Thyroid Cancer
Thyoid cancer is a spectrum of disease from ones that are slow growing to ones that have very aggressive biology. There are four main types of thyroid cancer:
The most common type is Papillary Thyroid Carcinoma (PTC). There has been a steady rise of diagnoses of PTC over time, and it is frequently picked up incidentally on imaging. This type tends to spread to the lymph nodes but is often curable and rarely fatal.
Follicular Thyroid Carcinoma is another well differentiated thyroid cancer that can sometimes spread to the lungs and bones. If identified and treated at an early stage, it has very good cure rates.
Medullary Thyroid Carcinoma is different because it originates in different cell types in the thyroid and is associated with certain genetic mutations.
The worst kind of thyroid cancer is Anasplastic Carcinoma of the thyroid gland. This type if often found late and has limited treatment options.
There has been a trend to de-escalated treatment for low risk thyroid cancers. Some major overseas academic centres have programs of Active Surveillance (non operative) of low risk cancers that meet strict criteria. At the same time, advanced or aggressive thyroid cancer often needs careful excision of the thyroid gland and lymph nodes in the central and lateral neck. For thyroid cancer, it is important to have a specialist surgeon who can offer all these options and discuss the evidence for them.
Dr Shaw is an associate member of Australia and New Zealand Endocrine Surgeons and has head and neck fellowship training to deal with all stages of thyroid cancer.