Thyroid cancer: ask an expert

Written by: Mr Ricard Simo
Published: | Updated: 22/06/2023
Edited by: Cal Murphy

In this article, top thyroid cancer surgeon Mr Ricard Simo explains the basics of thyroid cancer, including the different types, causes and symptoms. 

 

What is the thyroid?

The thyroid is a butterfly-shaped endocrine gland located in the middle of the neck. It is responsible for making thyroid hormone, which is essential for regulating the body’s metabolism.

 

 

 

Most thyroid nodules are benign and not of concern, but cancer of the thyroid gland has been getting more common, probably because of increased detection with imaging. The majority of this increase is accounted for by small, low-risk papillary thyroid carcinomas. Thyroid cancer can also occur in more advanced forms, with a firm mass in the neck or with spread to lymph nodes.

 

Thyroid cancer: 4 top facts

  1. Thyroid cancer is three times more common in women than men.
  2. There are four main types of thyroid cancer: papillary (most frequent), follicular, medullary and anaplastic (least frequent). Lymphoma can also occur in the thyroid but this is very rare.
  3. Thyroid cancer can be more aggressive over the age of 55.
  4. Thyroid cancer accounts for over 3% of all new cancer diagnoses each year.

 

Four types

  1. Papillary thyroid carcinoma – 8 out of 10 thyroid malignancies are papillary thyroid carcinoma. Most papillary thyroid carcinoma is low-risk. When solitary and under 4 cm, this form of thyroid cancer can sometimes be treated by only removing the affected half of the thyroid gland. It is important to tailor the treatment to the individual.
  2. Follicular thyroid carcinoma – 1 out of 10 thyroid cancers are follicular carcinoma. This and the Hurthle cell carcinoma variant can be higher risk.
  3. Medullary thyroid carcinoma – This type of thyroid cancer usually occurs sporadically, but medullary carcinoma can run in families and can be part of a condition called MEN type II.
  4. Anaplastic thyroid carcinoma – This is a fast-growing and very aggressive form of thyroid cancer, accounting for less than 1% of thyroid cancers.

 

Lymphoma can also be found in the thyroid. Lymphoma is a cancer that develops in the lymph system (part of the immune system).

 

 

What are the causes of thyroid cancer?

Usually there is no cause to be found for thyroid cancer; thyroid cancer is usually spontaneous. The incidence is much higher in women than in men. The risk factors associated with thyroid cancers include radiation exposure, a family history of thyroid cancer in a first-degree relative, and certain rare syndromes, such as Cowden syndrome.

 

What are the symptoms of thyroid cancer?

Most thyroid cancer, and low-risk papillary thyroid carcinoma in particular, cause no symptoms. Thyroid cancer symptoms can include:

  • A firm lump around the middle of the neck which moves upwards on swallowing
  • Firm lumps in the outer neck
  • Weakness of the voice lasting more than several weeks

 

The keys to diagnosis are ultrasound and fine needle aspiration cytology (biopsy). Sometimes a contrast-enhanced CT scan is needed because CT can show more extensive disease very clearly. Radioactive iodine therapy is frequently an essential part of treatment, and radiotherapy can be needed in certain more advanced cases.

 

 

 

If you are concerned about thyroid cancer and would like to book a consultation with Mr Simo, do not hesitate to do so by visiting his Top Doctors profile today.

 

By Mr Ricard Simo
Otolaryngology / ENT

Mr Ricard Simó is one of London's most distinguished consultant ENT surgeons, specialising in head and neck oncologic surgery, thyroid, parathyroid and salivary gland surgery. He is also experienced in revision head and neck surgery.

In addition to his private practice at London Bridge Hospital, Mr Simó is Consultant Head, Neck and Thyroid surgeon at Guy's and St Thomas' Hospital NHS Trust and has accrued experience on a number of different units, completing his education and training in Spain, the UK and the USA. Mr Simó graduated from the University of Barcelona in 1988 before going on to train in Otorhinolaryngology Head and Neck Surgery in Nottingham, Shrewsbury and Manchester. He was later awarded a travelling fellowship from the Royal College of Surgeons and Physicians of Glasgow in order to go to Philadelphia, Pennsylvania to further train in head and neck oncology and thyroid surgery.

He has won multiple awards for the work in his field, and has published over 150 original articles in peer reviewed medical journals. He has edited an Atlas in Head and Neck Surgery and has authored 22 chapters in national and international head and neck surgery textbooks. Mr Simó is also a reviewer for a number of different head and neck surgery and otorhinolaryngology journals. His research interests include thyroid surgery, antibiotic therapy in head and neck surgery, and management of the occult primary in head and neck cancer.

Mr Simó is an honorary senior lecturer and clinical advisor at Guy's, King's and St Thomas' School of Medicine, is an active council member of the ENT-UK Head and Neck Society, and the section of laryngology and rhinology of the Royal Society of Medicine. He participates in the training of both undergraduate and postgraduate doctors, as well as GPs.

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