Understanding Thyroid Cancer
- A new population-based study, led by Cedars-Sinai investigators, is suggesting that the overdiagnosis of thyroid cancer, a disease actress Sofia Vergara beat more than two decades ago, continues to be a “crucial unresolved public issue” across the the U.S. as survival rates have not increased.
- The study found that the annual incidence rate of the disease per 100,000 people more than doubled from 1975 to 2009, and authors of the study suggest the need for active surveillance.
- Thyroid cancer is a disease that begins in the thyroid gland, which is at the base of the neck. The cancer will often present itself as a large bump (tumor) in the neck, and symptoms of thyroid cancer can be mistaken for a common cold.
- Chances of cancer recovery increase significantly with early detection, so it’s important to address any new or unusual symptoms you’re experiencing with your doctor promptly.
- Coping with a diagnosis or some other stressor in your life can be an emotional experience that affects your mental health. Psychiatrist Dr. Lori Plutchik suggests people facing these challenges tap into their support group to help navigate their emotions.
Results from the population-based study, which was led by Cedars-Sinai investigators, reveals new insight that the disease is overdiagnosed and despite a push in screenings and treatment, survival rates have not increased.
Read MoreThe study authors note that the reported increase was more prevalent in women between the ages of 40–69 years and men ages 50 to 79 years old.
Senior author of the study, Zachary Zumsteg, MD, associate professor of Radiation Oncology and Biomedical Sciences at Cedars-Sinai Cancer said in a statement, “Many studies have established that the incidence of thyroid cancer has dramatically increased for at least four decades, but the probability of dying of thyroid cancer has remained exactly the same.
“This means we are diagnosing and treating many cancers that would do no harm despite recent efforts to reduce overdiagnosis.”
Explaining further, Dr. Zumsteg said, as per Cedars Sinai, “People visiting the doctor in 1975 were less likely to receive imaging than those visiting the doctor in 2019.
“So today doctors are finding thyroid nodules that would not have been detected in previous decades, leading to more biopsies and diagnoses of small, slow-growing thyroid cancers that might not require treatment.”
He added, “Our analysis found that in 1975, the probability of being diagnosed with thyroid cancer was basically the same in people of all ages.
“Over time, the increase has been concentrated in women ages 40-69 and men ages 50-79. This especially affected women, who tend to interface with the medical system more often than men.”
Meanwhile, Dr. Allen Ho, MD, Director of the Head and Neck Cancer Program at Cedars-Sinai in Los Angeles, who previously spoke with SurvivorNet about HPV and Cancer Risk, addressed how “active surveillance” may help in thyroid cancer cases. He is leading a Cedars-Sinai clinical trial on this matter.
“The hope is that these [clinical] trials will make clinicians and patients more comfortable with active surveillance and that updated clinical guidelines will bring the practice into widespread use,” Dr. Ho explained.
“If current trends continue, we will continue to overdiagnose thyroid cancer and to needlessly treat patients—doing more harm than good.”
Sophia Vergara’s Battle With Thyroid Cancer
Vergara, who married actor Joe Manganiello in 2015 and finalized her divorce from him last year, found a lump in her neck by chance back in 2000.
Her family has a history of thyroid cancer, which affects how your body uses blood sugar, so she had taken her son to get checked out early for diabetes.
“While we were there, the doctor wanted to check me, too, and he found a lump in my neck,” Vergara said in an earlier interview with Health.
Vergara, a mom of one, had no symptoms at the time and questioned having to undergo surgery but she went through with it followed by iodine radiation treatment, and was glad she did.
“When you go through something like this, it’s hard, but you learn a lot from it,” she said. “Your priorities change. You don’t sweat the small stuff. And it had a good ending.”
View this post on Instagram
She had to take a pill every day. “It controls your body’s metabolism and gives you the levels that you need. An unregulated thyroid can lead to problems with your weight, hair loss, and other things, so they give me a blood test every three months to see where my level is,” Vergara explained.
“Actually, I feel very lucky. In a lot of women, the cancer isn’t found until around menopause and by then its too late.”
The Latin bombshell, who has always had a charitable side to her, helped build a cancer center in her hometown of Barranquilla.
“I visited the cancer ward of a hospital in Colombia, and parents were just sitting on the floor while their kids were being treated,” she said.
“When you’re a mother and your kid is sick, you feel it yourself,” the mom-of-one added, noting that she wanted to set up a “comfortable place for parents.”
View this post on Instagram
Recognizing Thyroid Cancer Symptoms
Thyroid cancer is a disease that begins in the thyroid gland, which is at the base of the neck. The cancer will often present itself as a large bump (tumor) in the neck. It remains unclear what causes the disease. Some symptoms of thyroid cancer can be mistaken for a common cold.
Dr. Scott Strome, a head and neck cancer surgeon who is currently the dean of the University of Tennessee College of Medicine, and previous chair of head and neck surgery at the University of Maryland School of Medicine, explained thyroid cancer in an earlier interview with SurvivorNet.
7 Common Signs of Thyroid Cancer & How to Spot Them
“We’re now able to detect thyroid disease, thyroid cancers, much earlier than we used to be able to,” Dr. Strome said. “We tend to see it predominantly in younger women, but it can occur in both men and women. In most cases, I tell my patients that, ‘Your thyroid cancer is a barnacle on the ship of life.’”
Advocating for Your Health
- Second Opinions on Your Cancer Diagnosis or Treatment: Do You Need One?
- Your Diagnosis May Be Difficult But You Deserve Comfort and the Best Care How Can Cancer Survivors Advocate For Themselves?
- Be Pushy, Be Your Own Advocate… Don’t Settle
- Paying for Cancer — Find Someone Who Will Advocate For You
- Mental Health and Cancer — The Fight, Flight or Freeze Response
Dr. Strome suggests finding an experienced thyroid expert for treatment.
“Folks who have thyroid cancer, they need to go to a really experienced thyroid setting and have folks who really understand the disease. Those are for the most indolent type of thyroid cancers, called papillary,” he explained.
“Thyroid cancer is a pretty interesting disease, because papillary is a really indolent cancer. On the other end of the spectrum, you have what’s called anaplastic thyroid cancer, which may be one of (if not the) most aggressive cancers that we see. So it’s a whole spectrum of disease.”
Treatments for thyroid cancer can include surgery, hormone therapy, radioactive iodine, radiation, and chemotherapy.
Symptoms of thyroid cancer include the following:
- A lump in the neck, sometimes growing quickly
- Swelling in the neck
- Pain in the front of the neck, sometimes going up to the ears
- Hoarseness or other voice changes that do not go away
- Trouble swallowing
- Trouble breathing
- A constant cough that is not due to a cold
“Most people have no discrete symptoms; the majority of cases now are found incidentally,” Dr. Allen Ho, an ENT at Cedars-Sinai, said in a previous interview with SurvivorNet.
“However, a sizable number of people may first discover their cancer when they feel a bump on their neck. Other possible late symptoms include problems swallowing, the sensation of something in their throat, neck compression when laying flat or voice changes.”
The good news is that many of these possible symptoms, including lumps in the thyroid, are both common and commonly benign — but it never hurts to ask your doctor.
Chances of cancer recovery increase significantly with early detection, so it’s important to address any warning signs of thyroid cancer, or any cancer for that matter, with a medical expert swiftly.
Coping With Emotions After Cancer
It’s important to remember that coping with a diagnosis, like cancer or other illness, is not easy and usually brings a string of emotions.
Although some people may feel positivity and hope amid their cancer journey, others can feel angry, sad, or determined, and it’s completely normal. Sarah Stapleton, a licensed clinical social worker, encourages cancer warriors and their families to be “patient with your emotions.”
“It’s also important that you understand how you communicate with your providers, but also with your loved ones,” Stapleton previously told SurvivorNet.
“Be Patient With Your Emotions”: A Social Worker’s Insights Into Handling a Cancer Diagnosis
“We can’t always assume that people know what we need at a given time, and there are going to be times when you don’t want to speak about your diagnosis and you don’t want to speak about cancer.”
Meanwhile, Psychiatrist Dr. Lori Plutchik previously explained to SurvivorNet, “People have a range of emotions when they’re diagnosed with cancer.”
“And they can include fear, anger … and these emotions tend to be fluid. They can recede and return based on where someone is in the process. Going through a cancer diagnosis is just the beginning of a complicated, complicated process,” she added.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
