All of it. I now get these hormones from medication, and I get calcium from over-the-counter supplements.

According to the American Thyroid Association, about one in every eight women will suffer from thyroid illness during their lifetime. (Andrey Popov/Dreamstime/TNS)

Credit: TNS

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Credit: TNS

Thyroid cancer

Unlike the tumor in my breast, which was the size of a grain of rice, I could both see and feel my thyroid lump. I’ve had hypothyroidism — an underactive gland — for years, so I knew that’s where the problem was.

My breast cancer oncologist, Dr. Kristina Bowen at Georgia Cancer Specialists, suggested an ultrasound, which found nodules. “Nodules,” I learned from Dr. Michael Maggart, who performed my biopsy at Emory University Hospital, are fairly common in women my age. In fact, one nurse said more women my age (57) have nodules than don’t have them.

Most thyroid nodules aren’t serious, according to the Mayo Clinic. They can be solid or filled with liquid (mine were both), and only a small percentage of them are cancerous.

I wasn’t feeling optimistic, however, and a biopsy confirmed my fears.

Papillary thyroid cancer — my diagnosis — is the most common type, making up about 80% of all cases of thyroid cancer, according to the Columbia Thyroid Center. There are more than 20,000 new cases each year.

Thyroid cancer is now the fastest growing cancer diagnosis in the United States, more than doubling since the 1970s, according to Clayman Thyroid Center. It is the fourth most common cancer in women, affecting us three times more often than it does men.

“Part of the increasing rate of thyroid cancer is that we’ve gotten so good at detecting it through imaging like ultrasounds and CT scans,” Dr. Rashmi Roy, senior thyroid surgeon at the Clayman Thyroid Center, said in a press release. “And that’s important, because as is true with all cancers, early detection is key.”

Although most people have no symptoms and the cancer is found during another exam, there are some signs to look for:

  • Lump or mass in the neck
  • Feeling like you need to swallow something
  • A cough that won’t go away
  • Change in voice
  • Bad fatigue
Thyroid cancer is often detected by a lump that is big enough to be seen or felt. 
Photo by Nancy Clanton / nancy.clanton@ajc.com

Credit: Photo by Nancy Clanton / nancy.clanton@ajc.com

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Credit: Photo by Nancy Clanton / nancy.clanton@ajc.com

Treatment

The most common treatment for thyroid cancer is a thyroidectomy — surgical removal of one or both lobes of the gland.

To access the gland, surgeons make an incision on the front of your neck. They do their best to cut along a natural crease, so any scarring will be hardly noticeable once it heals.

Surgery usually lasts two to 2½ hours, depending on what the doctor finds once they open you up. My cancer was more involved than the ultrasound revealed, resulting in not just the removal of my thyroid and two parathyroid glands, but also requiring my left vocal cord be severed because the cancer was entangled with it.

My surgeon, Dr. Neil Saunders, and nurses all assured me vocal therapy could help restore my voice, but it was unnecessary. I was talking during recovery and sounded nearly normal in a few days. This might not be your experience, however.

An upside — if you can call it that — to thyroid cancer is I won’t have to go through chemotherapy or radiation this time around. Those treatments are seldom needed after thyroid surgery.

Conclusion

Like any other cancer, be vigilant if you notice something out of the ordinary. If caught early, the five-year survival rate for thyroid cancer in the United States is 98%, according to cancer.net.