थाईराइड कैंसर के बारे में जागरूक रहें— प्रो.ज्ञान(पीजीआई)

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Thyroid

  1. What Is Thyroid ??
  2. Thyroid is a butterfly shaped gland situated in the neck on both side of the windpipe. It secretes thyroid hormone
  3. Doctor often people says that they are suffering from thyroid. What does it mean??
  4. Thyroid gland secrets thyroid hormone, sometimes its secretion may get disturbed, that is called by the doctor that you have thyroid hormone disorder and in common man language it is called as Thyroid
  5. Doctor if thyroid hormone is decrease or increase than how a person know it ? and how it present??
  6. The thyroid hormone hyper secretion and hypo secretion present differently in human.

Hypo secretion of thyroid hormone present as:

  1. Tiredness, weakness, forgetfulness, lack of concentration, hair loss, constipation, obesity, lethargy, dryness of skin, cold intolerance, hard of hearing etc.

Excess  secretion of the thyroid hormone present as:

  1. Irritability, palpitation , tiredness, hair loss, weight loss in spite of good appetite, hot intolerance, sweating, increase frequency of defecation and urination etc.
  2. Other than these the goiter may be present in both the condition that may present diffuse enlargement of thyroid or nodular enlargement of thyroid gland.
  1. Doctor how to investigate the disturbance in secretion of thyroid hormone?
  2. Thyroid hormone disturbance is checked by the 2 to 3 ml blood sample of the patients from the lab. They check the TSH & T4 from the blood.
  3. Doctor what happen after the blood reports arrived? Does they require medical treatment or cured by itself?
  4. Usually we see the TSH report and if it more than ten than need medical management with thyroid hormone tabelet
  5. How much Thyroid hormone tablet is required and when it has to be taken?
  6. Usually thyroid hormone instructed to take early in the morning with empty stomach and any food should be taken after one hour. If you take thyroid hormone tablet with food than it will not absorbed properly in the stomach

Usually this thyroid hormone tablet is to be taken lifelong however the dose of medicine is needed to be adjusted during the life time.

  1. Doctor what we have to do for the excess secretion of thyroid hormone?
  2. Thyroid hormone excess production from thyroid gland can be diagnosed by nuclear scan using radioactive iodine. It can also differentiated, that this excess hormone is due to over activity of thyroid cells, excess thyroid hormone secreting tumor in thyroid gland or thyroid gland inflammation that causing leakage of excess thyroid hormone in the blood circulation. In case of thyroid inflammation we have to wait till the inflammation subsides and the excess thyroid hormone become normal. In case of thyroid gland excess secretion of thyroid hormone that can be treated by anti thyroid drugs or the thyroid gland to be destroyed by the high dose of the radioactive thyroid  hormone or  the entire thyroid gland to be removed surgically from the body.  In case of the multinodular goiter with excess secretion of thyroid hormone it is to be required to remove the thyroid gland surgically.
  3. Doctor does the goiter can happen without disturbance in thyroid hormone secretion?
  4. Yes it can happen and thyroid gland can enlarged without disturbance in thyroid hormone secretion. However it may causing compression over the wind pipe and food pipe in the neck need to be removed surgically to get rid of compressive symptoms and development of thyroid cancer  in the goiter.
  5. Does every thyroid swelling means thyroid cancer?
  6. No, all goiter are not cancerous however whenever you notice goiter in the neck you can consult to your doctor to rule out malignancy after few test prescribe by your doctor. It usually confirms by the fine needle aspiration cytology report and only 5% thyroid swellings are cancerous.
  7. How we can identify the thyroid cancer ?
  8. There are few signs and symptoms which indicate the possibility of thyroid cancer
    1. Swelling in the neck other than goiter
    2. Rapidly increasing in size of goiter
    3. Change in voice
    4. Difficulty in swallowing
    5. Difficulty in breathing
    6. Cough during drinking and eating
    7. Blood during cough

These features may present without cancer however if there is above features are present, Is it possible to treat thyroid cancer?

  1. Sure; 60% of thyroid cancer can be treated completely by the adequate treatment. However 1-2% patients cannot be cured by the any means of treatment

Thyroid cancer is usually treated with three main steps.  First is surgically removed the thyroid gland along with removal of the other glands present in the neck, second is radio=iodine treatment and finally thyroid hormone suppressive therapy.

  1. Surgery: Complete removal of the thyroid cancer by surgery is the main and effective way to treat the thyroid cancer. By thyroid surgery the thyroid gland to be removed completely along with the involved lymph nodes in the neck. Therefore this surgery to be performed by a trained surgeon. Because the adequate surgery can increase the survival of the patient.
  2. Radio-iodine Therapy: Next step after surgery is to ablate the remaining thyroid tissue from the body by the high dose of radio-iodine therapy. It kills all thyroid cells from the body therefore it removes the chances of recurrence of thyroid cancer in the future.
  3. Thyroid Hormone: High dose of thyroid hormone suppress the Thyroid stimulating hormone secretion which ultimately reduce the growth of thyroid cells in the body. The thyroid hormone requires suppressing for rest of life however the extent of suppression is depends on the thyroid cancer burden in the body.
  1. Does after the completion of treatment is it necessary to consult with doctor?
  2. After completion of treatment, everyone have to keep in touch with your treating doctor to know the extent of suppression, status of thyroid cancer in future and side effect of the thyroid treatment. Therefore it is advised that everyone have to keep in touch with treating doctor for rest of the life.
  3. What are the side effects of surgery?
  4. There are several complications of surgery it may be long term or short term. The common short term side effect is change in voice and reduces the calcium metabolism in the body. Apart of these there may be chances of permanent damage of voice nerve and calcium regulating parathyroid gland.  There are chances of damage of blood vessels during surgery causing heavy bleeding.
  5. Can thyroid cancer be treated without surgery?
  6. Yes, the papillary type of thyroid cancer less than one cm can be treated with thyroid hormone suppressive therapy only. But you have to keep in close contact with your treating doctor.
  7. What are the different method of thyroid surgery and can it is done without scar in the neck?
  8. The thyroid surgery traditionally be done by a horizontal cut in the lower part of the neck however now a days the scar less thyroid surgery is become popular in the Asian country. This type of scar less surgery is now possible in SGPGIMS also.
  9. How can prevent the thyroid cancer?
  10. The exact cause of thyroid cancer is not known however there is several risk factors for the thyroid cancer. That includes smoking, radiation during childhood and family history of thyroid cancer.

 

Dr. Gyan Chand
Additional Professor,
Endocrine & Breast Surgery,
SGPGIMS, Lucknow, INDIA, 226014

 

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