Thyroid issues seem to be fairly common, but many of us don’t know exactly what the thyroid is, what is the function of the thyroid gland, and what causes thyroid cancer. Senior oncology surgeon in Singapore, DR DENNIS LIM, answers these questions and gives advice on symptoms, causes and treatments to tackle this curable disease.
What is the thyroid and the function of the thyroid gland?
The thyroid is a small endocrine gland found in the front of the neck. It consists of two lobes that sit on either side of the trachea, frequently described as butterfly-shaped. The function of the thyroid gland is to make thyroxine, a metabolic hormone that is essential for life. This hormone regulates metabolism, growth and development in the body. And it also impacts various bodily functions including heart rate, body temperature, energy levels and weight.
What type of cancer can form in the thyroid gland?
The most common cancer that develops in this gland is called papillary thyroid cancer. It’s so named because of the way it looks under the microscope. In most populations in the world, papillary thyroid cancer makes up more than 90 percent of all thyroid cancers. Today, its incidence worldwide is increasing due to earlier detection by ultrasound.
Is it painful and how is it usually diagnosed?
Thyroid cancers are usually “silent” in the early stages, and present as an asymptomatic lump in the neck. For this reason, more often than not it is picked up and diagnosed on ultrasound screening. I perform a series of diagnostic tests in my clinic for a range of thyroid conditions depending on the symptoms described including:
- Thyroid ultrasound – High-frequency sound waves are used to capture images of the thyroid, and locate and map out nodules.
- Fine-needle aspiration biopsy (FNAB) – A sample of cells is extracted from the nodule using a fine needle, and examined for signs of cancer.
- Blood tests – Thyroid hormone levels are measured to detect hyperthyroidism or hypothyroidism, both of which are indicative of nodules or other thyroid conditions.
As thyroid cancer progresses or spreads it may cause more distressing symptoms such as shortness of breath, difficulty swallowing, pain in the neck and throat area and/or hoarseness or voice change.
What causes thyroid cancer?
We know that radiation exposure causes thyroid cancer, as seen after the nuclear accidents of Chernobyl and Fukushima. However, like other types of cancer, most cases are due to random genetic mutation. Other contributory risk factors include genetic predisposition, certain medical treatments (radiation) and environmental factors.
What are the current treatments available?
Papillary thyroid cancer is treatable for cure if diagnosed early. The treatment for PTC is surgery and Radioactive Iodine in selected cases. Surgery to remove the thyroid gland takes around three hours and is a complex but safe operation. The use of a continuous nerve monitor for the recurrent laryngeal nerve to the voice box is routine in my practice.
What is the recovery like?
Surgery requires about two-to-three days hospitalisation and a fortnight’s recovery. Pain is surprisingly slight, and usually alleviated with oral medication only. Thankfully, there is minimal impact on a patient’s lifestyle.
About this oncology surgeon
Dr Dennis Lim is a senior oncology surgeon in Singapore who specialises in thyroid, head and neck, parotid and melanoma surgery. He’s the medical director of Dennis Lim Surgery, where he provides his patients with personalised cancer treatments and head and neck surgery for a variety of conditions.
#11-09 Mount Elizabeth Medical Centre, 3 Mount Elizabeth
6836 5167 | dennislim.com.sg
This article first appeared in the June 2024 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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