By Barry Durrant-Peatfield
Thyroid cancer can occur in all age groups. People who have had radiation therapy to the neck are at higher risk. This therapy was commonly used in the 1950s to treat enlarged thymus glands, adenoids and tonsils, and skin disorders. People who received radiation therapy as children have a higher incidence of thyroid cancer.
Most distressing can be marked enlargement of the thyroid, which may be symmetrical or asymmetrical. This, the goitre may be due to a number of factors. Iodine deficiency will cause chronic enlargement; but this is rarely seen today, except in remote inland areas. Many people develop a diffuse, usually soft enlargement, especially teenage girls, with no real symptoms requiring attention. Sometimes, these quietly disappear, but they may progress to become rather harder and with lumps and nodules over the years. It is then called multi-nodular goitre, and may be inconvenient or unsightly. At this point, medical advice should be sought. X-rays and ultrasound may show its full extent, and whether further tests or intervention are required. Once such is the use of radioactive iodine, which is taken up to a greater degree by the abnormally active thyroid nodules and will show up as hot spots on a thyroid scan, providing a picture of the thyroid tissue health.
It is more common for the thyroid to present a nodule as a lump one side or the other. Many of these patients will have had the full thyroid function tests, but most often will have the nodule drained by a fine needle (fine needed aspiration (FNA) for the technically minded). The fluid and cells are subjected to microscopy. At this point, cancer cells may be looked for, which is why a growing nodule is not something you should try to deal with yourself. Fortunately, cancer is really quite rare and has a very high survival rate (95% overall); the average practice may not see more than one case every few years or so.
For the sake of completeness, I am going briefly to list the types of thyroid cancer that occur. Early on in life, and in young women, the cancer is likely to be papillary cancer (from its frond like appearance under the microscope). Later on in life, after about the age of 30, the cancer is more likely to be follicular cancer. Much rarer are medullary, lymphoma, or anaplastic cancer, the last two really only occurring in older age groups.